Editor-in-Chief: Alaa Abd-Elsayed, MD, PhD
BACKGROUND: Most patients with gadolinium deposition disease (GDD) report early onset of persistent neuropathic pain. No widely available or rapidly acting pain relief method has been reported.
CASE PRESENTATIONS: Five GDD patients without benefit from non-opioid pain relievers and with no history of opioid treatment received a clinical practice trial of open-label, low-dose naltrexone (LDN). Four had received intravenous Ca-DTPA chelation. Before starting LDN, patients rated their pain on a scale of 0 to 10. Patients rated the degree of pain relief weekly using the Global Clinical Impression – Improvement Scale. Pain was very much or much improved for 4 patients, starting during week 2 in one patient and week 4 in 3 patients. Pain relief began at naltrexone dose 3.0 to 4.5 mg per day and reached a maximum after 4 to 8 weeks.
CONCLUSION: These case results suggest that a well-designed, adequately powered, controlled trial of LDN in GDD patients is merited.
KEY WORDS: Case series, gadolinium, naltrexone, pain