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Q & A: LDN Effects and Side Effects

The benefit from LDN has been reported to be cumulative in some conditions such as multiple sclerosis and fibromyalgia, and the time it takes to achieve maximal benefit varies amongst individuals.
Some users experience benefit within days. Others report it taking much longer to see benefit; some users with conditions such as multiple sclerosis and fibromyalgia have reported a cumulative benefit over time- only seeing full benefit between 6-12 months after starting. Further complicating matters, sometimes a dose adjustment may change the benefit experienced. Given all these possibilities, an individual's response time to LDN can vary.
In theory the answer is yes, and therefore it may make sense if LDN is losing its effectiveness to take a break from using it every so often. This question has not yet been addressed in clinical trials.
The side effect identified in controlled clinical trials in which LDN was taken at bedtime has been sleep disturbance (vivid dreams). Most LDN users who experience this side effect find that it disappears within the first few weeks. If it does persist, LDN can be taken in the morning instead, and this often eliminates this side effect.
Information about side effects is best obtained from prospective clinical trials (trials that collect information about how subjects feel right now and going forward in time). One reason for this is because one must separate between correlation and causation; following many people at various points in time helps clarify this. For instance, it is often difficult to separate what may be a medication side effect from what may be a fluctuation in one's medical condition or the occurrence of unrelated illnesses or symptoms. Another benefit of prospective data collection is that it avoids the problem of relying on memory (i.e. studies that ask patients to recall what symptoms they experienced in the past). Since we all have flaws in what we remember and what we do not, we must be cautious about drawing conclusions from retrospective (after the fact) reports. Also, while individuals can have uncommon or rare reactions to medications, this information is often less useful to the person considering taking a medicine than the most common experiences gathered from many subjects participating in prospective clinical trials. Be sure to discuss any LDN side effects with your prescriber. Locate an LDN prescriber here.
LDN is not addictive. However, when stopping to take LDN it is possible that symptoms of the disease for which it was taken may recur.
Withdrawal effects refer to a group of symptoms that occur when medication is abruptly discontinued or decreased. Because LDN does not stay in the body more than a few hours, and its main effect occur by stimulating the body's own immune system, classic "withdrawal effects" (such as with opioid medications) are not expected. Regarding tapering off LDN, it is unknown whether it would provide any benefit. Similar to other medications, if a disease enters a state of remission on LDN, it will often stay that way for a while even without the use of LDN. However, since LDN does not cure disease, but rather regulates immune system function, it is possible that some patients may experience a relapse when stopping LDN, whilst others do not. It is not known whether tapering would prevent, or delay, a relapse. Those patients who are particularly sensitive to changes in medication may wish to taper off LDN simply as a precaution, and, due to the variety of variables that may be involved, consult with their physician about how to best do so. Locate an LDN prescriber here.
This issue has not yet been addressed in studies. There have been many reports of use of LDN during pregnancy with satisfactory outcome. This issue should be discussed with a physician well experienced with LDN therapy. Locate an LDN prescriber here. Read what Dr. Phil Boyle, a fertility expert, has to say about LDN use during pregnancy.
While this topic is not well-understood, there is a publication that asserts "data indicate that naltrexone is minimally excreted into breastmilk. If naltrexone is required by the mother, it is not a reason to discontinue breastfeeding." The data this statement is taken from is a case of a breastfeeding mother who was taking high dose naltrexone (50mg a day). Her 6 week old infant was tested to see what, if anything, from the naltrexone was passing from mother to infant. A "very low concentration" of a naltrexone byproduct was found in her 6 week old infant, who was determined "was healthy, achieving expected milestones, and showed no adverse effects". While it is not definitively known, it is reasonable to assume that when taking LDN (approximately a tenth of the dose of high dose naltrexone) there would be even less naltrexone passing to the infant, and therefore would present even less concern. Nevertheless, the possible advantages and risks of taking LDN while breastfeeding should be discussed with a physician well-experienced with LDN. Locate an LDN prescriber here.
Appetite suppression is a known possible side effect of high-dose (i.e. 50 mg) naltrexone with an incidence of at least 10% of users. The exact incidence in users of low-dose naltrexone is unknown, but there have been some reports from individuals. In addition, some clinicians are using LDN to help treat obesity. One such clinician, Dr. Mark Shukhman, whose interview appears here , actually prescribes LDN for appetite control because he has witnessed its efficacy.
There are some reports from individuals experiencing weight loss while taking LDN for their medical condition.