The use of naltrexone in the treatment of chronic pain: a systematic review

This study aims to assess the efficacy of low-dose naltrexone (LDN) in treating chronic pain. We conducted a systematic review using the PICO strategy: (P) Patients with chronic pain, (I) Use of oral naltrexone, (C) Placebo or active drug and (O) Pain relief and quality of life. We included articles from PubMed, Scopus, Cochrane CENTRAL and EMBASE databases. Seven randomized clinical trials involving 406 patients were analyzed. The doses ranging from 2 to 4.5 mg once daily across all studies. Various chronic pain conditions were evaluated. The results suggest that low-dose naltrexone is not effective in managing chronic pain and improving the quality of life in patients with diverse chronic pain conditions. However, further research with larger sample sizes and standardized methodologies is necessary. This study looks at how well low-dose naltrexone (LDN) works for treating long-lasting pain. We reviewed research where patients with chronic pain were given either LDN or a placebo (a fake treatment). We found eight studies that included a total of 421 patients. The LDN doses used ranged from very small amounts 2–4.5 mg, taken once a day. These studies looked at different types of chronic pain. Our results suggest that LDN cannot help to reduce pain and improve the quality of life for people with chronic pain. However, more research with larger groups of people and consistent methods is needed to confirm these findings. The review encompassed 421 patients across eight randomized clinical trials, addressing various chronic pain conditions such as fibromyalgia, multiple sclerosis, Gulf War Illness, diabetic neuropathy, arthritis and chronic pain in HIV-positive patients. Low-dose naltrexone (LDN) doses ranged from 2 to 4.5 mg daily across the studies. Results indicated that LDN may effectively reduce chronic pain and improve quality of life in several chronic pain conditions. Some studies reported significant pain reduction and quality of life improvements with LDN compared with placebo. Other studies found no significant differences between LDN and placebo or other treatments. Mild to moderate adverse effects of LDN were reported, including headache and fatigue. The studies reviewed had varying methodologies and sample sizes, indicating the need for further research with larger and more standardized trials. The review emphasises the potential of LDN as a treatment for chronic pain but highlights the necessity for more consistent and robust evidence.