Therapeutics · Emerging Therapies
RRM Academy Synopsis
NaProTechnology uses low dose naltrexone for endorphin deficiency
The presentation describes low dose naltrexone as a treatment for clinical endorphin deficiency. The 2013 talk reviews earlier studies and then presents case reports of women with infertility or repeated miscarriage who went on to conceive.
Key Findings
- A cited study of 66 women with hypothalamic ovarian failure on naltrexone reported cycle normalization in 49 women and 18 pregnancies.
- A cited double-blind, placebo-controlled crossover study of 20 women with premenstrual syndrome found mean Menstrual Distress Questionnaire scores dropped 28 points on naltrexone (P = .016).
- A cited 2011 randomized placebo-controlled trial treated 40 patients with moderate to severe Crohn's disease for 12 weeks. Low dose naltrexone gave 88% clinical response against 40% on placebo (P = 0.009).
- The presenter states that clinical experience with low dose naltrexone, used since 2004, includes an 80% response in premenstrual syndrome and over 200 pregnancies with naltrexone.
- One case describes two healthy births, in June 2009 and May 2011, after five years of infertility and three previous failed IVF attempts, with treatment that included low dose naltrexone.
Interpretation
The source is a conference talk of 132 slides, given in August 2013. The talk joins a review of earlier studies to case reports. The presenter reports that no published work covers low dose naltrexone in infertility, miscarriage, premenstrual syndrome or pregnancy. The International Institute for Restorative Reproductive Medicine announced plans for a trial. Published reproductive studies exist for high dose naltrexone, and the talk reviews four infertility papers. The placebo-controlled trial of the low dose studied Crohn's disease.
RRM Context
NaProTechnology evaluation looks for the cause of infertility in both partners. The talk lists endorphin deficiency among its possible diagnoses, beside hormonal, ultrasound, surgical and immune findings. In the first case, the couple's evaluation found endometriosis in the woman and a sperm disorder in the man, along with other diagnoses, and each received its own treatment. Three failed IVF attempts preceded that evaluation.
Abstract
Naltrexone hydrochloride is a licensed drug with a growing number of novel uses. Nothing has been published on low dose naltrexone for infertility, miscarriage, PMS, or pregnancy, but there is published literature on high dose naltrexone. First synthesised in the 1960s and licensed in the USA in 1985 and Ireland in 1991, naltrexone at 50-150mg per dose is used as adjunctive treatment of opioid dependence and now alcohol dependence (unlicensed). It works through competitive inhibition of opioid receptors in both the central and peripheral nervous system.
