Low Dose Naltrexone and Parkinson's Disease II: Side Effects

LDN Revisited - Information for Any Patient Considering LDN as a Treatment
Just a brief update about Low Dose Naltrexone side effects, expectations and caveats. Our original article appeared on May 31, 2009. A follow up article was posted on June 19, 2009.

There can certainly be side effects. If your are already taking a medication containing an opiate, LDN is not for you.

If you have MS, you may find that your symptoms seem to worsen during the first month. A darkest before dawn result. To counteract that you might want to ease up to the dose recommended by your doctor even though it is already a low dosage but consult your physician first.

A recent site for LDN use for Multiple Sclerosis is a good read for anyone considering taking this medication. The site is Friends with MS. They do list side effects they have observed. Keep in mind that there could be interactions with MS meds causing the symptoms or brain chemistry particular to MS. The general report is of positive results using LDN.

Another helpful site is specifically Side Effects of Low Dose Naltrexone. In it the author points out that daytime naps can be helpful and healthful.

We would also suggest a look at the Mayo Clinic website on LDN possible side effects.

It is not unusual for patients to feel tired and yet there may be some sleeping issues. Feeling nervous, restless or anxious are more common symptoms. There may be a variety of digestive tract issues such as nausea, stomach cramps, constipation, diarrhea. Another area of discomfort can come from headaches, sinus issues, loss of appetite or weight gain, increased blood pressure, rapid pulse, irritability and thirst. On rare occasions there can be a skin rash and itching, blurred vision, frequent urination (several patients found the reverse) as well as fever, disorientation, mood changes, hallucinations, tinnitus, and chest pain.

Frankly, read the side effects from whatever you take now. You'll find most of the above listed there as well. What we have read is that most patients don't seem to experience many if any side effects. LDN is something to consider in the PD treatment arsenal.

Although the Parkinson's LDN database at LDN World Database is small, it will provide some helpful information. If you are using LDN for PD or know someone who is, it would be a great idea to make your addition to the database.

addendum: 6/27/11
If you do use LDN, it is important to wear a Medical Alert Bracelet with that information: Low Dose Naltrexone 4.5mg.
In the event of a bad fall or injury, narcotic painkillers might be administered. Your suffering will be 10x the suffering because of the reaction your LDN body will have to the narcotic.
There are a few companies which offer dog tags, pendants, wallet cards, bracelets and the like. It is important that the information be on the tag itself.

addendum: 9/27/11
Clinical Trial NCT01052831 is enrolling now for the study of LDN, Low Dose Naltrexone for Impulse Control Disorders (ICDs) in Parkinson's disease.

addenda: 4/02/12

See an informative 10 minute video taken at the Parkinsons Recovery Summit posted in the blog, About Parkinson's Disease blog of Robert Rodgers, PhD. The speaker is a woman with PD who is now taking LDN on a regular basis.

The LDN Science website

Cogane, a Future Treatment with Hope for a Parkinson's Disease Cure

Cogane Hold Promise for PD, Alzheimer's, ALS, Neuro-Motor and Psychiatric Disoders

It's taken awhile to get this article ready so our apologies to Ken and Hen.

According to Phytopharm, Cogane also known within the company as PYM50028, is a non-peptide orally bioavailable neurotropic factor inducer that crosses the blood-brain barrier. Cogane stimulates the release of neuronal growth factors and increases neurite outgrowth by elevating the levels of GDNF, glial derived neurotrophic factors. Cogane also increases the levels BDNF, brain derived neurotropic factor. Neurotrophic factors can aid the survival of neurons.

GDNF is a protein which has been encoded by the GDNF gene. In its recombitant form it has been shown to promote the survival of dopamine neurons for PD and motorneurons for ALS. GDNF also promotes the survival of serotoninergic and catecholamingeric neurons. The catecholamingeric neurons control a variety of cognitive, motor and endocrine functions. They are associated with many psychiatric and neurodegenerative disorders.

The hope for Cogane is that it lives up to its neuroprotective and neurorestorative potential with safety of use which means that while it might be not only a treatment as a PD progression reducer or even progression reversal, it might also be a cure. It may also become a treatment for Alzheimer's disease.

The largest problem with bringing Cogane to the market is the enormous amounts of money that are needed to bring a drug through the requisite trials and application processes. Phytopharm has done a restructuring to reduce costs and to extend its available cash to September 2010. They are also considering other options and are also seeking grant funding. The Michael J Fox Foundation awarded a $1.16 million grant towards the dosage trials.  The phase 1 trials has been completed and phase 1b is currently recruiting. The Cure Parkinson's Trust partly funded the latest phase and has since committed to ongoing support to develop Cogane.

One important thing to note is that Phytopharm is not the only company working on the GDNF approach to treating Parkinson's disease. During the next few weeks we will provide information of the status of other GDNF research and development as well as clinical trials.

Good news for Phytopharm is that in March the stock tracking of PYM on London Stock Market was 4.25p Footse (down 3 days later to 4.13p) back again to 4.25p by 3/27/09. As of this morning, PYM was at 6.88p (up 1.93) Results of the Phase 1b trial are expected in the last quarter of 2009 and then Phytopharm can move on to Phase II.

Addendum - June 2010
Phase 1b has been completed and Phytopharm recently announced that they have received FDA protocol approval to begin Phase II clinical trials for Cogane.  Enrollment will begin in late 2010.  We'll be posting that information and links to enrollment when it is announced.

You can read the Phytopharm press release here