What is it?
Naltrexone is known as an aid in treating addiction to alcohol or opiates (morphine-like substances). In low doses, Naltrexone ('low-dose naltrexone' or LDN) may stimulate the body's own production of endorphins (happiness hormones). This could potentially help with chronic pain. LDN may also have effects on the central nervous system. Therefore, LDN could potentially alleviate symptoms such as cognitive impairment and fatigue, complaints that are common in post-COVID-19 patients.
What is known about the effect on Post-COVID?
The use of low-dose Naltrexone in patients with post-COVID-19 is not yet included in regular guidelines. However, LDN can be prescribed off-label to (potentially) alleviate some symptoms. This is called "symptom management." Some people with post-COVID-19 are already using LDN. This can be prescribed by an expert center or through their own healthcare provider. Therefore, LDN is not a standalone treatment. It is a medication that can be tried in addition to the standard recommendations for post-COVID-19 (such as energy management/pacing).
The drug has previously been used with some success in the treatment of ME/CFS. Several (small) studies have already been conducted on the use of LDN in post-COVID-19 cases. These are small studies that do not yet provide sufficient evidence to recommend LDN for all patients with post-COVID-19. The studies described that LDN in some post-COVID patients Naltrexone can improve quality of life, reduce fatigue, improve sleep, and reduce pain. It is still unknown which patients it might help and which not. Therefore, further research is needed into the effectiveness and effects of Naltrexone on post-COVID symptoms.
When using LDN, a careful, gradual increase is necessary. There are also potential side effects. Therefore, it's important that patients receive proper medical supervision during use. Currently, LDN is not covered by health insurers, so there are costs associated with its use.
Who can prescribe LDN?
A treating physician, such as a general practitioner (GP), can decide to prescribe LDN. Because it is an off-label treatment, the GP makes their own decision about whether or not to prescribe the drug. Furthermore, LDN can have side effects. Common side effects include headaches, vivid dreams/nightmares, or difficulty sleeping. These side effects may resolve on their own; sometimes it's necessary to (temporarily) reduce the dosage or stop taking the drug. If you wish to stop taking the drug, always do so in consultation with your doctor. It's important that you only try LDN as a trial treatment in close consultation with your doctor, so they can properly guide you and regularly monitor the effectiveness of the drug and how to manage any side effects.
Post-COVID-19 has a wide variety of symptoms, more than 200. The precise causes of post-COVID-19 are not yet fully understood, and there are currently no known treatments that can cure it. The approach to post-COVID-19 consists partly of energy management (e.g., through pacing) and partly of symptom management. This means that treatment and/or medication can be used to reduce symptoms. LDN is an example of this and means that LDN can have a positive effect on symptoms as long as it is used. Discontinuing use carries a high risk of recurrence.
We sometimes hear, however, that using LDN leads to improved energy balance, which allows the body to recover (some) naturally over time. They may then experience longer-term stability after stopping LDN, as LDN is no longer necessary.
