A Study on Naltrexone

Discussion in 'Research News' started by daedalus, Nov 6, 2012.

tinnitus forum
    1. daedalus

      daedalus Member

      Location:
      Brussels
      Tinnitus Since:
      04/2007
      Subjects and methods: 86 patients received the drug treatment, while 30 patients received no treatment. Results: Overall tinnitus distress was significantly reduced for the drug treatment group, while for the waiting control group this was not the case. No significant effect could be obtained for tinnitus intensity. A closer look at the data indicates that this effect is mainly generated due to a significant difference in the 50 mg drug treatment group for tinnitus distress. Conclusion: our results indicate that naltrexone might have an effect on tinnitus distress

      http://www.ncbi.nlm.nih.gov/pubmed/23110786
       
      • Informative Informative x 1
    2. RaZaH
      Not amused

      RaZaH Member Benefactor Team Tech

      Location:
      Reykjavík, Iceland
      Tinnitus Since:
      2012/04
      Cause of Tinnitus:
      Benzo + loud noise
    3. Robb
      Question it

      Robb Member Benefactor

      Location:
      Germany
      Tinnitus Since:
      09/2013
      Hmm interesting; study results look not too bad..
       
    4. James White
      Anime

      James White Member Benefactor

      Location:
      Toulouse, France
      Tinnitus Since:
      April 2013
      Cause of Tinnitus:
      Maybe loud music. Not sure.
      The tinnitus duration in those patients in which tinnitus remitted completely ranged between 3 months and 9 years.
      Interesting, i guess this may be easier to get than Retigabine
       
    5. Zimichael

      Zimichael Member Benefactor

      Location:
      N. California
      Tinnitus Since:
      (1956) > 1980 > 2006 > 2012 > (2015)
      Cause of Tinnitus:
      Ac. Trauma & Ac.Trauma + Meds.
      Mmmmmmm...Naltrexone is supposedly an opiod antagonist, yet Tramadol (another pain med - which I tried for mood enhancement, not really T) is a mild opiod agonist! How they hell that works is beyond me. Both opiod related pain killers but inverse action...or summat???
      Anyway, if anyone has experience with Naltrexone please share. Not much came up on a TT search, yet I think I have heard it mentioned before, somewhere.

      Best, Zimichael
       
    6. rtwombly
      Bookworm

      rtwombly Member

      Location:
      Southeast USA
      Tinnitus Since:
      01/2014
      Cause of Tinnitus:
      Unknown
      @Zimichael I think it was mentioned in a paper I read about possible off-label prescriptions for tinnitus. Maybe you read the same one.
       
    7. jazz
      No Mood

      jazz Member Benefactor

      Location:
      US
      Tinnitus Since:
      8/2012
      Cause of Tinnitus:
      eardrum rupture from virus; barotrauma from ETD
      The drug is used to treat addiction, especially to alcohol, like Acamprosate. (The latter was also tested on tinnitus.) Naltrexone helps with addiction by affecting dopamine. And dopamine pathways are implicated in tinnitus. But note Naltrexone helps with tinnitus distress, not volume. However, it is possible that by favorably affecting mood, you will be able to habituate. Some people do habituate to loud tinnitus, though most people--myself included--believe this must be very difficult.

      Med Hypotheses. 2005;65(2):349-52.

      Tinnitus dopaminergic pathway. Ear noises treatment by dopamine modulation.
      Lopez-Gonzalez MA1, Esteban-Ortega F.

