| Description: |
Naltrexone is an oral medication that is used for the treatment of opiate and alcohol addiction. It has been claimed that low dose naltrexone, known as “LDN,” is effective for treating MS symptoms, preventing MS attacks, and slowing down progression of MS. |
| Rationale: |
There are multiple hypotheses about how LDN could produce therapeutic effects in MS. It has been proposed that LDN may produce changes in the immune system that are beneficial for MS. Another theory claims that LDN decreases nervous system injury that is caused by compounds known as “free radicals” and “excitotoxins.” |
| Evaluation: |
Beneficial effects of LDN have been reported in small studies in two gastrointestinal conditions, Crohn’s disease and irritable bowel syndrome. There are many anecdotal reports of people with MS experiencing beneficial effects with LDN. There are not any published studies of LDN treatment in people with MS or in the animal model of MS. Clinical trials of LDN in people with MS are being conducted. |
| Risks: |
In MS and other conditions, the safety of LDN use, especially on a long-term basis, is not known. It has been reported anecdotally that LDN may increase wakefulness and may increase muscle stiffness. |
| Costs: |
Risks/costs: LDN is of low-moderate cost. |
| Committee opinion: |
In the opinion of the committee, LDN is a low-moderate cost therapy for which there is no rigorous evidence about safety and effectiveness in MS. Since it is not known if LDN affects the disease course in MS, LDN should not be used instead of conventional disease-modifying medications. Further studies of LDN are needed, including human and animal studies of possible immune changes with LDN and studies of the effectiveness and safety of LDN in the animal model of MS and in people with MS. |
