What is Naltrexone? Naltrexone is an FDA approved medication that is used in high doses (50-100mg) to help with drug abuse. It blocks the opioid system of the body, so that someone who is trying to stop using narcotics who takes LDN, won’t get ‘high’ from them. And thus they are less likely to relapse. LDN is a completely different thing than regular dose naltrexone. LDN is LOW DOSE naltrexone. Typically 4.5mg, but some people respond to doses as low as 0.5mg. This is why LDN is completely unlike most medications. LDN works in a way that is unlike other drugs. With most drugs, the medication itself is meant to have some therapeutic or symptom blocking effect. Relative the incredible complexity and intelligence in your body-mind system, medications are fairly crude, and inaccurate. LDN is the opposite. LDN creates a temporary blockade of your body’s opioid system. As a result, your body-mind system boosts the its own natural opioid production and sensitivity. Your body’s response to LDN is what creates the therapeutic effect. And here’s the good news: Your body’s own response is much more intelligent than anything a drug can do. Because your body knows itself. It’s uniqueness. It’s complexity. This is part of why LDN often helps many people when conventional medicine fails. What are the benefits of LDN? There are two main effects of the body’s opioid boosting response to LDN. And there are other benefits as well. One is better pain control. LDN triggers the body to enhance its own natural pain blocking chemistry. Some people have life-changing improvements in pain from fibromyalgia, arthritis, neuropathy, spinal cord injury, auto-immune disease, post-surgical pain, trauma, etc. A second major benefit is modulation of inflammation. LDN has been shown to reduce the levels of chemicals called cytokines that drive inflammation. For that reason, many people get benefit if they have auto-immune diseases like Crohn’s disease, multiple sclerosis, rheumatoid arthritis, anklylosing spondylitis, psoriasis, psoriatic arthritis, chronic immune neuropathy, HIV, Ulcerative Colitis, hypothyroidism from Hashimotos thyroiditis, and so on. Much suffering from chronic pain and illness is due to low-grade inflammation. We’re understanding now that many chronic pain syndromes have an inflammatory component. This is relevant to chronic spinal cord injury, fibromyalgia, neuropathy, brain injury, CRPS, pinched nerves, and so on. Inflammation is also known to contribute to all the degenerative diseases that plague modern society including Parkinson’s disease, Alzheimers, cardiovascular disease, diabetes, thyroid disease, etc. LDN is often helpful in these conditions. What is LDN used for? As discussed above, LDN seems to help people with a variety of issues, especially problems with pain and low-grade inflammation. There is broad experience in the international community of doctors who try to help people for whom conventional medical approaches are limited or ineffective. Benefits have been reported with the following conditions: Auto-immune diseases: Ankylosing Spondylitis, Behcet’s Disease, Celiac Disease, Chronic Fatigue Syndrome, CREST syndrome, Crohn’s Disease, Dermatomyositis, Dystonia, Endometriosis, Fibromyalgia, Hashimoto’s Thyroiditis, Irritable Bowel Syndrome (IBS), Myasthenia Gravis (MG), Nephrotic Syndrome, Pemphigoid, Primary Biliary Cirrhosis, Psoriasis, Rheumatoid Arthritis, Sarcoidosis, Scleroderma, Sjogren’s Syndrome, Stiff Person Syndrome (SPS), Systemic Lupus (SLE), Ulcerative Colitis, Wegener’s Granulomatosis. Chronic or Degenerative Illnesses: ALS (Lou Gehrig’s Disease), Alzheimer’s Disease, Autism Spectrum Disorders, Hereditary Spastic Paraparesis, Multiple Sclerosis (MS), Parkinson’s Disease, Post-Polio Syndrome, Post-Traumatic Stress Disorder (PTSD) ⇒, Primary Lateral Sclerosis (PLS), Progressive Supranuclear Palsy, Transverse Myelitis. Other diseases: Emphysema (COPD), Interstitial Lung Disease, Pulmonary Fibrosis, HIV/AIDS, Depression (Major; and Bipolar), Lyme Disease (LATE Stage).

If you are interested in trying LDN in New York, Connecticut, Rhode Island, New Jersey, or Israel, please click here to schedule an appointment.  Check with the office if you’re in another state.

What are the potential side effects of LDN? Remember that is an extremely low dose of medication. It’s opioid blocking effects last for a few hours. The rare side effects typically happen during or shortly after once-daily dosing. There are no large-scale long-term studies of LDN because it’s an off-label use of a generic medication and there is no financial incentive to pay the $millions it costs do do those studies.  There is lots of collective clinical experience, though.  The most common side effects are mild headache, vivid dreams, and a jittery/energized feeling. These go away if LDN is stopped. It is usually taken at night before bed, and this can contribute to the sleep disturbance and dreams. The insomnia and vivid dreams typically resolve when the medication is taken in the morning. Some people can have increased pain or overall feeling of malaise.. This usually responds to dose reduction. Some people are very sensitive and thus use a lower dose effectively. Is LDN an opioid or narcotic? No. It’s an opioid blocker. It doesn’t cross-react with allergies to opioids like codeine, morpheine, oxycodone, etc. It is important to note that use of LDN is not compatible with opioids (morpheine, oxycodone, percocet, tramadol, hydromorphone, fentanyl, etc). It is unlikely to cause a dangerous complication when used together, but neither medication will be effective. How do I get a prescription? First step is to set up an appointment on the convenient online scheduler by clicking here. Dr Shiller can prescribe for people in New York, New Jersey, Connecticut, Rhode Island, and Israel.  Other states coming soon, so if your state is not listed, please click here to contact the office now to get notified of when he can prescribe in  your state. You will receive a brief health questionnaire and medication record and fill it out and return it to the office. The doctor will review the form and confirm that there are no contra-indications to using LDN. If everything is good, you pay in advance and meet with Dr Shiller either in person or by secure video link, which we will provide you. During the visit, Dr Shiller will discuss your health issues and goals. Together you will clarify whether LDN is appropriate, determine the starting dose, and make sure you know how to use LDN. He then provides a prescription that you send to an appropriate compounding pharmacy, or sends it electronically for you. You pay the pharmacy and they send you the medication. Can I get LDN at any pharmacy? No. LDN is specially compounded. Dr Shiller has a list of a number of reliable providers both in the US and Israel. How much does it cost? The initial consultation with Dr Shiller is typically 20-25 minutes and cost $99 or NIS350 (not including medication cost). That includes an initial prescription for a two-month supply that will enable you to find the right dose, as well as 1-2 emails with the doctor during that time to address questions about dosing or effects. Once the correct dose is determined, you will receive an additional prescription for a 4 month supply at the correct dose. Subsequent visits for subscription renewal last 15 minutes and cost $69 or NIS250 (not including medication cost) for six month prescription. If there are more complex questions or followup issues, you can contact the office for a virtual or office followup, and they are billed according to time required. The cost of the medication itself depends on the pharmacy and dose. Estimated pharmacy cost for the initial two month prescription is roughly $80 or NIS400. Once the correct dose is determined, the subsequent cost is typically around $40 or NIS100 per month for the medication. It will cost less if you get a three month or six month supply. If you are interested in trying LDN, please click the button.

On the scheduler, make sure you scroll down and choose “LDN…” for the visit type.