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Post by the Scribe on Nov 27, 2020 1:04:42 GMT
Low Dose Naltrexone (LDN) as a Treatment for Autoimmune Disease
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Post by the Scribe on Nov 27, 2020 1:05:36 GMT
In Tiny Doses, An Addiction Medication Moonlights As A Treatment For Chronic Painwww.npr.org/sections/health-shots/2019/09/23/741783834/in-tiny-doses-an-addiction-medication-moonlights-as-a-treatment-for-chronic-pain
September 23, 20194:02 PM ET
Heard on All Things Considered
ALEX SMITH
FROM
KCUR 89.3
Alex Smith/KCUR
3-Minute Listen ondemand.npr.org/anon.npr-mp3/npr/atc/2019/09/20190923_atc_in_tiny_doses_an_addiction_medication_moonlights_as_a_treatment_for_chronic_pain_.mp3?orgId=60&topicId=1128&d=227&p=2&story=741783834&dl=1&siteplayer=true&size=3630819&dl=1
Transcript
Lori Pinkley of Kansas City, Mo., has struggled with chronic pain since she was a teenager. She has found relief from low doses of naltrexone, a drug that at higher doses is used to treat addiction.
Lori Pinkley, a 50-year-old from Kansas City, Mo., has struggled with puzzling chronic pain since she was 15.
She's had endless disappointing visits with doctors. Some said they couldn't help her. Others diagnosed her with everything from fibromyalgia to lipedema to the rare Ehlers-Danlos syndrome.
www.niams.nih.gov/health-topics/fibromyalgia
rarediseases.info.nih.gov/diseases/10542/lipedema
ghr.nlm.nih.gov/condition/ehlers-danlos-syndrome
Pinkley has taken opioids a few times after surgeries but says they never helped her underlying pain.
"I hate opioids with a passion," Pinkley says. "An absolute passion."
Recently, she joined a growing group of patients using an outside-the-box remedy: naltrexone. It is usually used to treat addiction, in a pill form for alcohol and as a pill or a monthly shot for opioids.
As the medical establishment tries to do a huge U-turn after two disastrous decades of pushing long-term opioid use for chronic pain, scientists have been struggling to develop safe, effective alternatives.
When naltrexone is used to treat addiction in pill form, it's prescribed at 50 mg, but chronic-pain patients say it helps their pain at doses of less than a tenth of that.
Low-dose naltrexone has lurked for years on the fringes of medicine, but its zealous advocates worry that it may be stuck there. Naltrexone, which can be produced generically, is not even manufactured at the low doses that seem to be best for pain patients.
Instead, patients go to compounding pharmacies or resort to DIY methods — YouTube videos and online support groups show people how to turn 50 mg pills into a low liquid dose.
Some doctors prescribe it off-label even though it's not FDA-approved for pain.
Article continues after sponsor message
University of Kansas pain specialist Dr. Andrea Nicol has recently started prescribing it to her patients, including Pinkley. Nicol explains that for addiction patients, it works by blocking opioid receptors — some of the brain's most important feel-good regions. So it prevents patients from feeling high and can help patients resist cravings.
www.kumc.edu/school-of-medicine/anesthesiology/faculty/andrea-nicol-md.html
At low doses of about 4.5 mgs, however, naltrexone seems to work completely differently.
"What it's felt to do is not shut down the system, but restore some balance to the opioid system," Nicol says.
Some of the hype over low-dose naltrexone has included some pretty extreme claims with limited research to back them, like using it to treat multiple sclerosis and neuropathic pain or even using it as a weight-loss drug.
www.ncbi.nlm.nih.gov/pubmed/29377216
In the past two years, however, there's been a big increase in new studies published on low-dose naltrexone, many strengthening its claims as a treatment for chronic pain, though most of these were still small pilot studies.
www.ncbi.nlm.nih.gov/pubmed/30917675
Dr. Bruce Vrooman, an associate professor at Dartmouth's Geisel School of Medicine, was an author of a recent review of low-dose naltrexone research. Vrooman says that when it comes to treating some patients with complex chronic pain, low-dose naltrexone appears to be more effective and well-tolerated than the big-name opioids that dominated pain management for decades.
geiselmed.dartmouth.edu/faculty/facultydb/view.php/?uid=6784
www.ncbi.nlm.nih.gov/pubmed/30248938
"Those patients may report that this is indeed a game changer," Vrooman says. "It may truly help them with their activities, help them feel better."
So how does it work? Scientists think that for many chronic pain patients, the central nervous system gets overworked and agitated. Pain signals fire in an out-of-control feedback loop that drowns out the body's natural pain-relieving systems.
