Abstract:
Aim: To evaluate the use of low-dose naltrexone (LDN) as a broad-spectrum analgesic. Methods: Retrospective cohort study from a single pain management practice using data from 2014 to 2020. Thirty-six patients using LDN for ≥2 months were matched to 42 controls. Pain scores were assessed at initial visit and at most recent/final documented visit using a 10-point scale. Results: Cases reported significantly greater pain reduction (-37.8%) than controls (-4.3%; p < 0.001). Whole sample multivariate modeling predicts 33% pain reduction with LDN, with number needed to treat (for 50% pain reduction) of 3.2. Patients with neuropathic pain appeared to benefit even more than those with \'nociceptive\'/inflammatory pain. Conclusion: LDN is effective in a variety of chronic pain states, likely mediated by TLR-4 antagonism.
Naltrexone has historically been used to treat various substance use disorders, but recent discoveries have sparked interest in using low-dose naltrexone (LDN) to manage chronic pain. This study compared pain levels reported by patients before and after at least 2 months of LDN treatment to those reported by patients with the same painful diseases, who did not take LDN. Overall, patients who took LDN reported significantly more pain relief than patients who did not take LDN. How LDN alleviates pain seems complex, but apparently involves an anti-inflammatory effect on cells in the brain and spinal cord. LDN is extraordinarily safe, with no known risks (unlike most standard pain medications), and should be studied more in the treatment of chronic pain.
摘要:
目的:评价小剂量纳曲酮(LDN)作为广谱镇痛药的应用价值。方法:使用2014年至2020年的数据,对一项单一疼痛管理实践进行回顾性队列研究。36例使用LDN≥2个月的患者与42例对照相匹配。使用10分量表在初次就诊和最近/最后记录的就诊时评估疼痛评分。结果:病例报告疼痛减轻(-37.8%)明显高于对照组(-4.3%;p<0.001)。全样本多变量建模预测LDN疼痛减轻33%,需要治疗的数量(减少50%的疼痛)为3.2。神经性疼痛患者似乎比“伤害性疼痛”/炎性疼痛患者受益更多。结论:LDN对多种慢性疼痛状态有效,可能由TLR-4拮抗作用介导。
纳曲酮历来用于治疗各种物质使用障碍,但最近的发现引发了人们对使用低剂量纳曲酮(LDN)治疗慢性疼痛的兴趣.这项研究比较了LDN治疗至少2个月前后患者报告的疼痛水平与患有相同疼痛疾病的患者报告的疼痛水平。没有服用LDN。总的来说,与未服用LDN的患者相比,服用LDN的患者报告疼痛缓解显著.LDN如何缓解疼痛似乎很复杂,但显然涉及对大脑和脊髓细胞的抗炎作用。LDN非常安全,没有已知的风险(不像大多数标准止痛药),并且应该在慢性疼痛的治疗中进行更多的研究。