TITLE:
Efficacy of Low Dose Naltrexone on Pain Reduction in Chronic Pain Syndromes: A Meta Analysis
AUTHORS:
Haroutiun Hamzoian, Shehzad Choudry
KEYWORDS:
Pain Management, LDN, Pain, Anesthesiology, Neurology, Low Dose Naltrexone, Chronic Pain
JOURNAL NAME:
Pain Studies and Treatment,
Vol.11 No.3,
July
30,
2023
ABSTRACT: Chronic pain is a multifaceted debilitating experience
often associated with significant physical and emotional burden. Low dose
naltrexone (LDN) has gained attention in recent years for its potential utility
in the management of fibromyalgia, irritable
bowel syndrome, multiple sclerosis, and painful diabetic neuropathy. LDN’s analgesic effects have been
associated with its ability to increase the production of endorphins
while reducing the production of tumor
necrosis factor-alpha, interleukin-6, reactive oxygen species and nitric
oxide. This meta-analysis aims to
systematically review and synthesize the available evidence on efficacy
of LDN as an analgesic in pain syndromes, with a focus on chronic (neuro)
inflammatory diseases. The goal is to provide clinicians with a more
comprehensive estimate of the effectiveness of LDN as a non-opioid option for
managing chronic pain and guide future research in the area. Thirteen randomized control trials, published from 1990 to 2022,
were selected for the analysis that satisfied inclusion criteria. The overall effects
in these studies were calculated using the standardized mean difference (SMD)
between the LDN and placebo groups. We found an overall SMD of -10.77 (95% CI: -13.96 to -7.58)
with a p-value of 0.002. This indicated that the LDN group experienced a
statistically significant reduction in pain
compared to placebo. This meta-analysis provides evidence for the potential
efficacy of low dose naltrexone in reducing pain and enhancing analgesia in
various pain syndromes. LDN may be a useful treatment option for patients
suffering from chronic pain, particularly with fibromyalgia, multiple
sclerosis, or diabetic neuropathy. However, further research is needed to
confirm the efficacy and safety of low dose naltrexone for chronic pain conditions,
especially with larger sample sizes, standardized dosing regimens and treatment
durations.