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Use of low-dose naltrexone in the management of chronic pain conditions: A systematic review.

Title
Use of low-dose naltrexone in the management of chronic pain conditions: A systematic review.
Publication Type
Journal Article
Research Type
Human
Reported as
Review
Date
December 01, 2020
Authors
E. Hatfield, K. Phillips, S. Swidan S, L. Ashman
Institution
University of Michigan
Link
Abstract

BACKGROUND: The authors aimed to evaluate the efficacy of low-dose naltrexone in the management of chronic pain conditions and determine its potential use in orofacial pain management.

METHODS: A comprehensive literature review was completed in the PubMed/MEDLINE, Embase, Cumulated Index to Nursing and Allied Health Literature, Dentistry and Oral Sciences Source Library databases up through June 17, 2019, using terms such as neurogenic, inflammation, naltrexone, temporomandibular, and chronic pain. The primary outcome was reduction in pain intensity and, secondarily, improvement in quality of life.

RESULTS: A total of 793 studies were obtained with the initial search and 8 articles were selected for evaluation. Of these 8 articles, 4 were case reports, 3 were clinical studies, and 1 was a randomized controlled trial. Six studies included data on fibromyalgia, 2 studies included data on chronic regional pain syndrome, and 1 examined multiple diagnoses, including fibromyalgia, interstitial cystitis, and chronic pelvic pain. The primary outcome of all of the studies was pain intensity reduction.

CONCLUSIONS AND PRACTICAL IMPLICATIONS: Low-dose naltrexone provides an alternative in medical management of chronic pain disorders as a novel anti-inflammatory and immunomodulator. It can offer additional management options, as orofacial pain conditions share characteristics with other chronic pain disorders. Owing to the size and heterogeneity of the studies, more large-scale studies are needed, along with additional studies assessing orofacial pain response to low-dose naltrexone.

Copyright © 2020 American Dental Association. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.adaj.2020.08.019 PMID: 33228882

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