DOSE:

4.5 mg

oral

Naltrexone

(daily)

BODY WEIGHT:

190 lb

In this report I will detail my experience taking 4.5 mg naltrexone (known as low-dose naltrexone) nightly for psychiatric purposes. First, the background information.

I have a diagnosis of bipolar 2 disorder and general anxiety disorder. Between the years 2008-2011 I abused various substances heavily, especially marijuana and benzodiazepines. I went to jail in 2012 and was released near the end of that year. After leaving jail my psychiatric symptoms worsened, though I was free from chemical dependency. I experienced mostly hypomanic symptoms with monthly/bimonthly “crashes” into depression. Furthermore I went through periods where I was unable to concentrate and experienced compulsive behavioral tics such as trichotillomania (pulling out my hair and chewing it). Anxiety became a major problem at school.

I saw a few neurologists and psychiatrists. I tried Lamictal, Zoloft, and Tegretol, all of which had adverse side effects and/or worsened my condition. A psychiatrist then decided to try low-dose naltrexone. I had to buy it from a special compounding pharmacy. It was 26$ for 30 pills (with insurance). The current theory behind low dose naltrexone’s mechanism of action is that it causes the brain to upregulate endorphin and enkephalin production. Naltrexone is a mu and kappa opioid receptor antagonist and at low doses it only partially covers the brain’s receptors. Sensing this, the brain upregulates endogenous opioid production. Recent research indicates a role of endorphins in mediating/modulating the immune system.

The first night I took one 4.5 mg pill. I did not experience any cognitive effects but did get a case of severe dry mouth. When I woke up the next day I felt better than usual. My overall mood was more positive in a subtle way. I also felt more clear-headed and in control of myself than usual. That night I took another pill. An hour later, I was brushing my teeth in the bathroom and had the shower running because I find that the sound triggers ASMR (autonomic sensory meridian response) – pleasurable tingling down my spine and on my scalp. This time, the ASMR was much more intense and pleasurable than usual. I believe this was the result of increased endorphin release because the brain’s maximum time of endorphin release (via the circadian rhythm) is in the late night and early morning. I still experienced bad dry mouth, but not as bad as the night before. I also experienced a very subtle, nagging craving for a cigarette (I used to smoke for 3 years and have quit for 2, except for very rare hookah use). That night I had a dream I was smoking marijuana. I had not had a using dream for over six months and I felt as though it was directly triggered by the pill. The next day I felt a greater sense of well being. I couldn’t help smiling on the walk to my classes. I felt as though I had an endorphin coat on my brain insulating it. I also still had a small nagging urge to get high.

I continued on low-dose naltrexone for a week. Over that time the dry mouth completely disappeared. I experienced a reduction in compulsive tics over the period. I felt happier, and more comfortable with my life. My ability to concentrate was also slightly increased. I also felt better physically; tendonitis/joint pain decreased noticeably. However, it did not help with social anxiety.

I ceased taking the medication because I was worried about the continued craving. I don’t know if it was the result of the increase in endorphins and if it was only temporary, or if it was a sort of nocebo effect. I may try to use it in the future.

Exp Year: 2014	ExpID: 103409
Gender: Male
Age at time of experience: 22
Published: Apr 12, 2016	Views: 5,802
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Naltrexone (338) : Alone (16), Depression (15), Medical Use (47)