Find us on:


Pharmacology Update: Low-Dose Naltrexone as a Possible Nonopioid Modality for Some Chronic, Nonmalignant Pain Syndromes

Pharmacology Update: Low-Dose Naltrexone as a Possible Nonopioid Modality for Some Chronic, Nonmalignant Pain Syndromes
Publication Type
Journal Article
Research Type
Reported as
March 27, 2019
Diana Trofimovitch, Steven J. Baumrucker
East Tennessee State University College of Medicine, Ballad Health System Hospice and Palliative Medicine

Pain can have a devastating effect on the quality of life of patients in palliative medicine. Thus far, majority of research has been centered on opioid-based pain management, with a limited empirical evidence for the use of nonopioid medications in palliative care. However, opioid and nonopioid medications such as nonsteroidal anti-inflammatory drugs have their limitations in the clinical use due to risk of adverse effects, therefore, there is a need for more research to be directed to finding an alternative approach to pain management in comfort care setting. The purpose of this article is to discuss a potential new drug that would adequately alleviate pain and enhance quality of life without significant risks of adverse effects that would limit its use.

Naltrexone is a reversible competitive antagonist at μ-opioid and κ-opioid receptors, which when used at standard doses of 50 to 150 mg was initially intended for use in opioid and alcohol use disorders. However, it was discovered that its use in low doses follows alternate pharmacodynamic pathways with various effects. When used in doses of 1 to 5 mg it acts as a glial modulator with a neuroprotective effect via inhibition of microglial activation. It binds to Toll-like receptor 4 and acts as an antagonist, therefore inhibiting the downstream cellular signaling pathways that ultimately lead to pro-inflammatory cytokines, therefore reducing inflammatory response. Its other mode of action involves transient opioid receptor blockade ensuing from low-dose use which upregulates opioid signaling resulting in increased levels of endogenous opioid production, known as opioid rebound effect. Low dose naltrexone has gained popularity as an off-label treatment of several autoimmune diseases including multiple sclerosis and inflammatory bowel disease, as well as chronic pain disorders including fibromyalgia, complex regional pain syndrome, and diabetic neuropathy. Low-dose naltrexone (LDN) may also have utility in improving mood disorders and the potential to enhance the quality of life. This article will therefore propose the potential off-label use of LDN in management of nonmalignant pain in the palliative medicine setting.

cbd oil legal in texas cbd oil cancer dosage cbd oil quotes therapy definition medical cbd coca cola personal trainer melbourne cbd serenity cbd oil reviews where to buy cbd cream cbd 50mg hemp for pain central business district where is cannabis oil legal cbd uf cbd cartidge cbd 1 best home security system white label cbd companies cbd sauve top cbd vape juice cbs brain cbd acdc cbd pet drops cali cbd infused gummy candy can cbd oil make you sick cbd with kratom cgb oil cbd tips cbd zyrtec definition scientific escort brisbane cbd strongest peppermint oil true bliss cbd oil call out other names for cbd how to know w cbd oil and rem sleep flavored body oil high life smoke shop charlotte 3 cbds of london cbd oils vape foria cbd oil cbd oil alabama legal having issues breathing after using cbd oil vape huge traduccion

ginnifer goodwin weight loss after baby 20 lb weight loss before and after prescribed medications for weight loss low carb weight loss plan weight loss guide three day weight loss diet best thyroid medication for weight loss leptin supplements review cellucor weight loss thyroid hormone pills weight loss weight loss grants homemade smoothie for weight loss 40 day water fast weight loss quick weight loss usa yanna crawley weight loss this is us star weight loss calorie formula for weight loss jorge garcia weight loss 2016 roller weight loss tulsa weight loss detox drinks recipes bulletproof weight loss topamax 50mg weight loss can vitamin d help with weight loss weight loss pills cambogia keppra and weight loss does cinnamon help with weight loss normal baby weight loss after birth orangetheory weight loss stories weight loss pills rating sleeping diet pills fish oil pills weight loss dance for weight loss at home how do i take alli diet pills weight loss cardio workouts what is relacore diet pills onions for weight loss best buy diet pills target weight loss pills reviews i need energy pills synjardy weight loss meal suppressants 600 calorie diet plan weight loss keto crush pills 40 pound weight loss

low testosterone premature ejaculation average hard penis erectile dysfunction medications india pharmacy cialis otc blood pressure primal health labs strong erection pills big penis head erection creams walgreens hidden penis pictures how expensive is cialis does the penis grow pharmacies viagra yoga erectile dysfunction jelqing technique pinus pumps penis surgery before and after perfect dick top male enhancement reviews mph t bomb testo boost elite big fat dicks free male enhancement samples by mail gnc energy automatic male sex toys herbs that increase blood flow free sample of viagra how do male enhancement pills work what are the health benefits of ginseng vasectomy erectile dysfunction sexual anxiety cure bupropion sexual side effects penus definition sex pills for girls side effects of extenz primal force supplement penis cancer symptoms stamina x pill penis heads tadapox review fempills reviews ed pictures rl x male enhancement male enlargement pills review

vape no A Tag