Mechanism of Action of Very Low-Dose Naltrexone

July 1, 2021
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Mechanism of Action of Very Low-Dose Naltrexone

There is no comprehensive experimental study that evaluates the specific pharmacology of very low-dose naltrexone (VLDN). Perhaps some applications in clinical settings are presented later in this blog. Because its dosing range is close to LDN’s, VLDN might exhibit impacts and properties similar to LDN.

 

Very Low-Dose Naltrexone in Clinical practice

Investigation groups have worked with very low-dose naltrexone following Dr. Mannelli’s guidance exclusively. VLDN is basically used along with the methadone detoxification regime to patients having a habit of substance abuse. Due to the less sensitive opioidergic system in these patients, the dose of VLDN is carefully chosen, and the usual daily dose is either 0.125 mg or 0.250 mg.

In two random, double-blind trials, opioid-dependent patients were observed as subjects for six days on a methadone regime with either placebo or VLDN. The study demonstrated that the active medication, VLDN, in the daily dosage of either 0.125 mg or 0.250 mg, produced significant advantages in attenuating withdrawal symptoms, decreased cravings, and improved patients’ commitment to their treatment in first-week follow-up.

In another similar study design, conducted on 174 patients, among whom only 85 completed the investigation, researchers compared the output of very low-dose naltrexone to placebo and low-dose clonidine. Again, the VLDN-receiving subjects reported significantly fewer withdrawal symptoms than patients receiving placebo and clonidine.

To prepare subjects for administering intramuscular extended-release 360 mg naltrexone. In a different trial conducted on 14 patients, VLDN was given gradually increasing doses for seven days combined with buprenorphine (for the initial three days). Medicines were decreased to 36% till the injection day from 67% at the beginning. While opioid-positive samples, except buprenorphine, have dropped from 23.8% to 14.1%. As an adjunct of the detoxification regimen, patients well-tolerated VLDN throughout the presented research, and patients did not report any adverse effects solely linked to the use of VLDN. Due to insufficient follow-up data, it is impracticable to define the results of VLDN for over a more than one week period. In a group of patients with a history of substance abuse, it still needs to be discovered if they may benefit from more prolonged VLDN or LDN therapy. On the other hand, patients who do not have a history of substance abuse but those who are undergoing undesirable effects of LDN can benefit from doses low enough to be qualified as VLDN.

 

 

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