They suspect that low doses of naltrexone dampen that inflammation and kick-start the body's production of pain-killing endorphins — all with relatively minor side effects.
Despite the promise of low-dose naltrexone, its advocates say few doctors know about it.
The low-dose version is generally not covered by insurance, so patients typically have to pay out of pocket to have it specially made at compounding pharmacies.
Advocates worry that the treatment is doomed to be stuck on the periphery of medicine because, as a 50-year-old drug, naltrexone can be made generically.
Patricia Danzon, a professor of health care management at the Wharton School at the University of Pennsylvania, explains that drug companies don't have much interest in producing a new drug unless they can be the only maker of it.
hcmg.wharton.upenn.edu/profile/danzon/
"Bringing a new drug to market requires getting FDA approval and that requires doing clinical trials," Danzon says. "That's a significant investment, and companies — unsurprisingly — are not willing to do that unless they can get a patent and be the sole supplier of that drug for at least some period of time."
And without a drug company's backing, a treatment like low-dose naltrexone is unlikely to get the big promotional push out to doctors and TV advertisements that have turned drugs like Humira or Chantix into household names.
"It's absolutely true that once a product becomes generic, you don't see promotion happening, because it never pays a generic company to promote something if there are multiple versions of it available and they can't be sure that they'll capture the reward on that promotion," Danzon says.
The drugmaker Alkermes has had huge success with its exclusive rights to the extended-release version of naltrexone, called Vivitrol. In a statement for this story, the company says it hasn't seen enough evidence to support the use of low-dose naltrexone to treat chronic pain and therefore is remaining focused on opioid addiction treatment.
www.alkermes.com/
Pinkley says she is frustrated that there are so many missing pieces in the puzzle of understanding and treating chronic pain, but she, too, has become a believer in naltrexone.
She has been taking it for about a year now, at first paying $50 a month out of pocket to have the prescription filled at a compounding pharmacy. In July, her insurance started covering it.
"I can go from having days that I really don't want to get out of bed because I hurt so bad," she says, "to within a half-hour of taking it, I'm up and running, moving around, on the computer, able to do stuff."
This story is part of NPR's reporting project with KCUR and Kaiser Health News.
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Post by the Scribe on Nov 27, 2020 1:13:27 GMT
RHR: Low Dose Naltrexone (LDN) as a Treatment for Autoimmune Disease
Chris Kresser, L.Ac
17.4K subscribers
In this episode of Revolution Health Radio (RHR) we discuss “Low-Dose Naltrexone (LDN) as a Treatment for Autoimmune Disease.” Find out how low-dose naltrexone works, what kind of conditions it’s been studied in and might be effective for, and how you might find a doctor that you can work with to take it.
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Post by the Scribe on Dec 2, 2020 19:37:55 GMT
Save money DIY with 50mg tabs and distilled water.
Compounding/making your own (LDN) low-dose Naltrexone
JT Bynum
164 subscribers
Informational video on compounding your own (LDN), low-dose Naltrexone
www.ebay.com/p/1475407829?iid=222170520592
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Post by the Scribe on Dec 2, 2020 19:59:32 GMT
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Post by the Scribe on Dec 4, 2020 13:43:23 GMT
The LDN Story (A documentary about low dose naltrexone)
96,546 views•Jun 22, 2015
LDN Documentary
840 subscribers
This documentary has been produced to promote wider knowledge of LDN (Low Dose Naltrexone).
Hear from several practioners on how they use LDN with their patients and witness 2 remarkable stories on how LDN has changed the lives of a 8 year old Jacob Valazquez in Miami and Sarah Morton in the UK who was suffering from Fibromyalgia.
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Post by the Scribe on Jan 13, 2021 9:52:04 GMT
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Post by the Scribe on May 2, 2022 10:52:43 GMT
Difference Between Naloxone and Naltrexone
www.differencebetween.com/difference-between-naloxone-and-naltrexone/
June 28, 2021 Posted by Madhu
The key difference between naloxone and naltrexone is that naloxone is used for emergency treatment for opioid overdose, whereas naltrexone is useful for long-term treatments of opioid-related disorders.
Naloxone and naltrexone are two types of very important medicine that are useful in treating disorders related to opioid intake.
CONTENTS
1. Overview and Key Difference
2. What is Naloxone
3. What is Naltrexone
4. Naloxone vs Naltrexone in Tabular Form
5. Summary – Naloxone vs Naltrexone
What is Naloxone?
Naloxone is a medication that is useful in blocking the effects of opioids. This drug is sold under the trade name “Narcan.” This medication is useful for countering the decreased breathing in opioid overdose. Moreover, we can combine this drug with an opioid (as a single pill) to decrease the risk of opioid misuse. The routes of administration of this drug include endotracheal, intranasal, intravenous, intramuscular, and intraosseous pathways.
