Research

PURPOSE: Naltrexone, an opioid antagonist at low dose (4.5 mg per day) helps in reducing the production of proinflammatory cytokines by suppressing the microglial cells in the CNS. This study is a retrospective chart review meant to investigate the efficacy of low dose naltrexone (LDN) for the treatment of patients with co-morbid depression and collagen disease.

MATERIALS AND METHODS: A retrospective chart review of patients presenting to a rural clinic (Wasco Mental Health) identified five patients receiving LDN from October 2008 to present. The outcome measure was the clinical global impression scale (CGI).

RESULTS: Five patients received at least one month of LDN. All patients were females with age ranging from 47 to 63, one Hispanic ethnicity, and four Caucasian. Two had a diagnosis of Major Depressive Disorder, two had Bipolar Type II and one had Bipolar Type I. Two patients with fibromyalgia only had minimal improvement. One patient with lumbar discopathy had no improvement. One patient with Lupus responded with much improved with liquid LDN; another patient with both Lupus and Fibromyalgia had a very much improved response on LDN capsule.

CONCLUSION: At week 4, 80% of patients experienced a certain degree of improvement with LDN. The use of LDN for osteoarthritis and lumbar discopathy in our study did not give a robust benefit. In addition, the use of liquid LDN appeared to be less effective as the capsule form. Prospective studies randomized using LDN and current practice guidelines for treatment of RA and fibromyalgia must be considered.