Low Dose Naltrexone: Side Effects and Efficacy in Gastrointestinal Disorders

Tuesday, 07 June 2011

Useful study with LDN and GI disorders:-

Use of low dose naltrexone has been advocated for a variety of medical problems. Only a few articles published in peer reviewed journals have documented side effects of low dosenaltrexone. The purpose of this study was to determine the frequency of adverse effects of low dose naltrexone in patients who have been treated for a variety of gastrointestinal disorders. The secondary purpose was to determine global efficacy in a retrospective survey. Patients (206) from a single gastroenterologist’s clinical practice who had been prescribed naltrexone were mailed a survey to evaluate the side effects and efficacy of naltrexone. Patients had either irritable bowel syndrome without evidence for small intestinal bacterial overgrowth, irritable bowel syndrome with evidence of small intestinal bacterial overgrowth, chronic idiopathic constipation, or inflammatory bowel disease.

Patients with diarrhea were given 2.5 mg daily, constipation 2.5 mg twice daily, and inflammatory bowel disease 4.5 mg daily. In the patients who returned the survey, 47/121 (38.8%) had no side effects. Of the 74/121 (61.2%) patients who had side effects, 58 had one or more neurological complaints, and 32 had one or more gastrointestinal side effects. In the patients with side effects, 24/74 (32.4%) had short lived symptoms. Low dose naltrexone was terminated owing to side effects in 20/74 patients (27.0%).

In 13 patients with idiopathic irritable bowel syndrome, 2 were markedly improved, 5 were moderately improved, 2 were unchanged, and 3 were markedly worse. In 85 patients with irritable bowel syndrome-small intestinal bacterial overgrowth, 15 were markedly improved, 32 were moderately improved, 11 were mildly improved, 23 were unchanged, 3 were moderately worse, and 1 was markedly worse. In 12 patients with chronic constipation, 7 were markedly improved, 1 was moderately improved, 3 were mildly improved, and 1 was unchanged. Two of 8 patients with inflammatory bowel disease were markedly improved, 1 was moderately improved, 1 was mildly improved, and 4 were unchanged. Low dose naltrexone frequently has side effects but in most is tolerable. It appears to be helpful for a number of patients with gastrointestinal disorders.