When this drug is administrated intravenously, the effect of the drug begins within about 5 minutes. There is another common method for administration; the method of spraying the drug into a person’s nose. Typically, the effects of this drug last for about 30 seconds to 24 hours. Since the duration of action of opioids is usually greater than the naloxone activity, we need to use multiple doses to block the effects of the opioids.
There can be some side effects of this medication, which include restlessness, agitation, nausea, vomiting, a fast heart rate, and sweating. In order to prevent these side effects, we can use small doses every few minutes until the desired outcome is obtained. The metabolism of naloxone occurs in the liver, and excretion occurs in the urine and bile.
Compare Naloxone and Naltrexone
Figure 01: A Naloxone Kit
When considering the chemical features of naloxone, the chemical name for this drug is N-allylnoroxymorphine. It is a synthetic morphinan derivative that originates from oxymorphone (an opioid analgesic that is derived from morphine). Moreover, the chemical half-life of this medication is around 24 months to 28 months.
What is Naltrexone?
Naltrexone is a medication useful in managing alcohol or opioid use disorder by reducing cravings and feelings of euphoria. This drug is sold under the trade names “ReVia” and “Vivitrol.” Moreover, we can find this medication is effective in treating other addictions, and we can also use it off-label.
Naloxone vs Naltrexone
Figure 02: The Chemical Structure of Naltrexone
However, a person that is dependent on opioids should not take this medicine before detoxification. The routes of administration of this drug include oral administration, intramuscular injection, and subcutaneous implant. Usually, the effects of naltrexone begin within 30 minutes of administration. Metabolism of naltrexone occurs in the liver, and excretion is through urine.
There can be some side effects of using this drug, including trouble sleeping, anxiety, nausea, and headache. However, this drug is not suitable for people with liver failure. We can identify this medicine as an opioid antagonist, and its mode of action is through the blocking of the effects of opioid that comes from both inside and outside the body.
We can describe naltrexone as substituted oxymorphone where the tertiary amine methyl-substituent is replaced with methylcyclopropane. Moreover, we can describe naltrexone as the N-cyclopropylmethyl derivative of oxymorphone. A similar molecule to naltrexone is nalmefene which has the same uses as naltrexone.
What is the Difference Between Naloxone and Naltrexone?
Naloxone and naltrexone are two types of very important medicine that are useful in treating disorders related to opioid intake. The key difference between naloxone and naltrexone is that naloxone is used for emergency treatment for opioid overdose, whereas naltrexone is useful for long-term treatments of opioid-related disorders.
The following infographic lists the differences between naloxone and naltrexone in tabular form.
repin/x/?guid=EV0avBTPSgz4
Summary – Naloxone vs Naltrexone
Naloxone and naltrexone are two types of very important medicine that are useful in treating disorders related to opioid intake. The key difference between naloxone and naltrexone is that naloxone is used for emergency treatment for opioid overdose, whereas naltrexone is useful for long-term treatments of opioid-related disorders.
Reference:
1. “Naltrexone: Uses, Dosage, and Side Effects.” Drugs.com.
www.drugs.com/naltrexone.html
Image Courtesy:
1. “NaloxoneKit” By James Heilman, MD – Own work (CC BY-SA 4.0) via Commons Wikimedia
commons.wikimedia.org/w/index.php?curid=52872570
2. “Naltrexone skeletal” By Fvasconcellos (talk · contribs) – Own work using: ACD/ChemSketch 10.0, Inkscape and vim (Public Domain) via Commons Wikimedia
commons.wikimedia.org/w/index.php?curid=4734065
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Post by the Scribe on Oct 18, 2022 19:12:08 GMT
There are some interesting and informative comments following this article at the below link. Well worth exploring other's experiences with this drug.
Reuters
Addiction drug shows promise lifting long COVID brain fog, fatigue
www.yahoo.com/news/addiction-drug-shows-promise-lifting-101204918.html
Julie Steenhuysen
Tue, October 18, 2022 at 3:12 AM
By Julie Steenhuysen
CHICAGO (Reuters) - Lauren Nichols, a 34-year-old logistics expert for the U.S. Department of Transportation in Boston, has been suffering from impaired thinking and focus, fatigue, seizures, headache and pain since her COVID-19 infection in the spring of 2020.
