Low-Dose Naltrexone For The Treatment of Fibromyalgia Pain

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By Chris Faubel, M.D. —

Arthritis Rheum. 2013 Feb;65(2):529-38
Low-dose naltrexone for the treatment of fibromyalgia: Findings of a small, randomized, double-blind, placebo-controlled, counterbalanced, crossover trial assessing daily pain levels.
Younger J, Noor N, McCue R, Mackey S.
Stanford University School of Medicine, Palo Alto, California. jarred.younger@stanford.edu.
Get the abstract here

Summary of Study

  • Small study = 31 women
  • Small dose naltrexone = 4.5 mg/day
  • Control = placebo
  • Benefits of the naltrexone group:
    • 28.8% pain reduction (naltrexone) vs 18% (placebo)
    • Improved mood and general satisfaction
    • NOT improved fatigue or sleep
  • No serious side effects

Commentary

  • As we all know, patients with fibromyalgia pain are some of the most difficult to treat.  Most, it seems, are resistant to trying low-impact exercise which has been shown to help.  And yes, Lyrica, Savella, and Cymbalta help some patients, but having another medication (low-dose naltrexone) that is inexpensive and well-tolerated is a great thing.
  • Problem Solved:  Currently (Feb. 2013), a scored 50-mg naltrexone tablet is the only commercially available formulation.  Acquiring a 4.5-mg pill is the biggest issue.  I have contacted Dr. Jarred Younger at Stanford University to find out where they obtained their 4.5-mg pills.  I was informed that they used a local compounding pharmacy (usually about $30+/month).  One commercial company is apparently currently doing clinical trials with low-dose naltrexone so they can get FDA approval.  Also, Skip’s Pharmacy out of Boca Raton, Florida will ship nationwide.

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