Low Dose Naltrexone

LDN has an exceptionally favorable long-term safety profile with minimal adverse effects outside the opioid contraindication. The article gives a low dose naltrexone dosing range of 0.25 mg to 6.5–7 mg. Low dose naltrexone dosing depends on patient response and tolerance. Full benefit from LDN requires 6 months to 2 years; early discontinuation is discouraged. LDN intermittently blocks opioid receptors rather than sustaining blockade, triggering a biofeedback response that upregulates endogenous opioid production. At low doses of 0.5–4.5 mg, naltrexone produces fundamentally different effects than standard doses through the principle of hormesis. LDN's primary mechanism for reducing excess cytokine production involves TLR4 blockade while preserving functional immune response. LDN must be compounded because it is not commercially manufactured at therapeutic low doses, and quality varies significantly between pharmacies. Concurrent opioid use is an absolute contraindication for LDN; patients must be fully opioid-free before initiating treatment. Vivid dreams are the most commonly reported side effect of LDN, are dose-dependent, and resolve with dose reduction. Low dose naltrexone is…