Therapeutic Uses and Efficacy of Low-Dose Naltrexone: A Scoping Review

Low-dose naltrexone (LDN) has been suggested as a novel treatment option for several conditions and is of increasing interest due to its potential ability to address certain medical conditions that lack effective treatments or frequently rely on the use of opioids as treatment. This article will synthesize evidence and assess the scope of literature that examines low-dose naltrexone's efficacy against painful and other relevant medical conditions. A scoping review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Resources utilized for the review included PubMed and Excerpta Medica database (Embase). Articles included were required to be original research, published in English, conducted on human subjects, published in the last 15 years, have full text available, and include treatment with naltrexone in an off-label capacity (i.e., not for the treatment of alcohol or opioid use disorder). Zotero (Corporation for Digital Scholarship, Vienna, VA), a reference management software, was used to review all search results with this criterion. Search results yielded 2,399 articles; 995 did not meet inclusion criteria, 1,166 were excluded after screening by title, and 142 were excluded after screening by abstract. Ultimately, 68 articles were included after a full-text review. The articles selected presented clinical examples of LDN efficacy for a variety of medical conditions. These articles also helped to illuminate the current gaps in research, pointing to the need for larger clinical trials and proper dosing studies.