sábado, 12 de junio de 2010

FAQ sobre LDN (en inglés)

Can LDN be used by recovering opiate addicts that have successfully complete suboxone treatment?
It would be inappropriate to use LDN until the opiate addiction has been complete resolved.

Are there any contraindications for combining LDN with Tricyclic or SSRI, SNRI Antidepressants?
At this time there are known contraindications for this combination.

Has anyone reported a heart reaction to LDN?
No one has reported a heart reaction to LDN or to naltrexone, as far as we are aware. If you have experienced such a reaction it would make sense to confirm that you did in fact take LDN and that the LDN was not mislabeled.

Is LDN of any value to those with Parkinsons?
Whilst no clinical studies have been carried out, there have been a number of reports of benefits derived from LDN in patients with Parkinson's disease. Research in preclinical models of Parkinson's disease is being planned at Penn State University by Dr. Ian S. Zagon.

Can LDN be used in combination with chemotherapy?
There is no known contraindication or reason not to combine LDN with chemotherapy. However, if any opiate pain killers are being taken with the chemotherapy, LDN would neutralize the effect of the painkillers for several hours.

Does LDN have any known interactions with warfarin(Coumadin)?
At this time there are no known interactions between LDN and warfarin (Coumadin).

Does the dose of LDN need to be adjusted according to body weight i.e. for a 25kg child?
The dose of LDN needed differs between people due to individual metabolic rates. Whilst 4.5mg works for most adults, the dose should definitely be adjusted according to body weight. For an adult, the optimal dose ranges between 2.5mg and 10mg daily, and for a child it would need to be adjusted accordingly.

How quickly can one expect to see benefit from LDN?
Most users typically experience benefit within days. If no benefit has been seen by the end of one month, it may be necessary to modify the dose being taken. If the dose adjustment does not help, it is unlikely that benefit will be seen from LDN in such cases.

Can LDN be given to a dog?
LDN can and has been used in animals. However as animals have a different metabolic rate to humans, a veterinarian should be consulted for the appropriate dose needed.

Does LDN need to be taken without food?
Food is not known to affect the absorption of naltrexone. It can therefore be taken with or without food.

I take 3mg LDN every night for over 1 year and have not felt this good for a long time. Do I need to increase my dose?
As explained on this website, LDN dose is a matter for individual titration. This is usually done under the instructions of the prescribing physician and is determined by your response to the dose being used. The effective dose ranges from 2.5mg to 10mg daily. So if 3mg works for you there would not be a reason to increase the dose.

Would LDN be indicated for other auto-immune disorders, such as lupus?
Based on its mechanism of action, LDN could in theory work for any autoimmune disorder. There have been favorable reports of its usage in lupus, although no formal studies have been conducted.

I have heard that LDN is used to enhance the effect of opioids and yet you warn not to take it with opioids. Please explain.
There have been studies showing that ULDN - Ultra Low Dose Naltrexone enhances the effect of opioids. It does this by sensitizing the receptors, much in the way that LDN works. However the dose used is typically less than 10% of an LDN dose. Naltrexone at a dose of around 1 -2 mg will block the effect of opioids in most people, for a short time. If you want to avoid the loss of effect of the opioids drugs, even for a short time, you should avoid combining LDN with opioids.

Can you take Prednisone (cortisone) while on LDN?
At this time there is no research showing any problem in combining these medications.

Is it possible for LDN to raise blood pressure?
This has not been reported previously. In fact endorphins are known to lower blood pressure and since LDN raises certain endorphin levels, one would if anything a regulation of blood pressure. If LDN does cause raised blood pressure, one should question whether the correct form of naltrexone has been used. It could be that a slow release form has been incorrectly used instead of an immediate release form.

Can LDN be taken with food?
Food is not known to interfere with the absorption of naltrexone.

Has LDN been used for diabetes?
No studies have been carried out yet in diabetes, whether type 1 or type 2. However there have been physician reports of LDN's help in regulating blood sugar levels in diabetes.

Is LDN an immuno-suppressive drug?
LDN is best classified as an immuno-regulator. It causes an increase in OGF levels - and OGF regulates proliferation of all cells, including immune cells (T-cells and B-cells). When immune cells are being produced in excess (leading to autoimmune conditions), OGF acts to slow down their proliferation. Whilst this can be construed as immune-suppression, it is most accurately described as immune-regulation.

Can LDN be taken by someone who has used Oxycodone for a long time?
Oxycodone is an opioid and its effect would be neutralized by LDN, at least for several hours. It would be important to first discontinue the oxycodone prior to starting LDN and this is best done with the guidance of a physician experienced with using both drugs.

Some people say that MS patients who have problems with spasms should only take 3mg of LDN & no more, can you verify this?
This question has not yet been addressed in clinical trials. Trials have consistently used 4.5mg dosages. Since people metabolize naltrexone at different speeds, it is sometimes necessary to make adjustments in individual dosages. This is best done by a physician experienced with prescribing LDN.

When will LDN be approved by the FDA to treat Multiple Sclerosis?
Obtaining FDA approval is a costly process, often running into hundreds of millions of dollars. Where a drug's patent has expired, no incentive exists for a drug company to invest the funds needed to gain FDA approval. It is unlikely that LDN will ever gain FDA approval for multiple sclerosis unless charitable sponsorship is found to finance the process.

