Sharafaddinzadeh 2010: low-dose naltrexone did not improve MS quality of life

What they tested

People with relapsing-remitting or secondary progressive multiple sclerosis (MS), two common forms of the disease, were randomly assigned to low-dose naltrexone (LDN) or a placebo (dummy pill). Neither they nor the researchers knew who had which.

Quality of life was measured with an MS-specific questionnaire (MSQoL-54). The main comparison was physical and mental health scores between groups in the middle and at the end of the study.

What they found

None of the measured areas, including pain, energy, emotional well-being, social and cognitive function, sexual function, role limits from physical or emotional problems, health distress or overall quality of life, differed meaningfully between the groups.

Health perception scores did differ between groups, but they already differed before treatment started, as well as in the middle and at the end.

The authors described LDN as relatively safe in these forms of MS but wrote that its efficacy is under question, and that a longer trial is probably needed.

Limits

• The abstract doesn't report the dose used or any side-effect numbers behind the authors' description of LDN as relatively safe.
• It lasted 17 weeks, which the authors suggested may be too short.
• The groups already differed on health perception at the start, which complicates comparisons on that measure.

What it means if you're considering naltrexone

Low-dose naltrexone is a different use from the 50 mg tablet used for alcohol or opioids. This trial is one of the reasons the evidence for LDN in MS is described as mixed: it found no meaningful quality-of-life benefit.

Another small trial the same year found better mental-health scores on LDN, so neither result settles the question.