Low dose naltrexone: side effects and efficacy in gastrointestinal disorders

Area of Science:

• Gastroenterology
• Pharmacology
• Clinical Medicine

Background:

• Low dose naltrexone (LDN) is increasingly used for various conditions.
• Limited peer-reviewed data exists on LDN's adverse effects and efficacy in gastrointestinal disorders.

Purpose of the Study:

• To determine the frequency of adverse effects associated with LDN in patients with gastrointestinal disorders.
• To assess the global efficacy of LDN in managing these conditions through a retrospective survey.

Main Methods:

• A survey was mailed to 206 patients treated with LDN by a single gastroenterologist for irritable bowel syndrome (IBS), IBS with small intestinal bacterial overgrowth (SIBO), chronic idiopathic constipation (CIC), or inflammatory bowel disease (IBD).
• Patients received varying LDN dosages based on their condition (2.5 mg daily for diarrhea, 2.5 mg twice daily for constipation, 4.5 mg daily for IBD).
• Survey responses were analyzed to evaluate side effects and efficacy.

Main Results:

• Of 121 respondents, 38.8% reported no side effects, while 61.2% experienced adverse effects.
• Neurological complaints (58 patients) and gastrointestinal side effects (32 patients) were most common.
• LDN was discontinued due to side effects in 27.0% of those experiencing them.
• Efficacy varied: 15/85 with IBS-SIBO were markedly improved, 7/12 with CIC were markedly improved, but 2/13 with idiopathic IBS were markedly worse.

Conclusions:

• Low dose naltrexone frequently causes side effects, predominantly neurological and gastrointestinal.
• Despite frequent adverse events, LDN is often tolerable and shows potential therapeutic benefits for a subset of patients with gastrointestinal disorders.
• Further research is warranted to optimize LDN use and manage its side effects in gastroenterology practice.