Opioids ULD naltrexone question

[polarthedog]

I’m supposed to see an addiction doctor this week, and I’ve seen your guys post so about low dose naltrexone, and i’d Like to try mixing it with my buprenorphine to prevent and lower tolerance, and for my depression.

So my question, do doctors in the USA prescribe ultra low dose naltrexone? Like a mg or less?

The only formulation ive heard of available in America is 50 mg tablets, that’s around a years worth apparently according to some people’s dosages I’ve read

 

[negrogesic]

Aside from the standard therapeutic high dose naltrexone, they mostly prescribe low dose naltrexone, most commonly in the 4.5mg range. I'm sure some brighter and more innovative physicians write prescriptions for ultra low doses but this is less common. Both have to be compounded.

I made mine myself, by diluting a 50mg tablet in 5000ml of mostly water (with some added preservatives/stabilizers) to create a 10ug/ml solution of naltrexone. Seems like it might be doing something, not sure. I feel like I'm plagued with the reverse of the placebo effect, whereby my hyperawareness that such an effect exists makes me discount things that are actually happening as placebo. If what is happening is real then it does seem to have an antidepressant effect. As my mind feels clearer. It also feels stimulating. The most clear effect in fact is insomnia if taken before bed. That property I feel was definitely not placebo but clearly induced by the naltrexone. I feel no change in craving for alcohol or opioids, which cannot be expected at these doses. Ultra low dose naltrexone doesn't block opioid receptors but seems to upregulate them a bit.

Not sure how well it works for opioid tolerance personally, not taking it for that. Given the nature of how buprenorphine works (partial agonism) my guess is that it won't have the same tolerance lowering effects. Couldn't hurt. At least not as far as i know.

 

[polarthedog]

Ultra low dose naltrexone doesn't block opioid receptors but seems to upregulate them a bit.

Not sure how well it works for opioid tolerance personally, not taking it for that. Given the nature of how buprenorphine works (partial agonism) my guess is that it won't have the same tolerance lowering effects. Couldn't hurt. At least not as far as i know.

No I mean I want to take the naltrexone to lower my bupe tolerance

 

[Lil'LinaptkSix]

No I mean I want to take the naltrexone to lower my bupe tolerance

Given the nature of how buprenorphine works (partial agonism) my guess is that it won't have the same tolerance lowering effects

 

[plumbus-nine]

Naltrexone turns into an inverse agonist once you have acquired mu opioid tolerance which is inevitably the case when taking agonists. As far as I know should ULN work same for bupe as it does for full agonists because the amount is too small to work through displacing the agonist and this would also mean powerful precipitated withdrawal like it is seen with normal, high doses of naltrexone. It blows my mind actually that people tolerate 50mg when just a few little mg if naloxone gave me a hour of solid agony even without opioid tolerance, I was just on memantine (which by itself reverses tolerance to opioids btw).

I have read mixed reviews about ULN, some say it works, other get little benefits. Makes sense that it feels stimulating somehow. Guess you need to carefully titrate your dose.