Avonex, Betaseron and Rebif: Based on pharmokinetics, it is assumed that LDN interacts with the interferon-based disease-modifying therapies, so patients on these drugs should NOT take LDN. However, it is OK to be used in conjunction with Copaxone.
Costs
The bad news: Your insurance probably won’t cover it, as LDN for MS is still in the “experimental” category.The good news: It’s pretty cheap - a little over a dollar per dose at a compounding pharmacy.
Additional Information/Points
Sleep Interactions: LDN can interfere with sleep, primarily in the form of very lucid dreams. This happens mostly in the first week of taking it, although for some people this effect lingers. You can discuss the use of a sleeping aid, such as Ambien, with your doctor, especially when you first start using LDN. Some people take Benadryl for this reason. Again, it is extremely important that you do not use ANY narcotics-based drugs while on LDN, including those which may have been used in the past to help you sleep.
See What the People Are Saying: One of my favorite sites for finding out about patient experiences with any drug is revolutionhealth.com. Go to this link on Naltrexone, then make sure use the scrollbar next to “Show reviews of Naltrexone for:” to find your type of MS. IMPORTANT: Remember that these results are undoubtedly influenced by “selection bias,” meaning people that experience extreme results (good or bad) are more likely to take the time to write in than those with neutral opinions. In the interest of presenting objective information, I’m not going to recommend any other websites, as the top search results for “low dose naltrexone” seem to range from enthusiastic to fanatical. Judge for yourself.
Relapsing or Progressive: Keep in mind when you look at results (both scientific and anecdotal) of LDN treatment in people with MS that relapsing MS may be more “inflammatory” in nature, while progressive forms of MS may be more “degenerative.” Therefore, if it turns out that LDN works in MS because it reduces inflammation through some mechanism, it may be more effective (or work differently) in people with relapsing forms of MS. However, reports (again, both scientific and anecdotal) do support some action in people with progressive MS.
Sources:
Bowling, Allen C. Complementary and Alternative Medicine and Multiple Sclerosis. 2nd ed. Demos Publishing: New York. 2007.
Gironi M, Martinelli-Boneschi F, Sacerdote P, Solaro C, Zaffaroni M, Cavarretta
R, Moiola L, Bucello S, Radaelli M, Pilato V, Rodegher M, Cursi M, Franchi S,
Martinelli V, Nemni R, Comi G, Martino G. A pilot trial of low-dose naltrexone in primary progressive multiple sclerosis. Mult Scler. 2008 Sep;14(8):1076-83.
National Multiple Sclerosis Society. Low Dose Naltrexone Update. June 2, 2008. Accessed: April 2009.
