Further Questions and Answers : Dr Bihari, MD

[Guest guest]

Further Questions and Answers

About LDN

LDN Homepage

Please Note:

Fundamental questions and answers concerning LDN can be found on the

LDN Homepage and on other pages of this website focused on specific

diseases such as cancer, HIV/AIDS, and MS.

This page contains other questions frequently asked, along with

corresponding answers.

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Can LDN be taken with other medications such as tranquilizers or

chemotherapy? How about interactions with alcohol or tobacco?

LDN can be taken along with any other medication or substance, so

long as it is not narcotic-containing. Naltrexone is a pure opioid

antagonist and it will block the action of narcotics. Some examples

of narcotic-containing drugs are Ultram, morphine, Percocet,

Duragesic patch and any codeine-containing medication.

Can LDN be taken along with any of the standard medications for

multiple sclerosis?

It can, and many people with MS do this. However, all of the standard

MS drugs, with the probable exception of Copaxone, are

immunosuppressant and thus tend to oppose the beneficial immune

system upregulation induced by LDN. Therefore, many people with MS

try to wean themselves away from these other medications when they

find that they are doing well on LDN.

What is the best dosage of LDN to begin treatment with?

For an adult who is not significantly below the normal weight range,

the optimal dose of LDN is 4.5mg, taken each night at bedtime; i.e.,

between 9pm and 3am. One can begin at this dose level. If one were to

develop persistent sleep disturbance (i.e., a sleep disurbance

lasting longer than 10 to 14 days) after starting LDN, which occurs

in less than 2% of users, then the dose may be decreased to 3mg or

2mg.

If I have to work on a night shift, for example from midnight to

8a.m., at what time should I take my LDN?

Continue to take LDN as recommended above; i.e., between 9pm and 3am.

This relates to the fact that the endorphins for each day are always

produced in the pre-dawn hours, regardless of the hours when one is

awake or sleeping.

If LDN is so wonderful, why isn't it FDA-approved or reported in one

of the respected medical journals?

Although the Food and Drug Administration approved naltrexone at the

50mg dosage in 1984, " low dose naltrexone " ( LDN ) in the 4.5mg

dosage has not yet been submitted for approval because the

prospective clinical trials that are required for FDA approval need

to be funded at the cost of tens of millions of dollars. In the

absence of such a current scientific clinical trial, medical journals

tend not to be interested in " anecdotal " reports of therapeutic

successes.

Can you supply me with the names of physicians in my town who

prescribe LDN?

Sorry, we have no such lists of physicians. But any physician may

ethically and legally prescribe LDN as an off-label prescription. If

you are very interested in starting LDN, and you are absolutely

unable to find any local doctor who will prescribe it for you—even

though you have shown them information from the website and made it

clear to them that LDN is compatible with any other medicine (except

narcotics) and that it has no toxicity and no significant side

effects—then you may want to set up a consultation with LDN's

discoverer, Bernard Bihari, MD. Such consultations are done either by

a visit to his office or through a very prolonged telephone

interview. His office telephone number in New York City is 212-929-

4196.

Can I have my LDN prescription filled at any pharmacy?

Low dose naltrexone prescriptions are generally filled at a

compounding pharmacy. The druggist uses either generic naltrexone

50mg tablets or bulk naltrexone powder to prepare the LDN capsules.

Because there have been occasional reports from patients of a poor

quality product coming from scattered pharmacies, we feature the

names of several pharmacies on the website that have shown themselves

reliable and experienced in correct LDN preparation. (Please note:

Under no circumstances should you accept a preparation of " long-

acting " or " slow release " naltrexone.)

I have HIV/AIDS complicated by lipodystrophy. What can I expect from

starting low dose naltrexone? Could I actually see a reversal in my

condition? How long would it take?

Of those people with HIV/AIDS who already have lipodystrophy, the

majority who begin taking nightly LDN experience a gradual reversal

of the signs of lipodystrophy. Although this may occur swiftly in a

few, in most people it has taken the better part of a year. Very,

very rarely do we hear of a non-responder—so rarely that we have to

doubt the legitimacy of their LDN supply.