Talk:Low-dose naltrexone

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Proposed updates

I looked through recent reviews of LDN. The general consensus is that there isn't sufficient evidence to recommend it's use for any condition. In June, the lead reflected this consensus, but that's no longer the case.

In 2023, two decently-sized RCTs of LDN for fibromyalgia (Bruun, Bested) were published, which were negative. A smaller RCT in 2024 (Tsui) for people with HIV with heavy alcohol use and chronic pain was also negative. But I haven't seen a review incorporating them. A commentary accompanying Brunn is paywalled.

The lead can also be tightened due to redundancies, and the history I think should be either removed or moved to the body. The interview with the late Bernard Bihari was published in a fringe journal, and I think it needs to be better contextualized at the very least. If Bihari's claims are incorporated, they should be fact checked. The history of AIDS is replete with fake treatments. ScienceFlyer (talk) 21:49, 3 August 2024 (UTC)[reply]

Thanks for bringing those articles to attention! I was hoping that the commentary piece would be accessible via WP:TWL, but no such luck. This article currently references the protocol[1] that is used in the trial by Bruun et al, but it is probably best to exclude these newer trials from the article for the moment and wait for a review. If we would like to mention them now, we must be careful to do so with appropriate WP:WEIGHT, given that the reviews currently cited in the article conclude slight positive for conditions like fibromyalgia, and that there don't yet appear to be any reviews into the use of LDN for HIV/AIDS patients (?).

I agree that we can improve the lead to better reflect that efficacy has not been proven. Similarly, I fully support further contextualising Bernard Bihari's claim of pioneering the use of LDN - though I don't believe it to be inaccurate, I would like to see it better verified. The interview currently referenced in the article mentions a 1985-86 clinical trial, and while I wasn't able to find that directly, I did find this article from 1987[2] which similarly credits Bihari introducing LDN to AIDS patient care. However, neither of these sources are as high quality as I would like. Ethmostigmus 🌿 (talk | contribs) 02:35, 4 August 2024 (UTC)[reply]

The current lead is the result of a very brief liturature search. I didn't dive that deep into the subject when creating the lead and I think that's definetly reflected in it. The reason I included the bit about the history was to explain how naltrexone went from a drug used for alcohol use to it's current usage. I would however be fine if that bit was taken out, as long as the original use of naltrexone and the fact that it is off-label is kept in the lead. I would however say that there is a lot of research pointing towards LDN being effective. I actually struggled quite a bit to find large studies that didn't reflect this. That's obviously not to say it is 100% effective, just that avaible research is showing it to be useful. CursedWithTheAbilityToDoTheMath (talk) 04:05, 4 August 2024 (UTC)[reply]