Low Dose Naltrexone for Chronic Pain- My Experiences
You may have heard about a “new” way some doctors are using to manage chronic inflammatory conditions such as psoriatic arthritis. It is called Low Dose Naltrexone (LDN). Naltrexone is a pharmaceutical, originally prescribed in higher doses for individuals who are struggling with opiate withdrawal or addiction.
Low Dose Naltrexone
I did my own research and approached my doctor about giving it a try. She told me that their rheumatology office as a whole hasn’t started using it yet, but she had been looking into it. So she decided to do a little more research, then would call me the next week and let me know what she thought. This made me very grateful that we had both worked so hard to foster open and honest communication with each other. I loved that she was open to my opinions and willing to try new things.
It wasn’t much later that I received a call from my rheumatologist, we were a go to give LDN a try, but there were a few snags and things to consider along the way. The suggested dosing for LDN (3.5-4) is not a dosage typically found in most pharmacies or commercially available. So my prescription had to be sent to a speciality pharmacy called a compounding pharmacy where there are qualified pharmacists who can prepare medications in certain dosages if needed.
Is LDN expensive?
My first thought was holy cow, how much is this going to cost me? Especially when I found out that since this was not an “approved” use of naltrexone, that my health insurance would not cover the cost. I was worried that I had come so far, trying something new, only to hit a financial brick wall. All I saw were dollar signs dancing in my eyes.
A few hours later I received a call from the pharmacy, my medicine was ready and it would cost me $36 for a 30 day supply. I was so relieved. While not “cheap,” for me that was doable. Now for the hard part, would it work? Would it make a difference? Would it help me manage the seemingly endless pain?
Giving it a try
The directions told me to take it in the evening, before bed. Because of how the pill works, it HAS to be taken in the evening to get the most benefit from the medication. So, it was with a hopeful heart that I took the first pill. I still struggle with the whole “take this pill and you will be magically fixed” mentality, so I may have been a bit overly hopeful that night. I feel asleep easier than normal, but didn’t notice much of a difference the next day like I had hoped.
It wasn’t until about 7-10 days later that I noticed a subtle change. Not like the change you feel when you take typical “pain” medication, like NSAID’s or opiates. Rather, it was like that constant hum of pain that exists in the background every second of the day was gone. It wasn’t replaced with another feeling like you get with opiates, it was just...quiet.
Low Dose Naltrexone for chronic pain
In the weeks that followed, I did notice a fairly odd side effect. I had crazy, vivid dreams. Not necessarily bad dreams or anything, just very bright, almost like 90’s technicolor dreams. Other than that, I haven’t experienced any real side effects at all.
It certainly isn’t a cure-all. Nor did it seem to help me on major flare days. However, it does make me feel like living with psoriatic arthritis is a little more manageable. It is also one of those cases that I did happen to miss the dose for 2 nights in a row and you better believe I noticed a big difference on that third day.
I’m still taking LDN and really believe it has made a difference in my daily pain levels. Or at least, in my perceived daily pain levels. To me, the relief is worth the out-of-pocket expense of it not being covered by my insurance.
Have you ever spoken with your doctor about Low Dose Naltrexone? Did it work for you?
Do you have a sleep disorder (eg. insomnia, sleep apnea, RLS) in addition to your PsA?