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6th World Congress on
Mental Health, Psychiatry and Wellbeing
March 20-21, 2019 | New York, USA
Low-dose naltrexone in
treating fibromyalgia
and major depressive
disorder
Jeeha Park, and Rachel Murphy
St. George’s University School
of Medicine, USA
L ow-dose naltrexone (LDN)
can modulate CNS microglial
cells and is being used as
an experimental treatment
to reduce inflammatory
autoimmune processes in a
number of diseases, including
fibromyalgia. Additionally, LDN
has been shown to demonstrate
antidepressant effects by
enhancing dopaminergic
signaling. This mechanism
suggests LDN as a possible
concurrent treatment of both
fibromyalgia and associated major
depressive disorder. Fibromyalgia
is considered a chronic disorder
of central nervous system pain
regulation. It is an inflammatory
rheumatic disease that presents
as widespread musculoskeletal
pain and stiffness. Fibromyalgia
does not have clear pathogenesis
and consequently does not have a
targeted treatment. Chronic pain
and major depressive disorder are
often diagnosed simultaneously;
40-60% of chronic pain patients
also have depression and require
concurrent treatment. There
is no direct cause-and-effect
relationship between chronic pain
and depression; however, two
illness share many biochemical,
physical and cognitive symptoms.
J.B. is a 32-year-old Caucasian
female with a past psychiatric
history of major depressive
disorder, generalized anxiety
disorder and panic attacks and
medical history of fibromyalgia
diagnosed in 2010. Patient has
recurring depressive episodes
with multiple etiologies including
problems with her family
and work and post-partum.
However, many of the depressive
episodes concurred with painful
symptoms of her fibromyalgia
and “dictated by the pain level.”
Patient’s fibromyalgia and major
depressive disorder did not
respond to duloxetine. There
was significant symptomatic
relief of both chronic pain and
depression with the initiation
of 6mg naltrexone. The patient
reported improvements in mood,
energy, and concentration from
suboptimal level. We discuss the
indications of this case and the
future possibility of using LDN as
a treatment option for patients
with concurrent fibromyalgia and
major depressive disorder.
INTERNATIONAL JOURNAL OF EMERGENCYMENTAL HEALTH AND HUMAN RESILIENCE 2019, VOLUME 21
DOI: 10.4172/1522-4821-C2-030
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