      Abstract

      To date, the neurophysiological model has been used to explain the complexity of tinnitus. However from now on, the tinnitus dopaminergic pathway opens new horizons for ear noises management. Tinnitus perception takes place in prefrontal, primary temporal and temporo-parietal associative areas, as well as the limbic system. Dopaminergic neurotransmitters go through prefrontal, primary temporal, temporo-parietal associative areas and the limbic system. Tinnitus perception and dopaminergic pathway share the same cerebral structures, which control attention, stress, emotions, learning, memory and motivated behavior. Distress of tinnitus emanates from these same cerebral functions. The dopaminergic pathway can be modulated by agonists and antagonists of their receptors and can reduce the perception of tinnitus, such as sulpiride, amisulpride, olanzapine, quetiapine, ziprasidone, zuclopenthixole and aripiprazole, still under investigation, that together with sound treatment as the Sequential Sound Therapy, and a personal contact with the patient, constitute a tinnitus integral treatment.​

      Sulpiride also affects dopamine and, taken with melatonin, has been studied as favorably reducing tinnitus perception:

      J Otolaryngol. 2007 Aug;36(4):213-9.

      Sulpiride and melatonin decrease tinnitus perception modulating the auditolimbic dopaminergic pathway.
      Lopez-Gonzalez MA1, Santiago AM, Esteban-Ortega F.

      OBJECTIVES:
      Sulpiride and melatonin decrease dopamine activity. Sulpiride, a D2 antagonist of dopamine receptors, and melatonin, a pineal substance with antidopaminergic action, are administered to tinnitus patients to decrease tinnitus perception.

      DESIGN:
      A prospective, randomized, double-blinded, placebo-controlled study was done.

      SETTING:
      General otorhinolaryngologic consultation for 2002-2004 in Seville, Spain.

      METHODS:
      One hundred twenty patients consulted for subjective tinnitus. They were included randomly in four groups of 30. One group took sulpiride (50 mg/8 h) alone, the second group took melatonin (3 mg/24 h), the third group took the same doses of sulpiride (50 mg/8 h) plus melatonin (3 mg/24 h), and the fourth group took placebo (lactose 50 mg/8 h), all for 1 month. Ninety-nine patients completed the study.

      MAIN OUTCOME MEASURES:
      Clinical history, tonal audiometry, tympanometry, and tinnitometry were done at the beginning and end of the study. Subjective grading of tinnitus perception and a visual analogue scale (0-10) were done for evaluation of results.

      RESULTS:
      Based on the subjective grading, tinnitus perception diminished by 56% in patients treated with sulpiride, by 40% in patients treated with melatonin, by 81% in patients treated with sulpiride plus melatonin, and by 22% in patients treated with placebo. Based on the visual analogue scale, tinnitus perception diminished from 7.7 to 6.3 in patients treated with sulpiride, to 6.5 in those treated with melatonin, to 4.8 in patients treated with sulpiride plus melatonin, and to 7.0 in those treated with placebo.

      CONCLUSIONS:
      Sulpiride and melatonin reduce tinnitus perception, decreasing dopamine activity. The tinnitus auditolimbic dopaminergic pathway has broad therapeutic implications. [emphasis added]
      Some people my also find this article interesting, but it does not refer to tinnitus. However, the article does refer to chronic pain:

      Pleasure in the brain is primarily mediated through the neurotransmitter dopamine. Neurons in the ventral tegmental area (the starting post for those dopamine tracts I talked about a few days ago) respond to sex, drugs, rock n' roll, food, and communicate with some other neurons in the nucleus accumbens, and a third neural network in the amygdala and the ventromedial prefrontal cortex. These are all segments of the "medial dopamine tracts" I reviewed at some length a few days ago. It may be of interest that those of you who derive pleasure from other people's pain (schadenfreude) experience your mischievous pleasure here as well.

      Pain is experienced in the aptly named "cortical pain network," which are regions of the brain a little separated from the pleasure centers. The different areas of the pain network collect sensory pain (such as a splinter in one's finger) and emotional pain. Typically, experiments used to isolate pain circuitry in the brain involve "aversive stimuli" such as electric shock.

      So it turns out that social pleasure and pain have hijacked these evolutionary circuits of pleasure and pain, so that if you score a date with that hot chick and share a high five with your frat brothers, or you get arrested for that meth lab you are running in the basement of the chemistry building at school, you will experience the pleasure and pain in the same areas of the brain that you experience sex and electric shock. It hurts to be human, sometimes. If you feel that you are fairly treated and are feeling cooperative, your pleasure centers are stimulated. If you grieve the loss of a loved one, your cortical pain network lights up.

