The MS community has shown substantial interest recently in a treatment known as low dose naltrexone, or LDN. However, although LDN has generated a lot of discussion, we are woefully short on scientific evidence regarding the effectiveness of this treatment. On one hand, there are people who claim that LDN is remarkably effective for treating MS symptoms and slowing down the disease course. On the other hand, there are those who state that LDN should not be used by anyone with MS. 

What is the truth?

Low Dose Naltrexone: The Basics
Before considering the evidence related to LDN, it’s helpful to know what it is. The “LD” of LDN refers to the use of “low dose” treatment, while the “N” refers to naltrexone, an oral medication that is approved by the Food and Drug Administration (FDA) for the treatment of alcohol and opiate addiction. 

The typical dose of naltrexone is 50 milligrams daily. With “low dose” treatment, daily doses of 1.5-4.5 milligrams are used. LDN is claimed to be effective for MS symptoms as well as multiple other diseases, including cancer, AIDS, rheumatoid arthritis, and Crohn’s disease.

It is currently not clear why low dose naltrexone might be beneficial for MS and other diseases. It has been claimed that LDN produces changes in the immune system that decrease disease activity in MS. It has also been proposed that LDN decreases the harmful effects of two classes of chemicals in the nervous system, free radicals and excitotoxins.

LDN and MS
At this time, the clinical evidence about LDN is limited but growing rapidly. In MS, there are many anecdotal reports (not scientifically verified) of people with MS experiencing benefits while taking LDN. There are also anecdotal reports that LDN is usually well tolerated but that it may worsen muscle stiffness. Many of these anecdotal experiences with LDN may be found on the Internet.

Several studies are underway to determine whether LDN has beneficial (or harmful) effects in relation to MS. One of these studies is being done at the University of California at San Francisco. This study is examining whether LDN has an effect on quality of life and multiple MS symptoms.

LDN and Other Diseases
In other diseases, small clinical trials have been published. One of these studies found that LDN produced improvement in Crohn’s disease, an immune disease of the intestines. Another study reported that LDN increased the number of pain-free days in those with another gastrointestinal condition known as irritable bowel syndrome.

Is Low-Dose Naltrexone Something You Should Consider?
Given what we do – and don’t – know about LDN, is it worth discussing with your doctor if you have MS? As noted, the information is limited--it is not known whether LDN is beneficial, harmful, or has no effect on MS symptoms.

With limited information, it’s reasonable to wait until more rigorous information becomes available before using this therapy. Nevertheless, you may want to discuss LDN with your doctor, to get his or her assessment.

In addition, if LDN is used, it should be recognized that the safety and effectiveness information is limited and that LDN should not be used instead of conventional disease medications (such as interferons [Avonex, Betaseron, Rebif] and glatiramer acetate [Copaxone]).

See Related Articles
Studies show a new treatment for Multiple Sclerosis (MS) may be on the horizon.  To read more about the drug shown to reduce the progression of MS, see New MS Drug Shows Promising Results in Early Tests.

If you have have taken the drug modafinil (Provigil) for Multiple Sclerosis (MS), see New Warnings About an Old Drug about possible harmful side effects.