Last June, her doctor suggested low doses of naltrexone, a generic drug typically used to treat alcohol and opioid addiction. After more than two years of living in "a thick, foggy cloud," she said, "I can actually think clearly." Researchers chasing long COVID cures are eager to learn whether the drug can offer similar benefits to millions suffering from pain, fatigue and brain fog months after a coronavirus infection. The drug has been used with some success to treat a similar complex, post-infectious syndrome marked by cognitive deficits and overwhelming fatigue called myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Drawing on its use in ME/CFS and a handful of long COVID pilot studies, there are now at least four clinical trials planned to test naltrexone in hundreds of patients with long COVID, according to a Reuters review of Clinicaltrials.gov and interviews with 12 ME/CFS and long COVID researchers. It is also on the short list of treatments to be tested in the U.S. National Institutes of Health's $1 billion RECOVER Initiative, which aims to uncover underlying causes and find treatments for long COVID, advisers to the trial told Reuters.
Unlike treatments aimed at addressing specific symptoms caused by COVID damage to organs, such as the lungs, low-dose naltrexone (LDN) may reverse some of the underlying pathology driving symptoms, they said.
Naltrexone has anti-inflammatory properties and has been used at low doses for years to treat conditions such as fibromyalgia, Crohn's disease and multiple sclerosis, said Dr. Jarred Younger, director of the Neuro-inflammation, Pain and Fatigue Laboratory at the University of Alabama at Birmingham.
At 50 milligrams - 10 times the low dose - naltrexone is approved to treat opioid and alcohol addiction. Several generic manufacturers sell 50mg pills, but low-dose naltrexone must be purchased through a compounding pharmacy.
Younger, author of a scientific review of the drug as a novel anti-inflammatory, in September submitted a grant application to study LDN for long COVID. "It should be at the top of everyone's list for clinical trials," he said.
Still, the drug is unlikely to help all patients with long COVID, a collection of some 200 symptoms ranging from pain and heart palpitations to insomnia and cognitive impairment. One 218-patient ME/CFS study found 74% had improvements in sleep, reduced pain and neurological disturbances.
"It's not a panacea," said Jaime Seltzer, a Stanford researcher and head of scientific outreach for the advocacy group MEAction. "These people weren't cured, but they were helped."
'HUMAN AGAIN' Dr. Jack Lambert, an infectious disease expert at University College Dublin School of Medicine, had used LDN to treat pain and fatigue associated with chronic Lyme disease.
During the pandemic, Lambert recommended LDN to colleagues treating patients with lingering symptoms after bouts of COVID.
It worked so well that he ran a pilot study among 38 long COVID patients. They reported improvements in energy, pain, concentration, insomnia and overall recovery from COVID-19 after two months, according to findings published in July.
Lambert, who is planning a larger trial to confirm those results, said he believes LDN may repair damage of the disease rather than mask its symptoms.
Other planned LDN trials include one by the University of British Columbia in Vancouver and a pilot study by Ann Arbor, Michigan-based startup AgelessRx. That study of 36 volunteers should have results by year-end, said company co-founder Sajad Zalzala. Scientists are still working on explaining the mechanism for how LDN might work. Experiments by Dr. Sonya Marshall-Gradisnik of the National Centre for Neuroimmunology and Emerging Diseases in Australia suggest ME/CFS and long COVID symptoms arise from a significant reduction in function of natural killer cells in the immune system. In laboratory experiments, LDN may have helped restore their normal function, a theory that must still be confirmed. Others believe infections trigger immune cells in the central nervous system called microglia to produce cytokines, inflammatory molecules that cause fatigue and other symptoms associated with ME/CFS and long COVID. Younger believes naltrexone calms these hypersensitized immune cells.
Dr. Zach Porterfield, a virologist at the University of Kentucky who co-chairs a RECOVER task force looking at commonalities with other post-infectious syndromes, said it has recommended LDN be included in RECOVER's treatment trials. Other therapies under consideration, sources said, were antivirals, such as Pfizer Inc's Paxlovid, anti-clotting agents, steroids and nutritional supplements. RECOVER officials said they have received dozens of proposals and could not comment on which drugs will be tested until trials are finalized. Dr. Hector Bonilla, co-director of the Stanford Post-Acute COVID-19 Clinic and a RECOVER adviser, has used LDN in 500 ME/CFS patients, with about half reporting benefits.
He studied LDN in 18 long COVID patients, with 11 showing improvements, and said he believes larger, formal trials could determine whether LDN offers a true benefit. Nichols, a patient adviser to RECOVER, was "ecstatic" when she learned LDN was being considered for the government-funded trials. While LDN has not fixed all her COVID-related problems, Nichols can now work all day without breaks and have a social life at home. "It has made me feel like a human again."
(Reporting by Julie Steenhuysen in Chicago; Editing by Caroline Humer and Bill Berkrot)
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