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Low Dose Naltrexone (LDN): The German MS Study
The very first clinical trial of Low Dose Naltrexone (LDN) for multiple sclerosis (MS) was conducted by the Evers Neurological Clinic, Sundern, Germany, between 2004 and 2005.
A summary of the study results in English was prepared by Ms. Simone Gabbay, a professional translator, and appears below. What is not indicated in either summary is that a dosage of only 3 mg was employed (4.5 mg is now considered optimal), and it was given in the morning instead of between 9 pm and 3 am (as recommended by Dr. Bihari). The study therefore is flawed in terms of LDN administration time and dosage. Even so, definite benefit was observed in about a third of the study participants.
LDN means "Low Dose Naltrexone." In Germany, Naltrexone is licensed under the name Nemexin. It is a substance that has been known here for some time, and was synthesized as early as 1963 as a so-called opiate antagonist. Since 1984, it has been applied in detox therapy with opiate-dependent patients (heroin, morphine).
Naltrexone was first recommended by the New York neurologist Dr. Bihari in the treatment of multiple sclerosis.
In subsequent years, a large number of MS patients in the U.S. have used Low Dose Naltrexone and reported numerous positive effects, such as lessening of fatigue, and improvement of spasticity, bladder dysfunction, and sensibility dysfunction.
Until the year 2004, however, no controlled study had been carried out. It is possible that LDN might have an effect on the immune system. Whether this effect is immunosuppressive or immunostimulative remains to be determined. Until this question has been clarified, LDN cannot be recommended for Relapsing/Remitting MS. [It is now known that LDN upregulates the immune system toward normal function.]
In Germany, LDN was almost unknown in the treatment of MS until August 2004, after which some MS patients began using it here as well. In order to verify the often very positive and by now numerous reports, the first clinical pilot study on the effects of LDN in MS worldwide was conducted at the Evers Neurological Clinic between October of 2004 and April of 2005, with a total of 60 patients suffering from progressive MS (with an EDSS score equal to or greater than 5.0). The study was randomized, double-blind, and placebo-controlled.
Study results showed that 30% of the participants had significant improvements in the areas of mobility and spasticity, and a reduction in EDSS score of 0.5 points in only 5 days. For the total group of all participants taking the substance, however, there was no significant improvement, which could possibly be due to genetic variations in opiate receptor structures.
LDN, which is administered in singular daily doses, is well tolerated (only mild sleep disturbances and lowering of blood pressure manifested at the beginning of therapy).
It is currently administered as a symptomatic medication to a narrowly defined group of MS patients under clinical observation.
For additional information about this study, visit
For more information about LDN, visit on
How to Obtain Low Dose Naltrexone
Side Effects & Dosing of Low Dose Naltrexone
Drugs To Avoid When Taking Low Dose Naltrexone
Why I Became An Advocate For Low Dose Naltrexone
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