■尽管有各种各样的镇痛药,许多慢性疼痛患者的疼痛缓解效果往往欠佳,部分原因是缺乏任何药物来解决常见疼痛综合征的伤害性成分。低剂量纳曲酮已用于治疗慢性疼痛,通常每天4.5毫克,尽管也注意到纳曲酮治疗慢性疼痛的有效剂量范围为每天0.1至4.5mg。我们进行了观察性分析,以确定41例慢性肌肉骨骼疼痛患者的纳曲酮每日有效剂量范围。
■385名患者的图表,115名男性,270名女性,年龄18-92岁,进行了审查。二百六十个慢性弥漫性患者,对称疼痛规定了滴定剂量的纳曲酮,以确定通过自我报告确定的最大有效剂量:1)减轻弥漫性/全身性疼痛和/或严重程度疼痛和/或2)对情绪的积极影响,能源,和精神清晰度。在确定最大有效的纳曲酮剂量之前和之后,给出了简短的疼痛清单和PROMIS量表。
■41名患者符合所有入选标准,成功达到最大有效剂量,并完成了前和后的结果问卷。在确定最大有效剂量的过程中证明了Hormesis,在很大范围内变化,BPI有统计学显著改善。
■低剂量纳曲酮治疗慢性疼痛的最大有效剂量是特异性的,提示需要1)剂量滴定以确定最大有效剂量,2)对初始试验未通过固定剂量纳曲酮的患者重新使用低剂量纳曲酮的可能性.
低剂量纳曲酮(LDN)已用于治疗慢性疼痛。有,然而,没有商定的有效剂量,使临床医生没有关于开始使用纳曲酮治疗的指南。似乎任何患者的LDN剂量都是特殊的,在一个小书房里,范围从0.1到6.0毫克/天。了解LDN的各种可能的作用机制可能有助于临床医生了解它如何以及为什么可以有效地减少慢性疼痛。提出了确定慢性肌筋膜疼痛最大有效剂量的滴定时间表。
UNASSIGNED: Despite the availability of a wide variety of analgesics, many patients with chronic pain often experience suboptimal pain relief in part related to the absence of any medication to address the nociplastic component of common pain syndromes. Low-dose naltrexone has been used for the treatment of chronic pain, typically at 4.5 mg per day, even though it is also noted that effective doses of naltrexone for chronic pain presentations range from 0.1 to 4.5 mg per day. We performed an observational analysis to determine the range of effective naltrexone daily dosing in 41 patients with chronic musculoskeletal pain.
UNASSIGNED: Charts of 385 patients, 115 males, 270 females, ages 18-92, were reviewed. Two hundred and sixty patients with chronic diffuse, symmetrical pain were prescribed a titrating dose of naltrexone to determine a maximally effective dose established by self-report of 1) reduction of diffuse/generalized and/or severity level of pain and/or 2) positive effects on mood, energy, and mental clarity. Brief Pain Inventory and PROMIS scales were given pre- and post-determining a maximally effective naltrexone dose.
UNASSIGNED: Forty-one patients met all criteria for inclusion, successfully attained a maximally effective dose, and completed a pre- and post-outcome questionnaire. Hormesis was demonstrated during the determination of the maximally effective dosing, which varied over a wide range, with statistically significant improvement in BPI.
UNASSIGNED: The maximally effective dose of low-dose naltrexone for the treatment of chronic pain is idiosyncratic, suggesting the need for 1) dosage titration to establish a maximally effective dose and 2) the possibility of re-introduction of low-dose naltrexone to patients who had failed initial trials on a fixed dose of naltrexone.
Low-dose naltrexone (LDN) has been used to treat chronic pain. There is, however, no agreed on effective dose, leaving clinicians without guidelines on initiating treatment with naltrexone. It appears that the dose of LDN for any patient is idiosyncratic, and in a small study, ranges from 0.1 to 6.0 mg/day. Understanding the various possible mechanisms of action of LDN may help the clinician to understand how and why it can effectively reduce chronic pain. A titration schedule to establish the maximally effective dose for chronic myofascial pain is presented.