My daughter (40) has Sjogrens, Graves, RA. She advised that her Rheumy had put her on Low-Dose Natrexone with amazing results. She suggested strongly that I try it for my PsA. It worked for me too! It has cut the pain factor by at least 70%. However, it does nothing for the fatigue 🙁 The good news is that it is virtually side-effect free with no downside. The bad news is that since it is an off-label drug, you have to go to a compounding pharmacy to get it (easily available) and insurance usually wont pay for it. That said, it is around $30 to $50 per month. Well worth it for the pain relief!!