      And what about opiates or wheat exorphins or binge eating? Turns out those activities stimulate the dopamine reward centers of the nucleus accumbens. That new weight loss drug is a combination of two older drugs, naltrexone and buproprion (wellbutrin). Naltrexone is a straight-up opiate blocker. It is FDA-approved to reduce cravings for alcohol, but to be honest I use it more often for people trying to kick an oxycodone or heroin habit. You have to be off opiates for a couple weeks or risk an exceedingly uncomfortable precipitated withdrawal, and once you are on naltrexone, your opiate tolerance will drop like a rock, so if you go back to using like you used to, you could easily overdose. But naltrexone isn't a controlled substance, and if you take your medicine as prescribed and try to use opiate drugs on top of it, those drugs won't work. There's nothing like a pharmacologic lock on the opiate system to help out an opiate addict. Naltrexone has been studied in binge eating and in gambling, and for some people, it seems to help. I've used it on a couple of occasions for sleep eating with extreme carb (grain) cravings with some success, also in patients with celiac who can't seem to kick the wheat habit. Naltrexone use requires monitoring of the liver, and typical side effects include upset stomach. But both of those are less noxious than a heroin habit in my opinion, but every case is different and risks and benefits must be discussed for each situation. [emphases added]​

      For further reading on naltrexone and dopamine--specifically as applied to alcoholism--please see this article:
      References:


       
      • Informative Informative x 4
    8. Rube
      Fine

      Rube Member Benefactor

      Location:
      U.S.A
      Tinnitus Since:
      7/2014
      So if I take 3mg melatonin daily I might see some decrease in t perception? This might make sense as I was taking melatonin nightly and stopped last week and since then have felt my t to be more noticeable and more instances of fleeting t. I'm going to go back on it and see what happens.
       
    9. Zimichael

      Zimichael Member Benefactor

      Location:
      N. California
      Tinnitus Since:
      (1956) > 1980 > 2006 > 2012 > (2015)
      Cause of Tinnitus:
      Ac. Trauma & Ac.Trauma + Meds.
      Geez @jazz you sure do come up with "definitive" research in stunning fashion. Great stuff above, cutting to the chase of once again, how complex and involved tinnitus is. Changing my 'perception' of T is not that much of a warm and fuzzy as finding something that would 'stop it'. Not sure my perception could change much more at current volume and reactivity, except if totally out of it c/o 3 or 4 glasses of wine, etc. No prescription needed.

      Oh well...Back to the drawing board. Zimichael
       
      • Agree Agree x 1
    10. jazz
      No Mood

      jazz Member Benefactor

      Location:
      US
      Tinnitus Since:
      8/2012
      Cause of Tinnitus:
      eardrum rupture from virus; barotrauma from ETD
      @Rube Yes, I think it helps. NAC helps too. I'm not sure how long you've had tinnitus. These supplements might be most effective early on. That said, I've taken melatonin nightly and it does help me sleep, and, I believe, helps with my tinnitus the next day. I've found both supplements (melatonin and NAC) useful. Neither has eliminated my tinnitus, but both have helped turned down the volume. (I just wish they were a cure!)

      @Zimichael Actually, alcohol either attenuates or exacerbates tinnitus. Unfortunately, I'm the latter. Wine and beer generally make me loud.
       
    11. Rube
      Fine

      Rube Member Benefactor

      Location:
      U.S.A
      Tinnitus Since:
      7/2014
      @jazz I have t for almost 4 months. When I was regularly taking melatonin to sleep after a few weeks I felt my t was lowered in volume which felt good enough for me to not need anything to sleep. Now that I'm off the melatonin a week or so the t level is back. I don't know for sure if it was the melatonin though.
      I was taking half a 3mg tab a night and I'm going back on it to see what happens.

