BACKGROUND: Persistent neuropathic pain (NP) is a prevalent and debilitating problem, often resistant to first-line treatment. Low-dose naltrexone (LDN) has shown promise in treating fibromyalgia and other forms of chronic pain.

CASE REPORT: Retrospective analysis was performed on 14 of 18 patients with diverse forms of NP who met inclusion criteria by using LDN (1.5-4.5 mg) as a second-line medical pain therapy. Pain Numeric Rating Scale (NRS-11) in all patients decreased from 6.29 ± 2.20 to 3.71 ± 2.89 (P = 0.001) from initiation to final visit. Median treatment length was 252 days with longest being 1,054 days. All 6 patients who remained on LDN > 1 year reported reduced pain NRS-11 at last visit. Side effects were mild and did not result in cessation of therapy.

CONCLUSIONS: LDN may show promise in treating persistent NP.

KEYWORDS: Case series, chronic pain syndrome, naltrexone, neuropathic pain