Can LDN be used together with OGF?
Research at present does not support taking the two together. Since LDN neutralizes the effect of OGF, it would not make sense to combine the two. However there are physicians who prescribe the two together, whilst advising a long distance (like 10 - 12 hours) between the two. Whether the results are better than taking OGF on its own remains to be clarified in a trial.

Is it ok to take LDN whilst on chemotherapy for treatment of cancer?
There is no known problem with combining LDN with chemotherapy, and in theory (based on work done in animals), LDN could enable the chemo to work more effectively. This is because LDN raises OGF levels that act to slow down cell division, this enabling the chemo to achieve more of its effect than if taken alone.

Is Naltrexone a steroid?
Naltrexone is not a steroid and not related to steroids in any way. Furthermore it does not have any direct effect on the hormonal system, so it does not interfere with the activity of steroids in any way.

Is it ok to take opiates during the day and LDN at night? Is there any concern about combining them other than that you'll lose the pain control the opiates provide? (not a huge deal to me, as it is reversible!)
It is ok but as you say, you will lose the pain control effect for a short while. It does not cause any damage. In fact, you may find that the pain medication works better afterwards as the naltrexone increases sensitivity of the cell's receptors to the opiates.

Have you heard of anyone having any level of success with alopecia areata?
We have not heard of this, but if you do use it for that purpose and if it works, make sure to let us know.

Sounds like LDN could work for Restless Legs Syndrome. Are there any cases known of using it for this?
We are not aware of LDN being used for restless leg syndrome. If you try it and it does work, make sure to let us know.

I've heard that some fillers that are used are not great, what are the best ones that I can ask my pharmacy to use?
The best filler to use is dextrose as it has very rapid absorption. Some fillers may slow down absorption on the naltrexone and this could result in a less optimal effect.

Please discuss taking LDN and alcohol usage, wine, in particular. If wine is consumed at night, should LDN be taken in the morning?
LDN does not interact with alcohol in any negative way. Whilst naltrexone is used to treat alcohol craving, there is no problem taking LDN after alcohol. LDN can be taken in the night or in the day as desired.

If a person takes LDN for 2-4 months and then stops, will the newly-formed opioid receptors remain, or will they go back to pre-LDN levels?
The newly formed receptors will last a short time, probably days at most.

You wrote: "Individuals vary in their metabolic speed and this will result in inter-patient variation..." Can you comment further on the range of dose and dosing interval?
This is something that at present can only be determined through trial and error or trial and success. Most patients do well with a single daily dose of 4.5mg, however some patients require less, and others require more, sometimes even 2 pills a day. The dose range for beneficial effect is usually between 2.5mg and 10mg per day. There is no reason to take LDN at night if it interferes with sleep, it is as effective if taken during the day.

Is LDN effective for treating Rheumatoid Arthritis and have any studies been done. Are there any drugs or alternate therapies that should not be taken with it
Patients suffering from rheumatoid arthritis who have tried LDN have reported amelioration of symptoms, however as yet no trials have been carried out. LDN should not be combined with any opiate, in order to avoid temporary loss of the pain relieving effect of the opiate.

Is LDN effective for treating cancer?
Studies have demonstrated LDN’s effectiveness in treating cancer in animals. However, no trials using LDN in human cancers has yet been conducted. Although there have been anecdotal reports of LDN being beneficial for cancer patients, only clinical trials will be able to provide the true answer to this question. LDN’s beneficial effects are achieved through the “rebound effect” it causes (for details please see the explanatory section "How Does Low Dose Naltrexone Work?",) and the levels of OGF produced during the rebound effect are not necessarily sufficient to slow down or control growth of large tumors. For this reason, OGF is being investigated in clinical trials as a treatment for cancer. For details about OGF, please visit our OGF section.

Can LDN be combined with other medications?
The answer to this is not known with certainty. However there does not seem to be a reason why LDN should interact with any medications other than opiate-family or opiate-mimicking painkillers. In the clinical trials conducted to date, no problems have been seen when LDN was combined with other medications being taken by the studies’ participants.

What is the correct dose to use for LDN?
Since LDN works through a "rebound effect" (for details please see the explanatory section "How Does Low Dose Naltrexone Work?", its beneficial effects only begin taking place once the LDN has been metabolized and removed from the cells. Since metabolism varies between individuals, there is no single dose that will work for every person. Some people find that a daily dose as low as 2mg is effective, and others have found that they achieve greatest benefit using two doses of 4.5mg each day (12 hours apart). The clinical trials so far have used a single daily dose of 4.5mg and for most users this dose seems to be effective.

When is the best time in the day to take LDN?
The clinical trials conducted so far have not shown any difference in effect if LDN is taken at night or in the morning. Most users prefer to take it in the evening, however this does sometimes disturb sleep in some individuals, and for these people taking it in the morning is preferred.

Can LDN be combined with painkillers?
LDN should never be combined with opiate or opiate-like painkillers, as it could neutralize their pain-killing effect for several hours. There is no known reason why LDN cannot be combined with other types of painkillers such as NSAIDs or Tylenol and similar drugs.

fuente: http://www.ldnscience.org/low-dose-naltrexone-ldn/questions-and-answers

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