      Thanks for your response!
       
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    12. jeannie
      Stressed

      jeannie Member

      Tinnitus Since:
      2013
      Cause of Tinnitus:
      Noise-induced, Ear Infection, Medication... Who knows?
      i took nac one time and it made my tinnitus louder?? maybe i should keep trying it.. i know one pill isnr much but now afraid to try it again....
       
    13. Rube
      Fine

      Rube Member Benefactor

      Location:
      U.S.A
      Tinnitus Since:
      7/2014
      • Informative Informative x 2
    14. undecided
      Fine

      undecided Member

      Location:
      Greece
      Tinnitus Since:
      04/2014
      Cause of Tinnitus:
      Unknown.
      Sulpiride is an interesting drug which I plan on testing in the future along melatonin.
      Maybe I should switch Sulpiride for Quetiapine which seems like a safer drug but has similar properties. I've tried Seroquel (quetiapine) a couple of times, very strong stuff, especially for sleep.
      Naltrexone also looks interesting but it requires a very special prescription in order to get, the other drugs I could just walk in and buy at the pharmacy.
       
    15. Rube
      Fine

      Rube Member Benefactor

      Location:
      U.S.A
      Tinnitus Since:
      7/2014
      Is the retigabine working for you?
       
    16. undecided
      Fine

      undecided Member

      Location:
      Greece
      Tinnitus Since:
      04/2014
      Cause of Tinnitus:
      Unknown.
      The 300mg pills have arrived from the UK at the local post office but they'll be delivered Monday morning probably.
      So I'll be starting then.
      Don't have very high hopes, the 100mg pills didn't do much at all (took them for about 12 days).
       
    17. jazz
      No Mood

      jazz Member Benefactor

      Location:
      US
      Tinnitus Since:
      8/2012
      Cause of Tinnitus:
      eardrum rupture from virus; barotrauma from ETD
    18. SoulStation
      No Mood

      SoulStation Member Ambassador Team Tech

      Location:
      New York
      Tinnitus Since:
      2012
      Cause of Tinnitus:
      Noise / Possible Medication
      Be careful man. Jumping right into 600 or 900 could be dangerous.
       
    19. undecided
      Fine

      undecided Member

      Location:
      Greece
      Tinnitus Since:
      04/2014
      Cause of Tinnitus:
      Unknown.
      I have some leftover 100mg pills.
      Then I'll be cutting the 300mg pills in half.
      I'll go slow for a week.
       
    20. RaZaH
      Not amused

      RaZaH Member Benefactor Team Tech

      Location:
      Reykjavík, Iceland
      Tinnitus Since:
      2012/04
      Cause of Tinnitus:
      Benzo + loud noise
      I am trying this stuff.
      LDN / Low Dose Naltrexone. 0.5 to 1 ml liquid before sleep.
      Ramping up to 4.5 in a couple of weeks.
      Only 2 days so far ...Interesting.
       
    21. Goldilocks
      Lonely

      Goldilocks Member

      Location:
      Sydney Australia
      Tinnitus Since:
      08/1995
      Cause of Tinnitus:
      Original T 1995, aggravated T 2014, increase 2016
      Has anyone else tried LDN (low dose naltrexone - under 5mg) lately? I just started it last week. More for chronic pain and inflammation, but I was wondering if it might not help with T as well.

      Would be good to hear from anyone who has been on it for a while.
       
    22. Nucleo

      Nucleo Member Benefactor

      Tinnitus Since:
      02/2011
      A terrible non-blinded study with poorly chosen controls. Only a crappy journal would publish this.
       
    23. Goldilocks
      Lonely

      Goldilocks Member

      Location:
      Sydney Australia
      Tinnitus Since:
      08/1995
      Cause of Tinnitus:
      Original T 1995, aggravated T 2014, increase 2016
      So there's absolutely nobody on this board that is on LDN right now?
       

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