Date of Award

Spring 5-2025

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Metzger, Jay

Keywords

LDN, low-dose-naltrexone, pregabalin, gabapentin, and fibromyalgia

Abstract

Fibromyalgia is a chronic pain disorder and often a diagnosis of exclusion characterized by widespread non-specific pain, fatigue, and cognitive dysfunction. Despite fibromyalgia’s significant prevalence, optimal clinical management remains uncertain because of its uncertain pathophysiology. This literature review evaluates the efficacy, safety, and tolerability of low-dose naltrexone (LDN) compared to gabapentinoids, including gabapentin and pregabalin, in the management of fibromyalgia symptoms. A literature review of studies published between 2005 and 2024 was conducted using PubMed's electronic search base. Specific keywords included LDN, low-dose-naltrexone, fibromyalgia, pregabalin, and gabapentin. Specific criteria were set to include all clinical trials and randomized controlled trials and articles including duloxetine, neuropathy, adolescence, and depression were specifically excluded. Pilot studies on LDN highlighted its potential anti-inflammatory benefits and its ability to reduce pain severity and improve quality of life, with minimal side effects reported. Conversely, gabapentinoids demonstrated a dose-dependent efficacy in pain reduction and improved sleep quality. However, they were also associated with notable adverse effects, including dizziness and sedation, which may limit their tolerability. Both treatments showed limited efficacy in addressing fatigue and depressive symptoms. The findings underscore the need for more extensive, long-term research to confirm the therapeutic potential of LDN and refine the clinical use of gabapentinoids in fibromyalgia management.

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