Low-Dose Naltrexone for Depression Treatment

Mechanism of Action

• Low-dose naltrexone (LDN) acts as an opioid antagonist for μ-opioid and κ-opioid receptors, antagonizes toll-like receptor 4, reducing pro-inflammatory cytokines, and modulates microglial activity which may affect neuroinflammation, according to the American Academy of Ophthalmology 1

Dosage and Administration

• For neuropathic pain conditions, LDN is typically started at 1.5mg at bedtime with gradual bi-weekly increases of 1.5mg to a final maximum dose of 4.5mg, as recommended by the American Academy of Ophthalmology 1

Contraindications and Precautions

• Due to its opioid antagonist properties, LDN should not be used in patients requiring opioid therapy as it could reduce analgesic efficacy or precipitate withdrawal, according to the American Gastroenterological Association 2
• LDN should be discontinued before procedures requiring opioid analgesia, as advised by the American Gastroenterological Association 2

Side Effects

• Common side effects of LDN include headache, tachycardia, and vivid dreams, as reported by the American Academy of Ophthalmology 1