Naltrexone is an opioid antagonist that is FDA-approved to treat alcohol use disorder and opioid dependence. Off-label it is used to treat pruritis (itching) in opioid using/cholestatic/uremic patients.
Naltrexone has been found to have different actions when used in lower doses than originally intended. This difference in activity is due to the nature of the molecule and the different dose-dependent effects of the L- and D- isomers of naltrexone.
Low dose naltrexone has shown to be effective in treating patients with depression. A good candidate for LDN is someone who has tried pharmaceuticals for depression previously, and did not show improvement, or those who want to avoid using typical anti-depressants. LDN can be used as part of combination therapy approaches alongside herbs, psychotherapy, and CBT for comprehensive depression management.
When depression is caused by inflammation, chronic illness/pain, or autoimmune conditions, or a patient is experiencing cognitive fog, poor memory, lack of focus, LDN can help. Depression often coexists with sleep disorders, and addressing both conditions simultaneously can lead to better overall outcomes.
LDN is associated with reducing inflammation in the body (hence why it is also used off label for itching), and regulating dopamine, which can help with all types of depression, especially if the patient has not responded to pharmaceuticals previously.
Custom compounding pharmacies working with telehealth providers have made LDN therapy more accessible, allowing patients to receive personalized depression treatment with precise dosing that can be adjusted based on individual response and tolerance.
Amanda Navarro, PharmD Candidate 2023
LDN Research Trust. (n.d.). Retrieved October 2, 2022, from https://ldnresearchtrust.org/