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Case report
Low-dose naltrexone as a treatment for chronic fatigue syndrome
  1. Monica Jane Bolton1,
  2. Bryan Paul Chapman2 and
  3. Harm Van Marwijk3
  1. 1 Patient, Manchester, UK
  2. 2 Patient, West Sussex, UK
  3. 3 Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
  1. Correspondence to Professor Harm Van Marwijk; H.vanMarwijk{at}


Naltrexone is used as an off-label treatment in low doses for several chronic immune-modulated disorders in many countries. Although only small-scale clinical trials have been performed, these suggest efficacy in several diseases including Crohn’s disease, fibromyalgia and Gulf War Illness. Despite numerous internet reports of response to low-dose naltrexone (LDN), no clinical trials exist in people with chronic fatigue syndrome. This condition is characterised by chronic profound fatigue, postexertional malaise, pain and autonomic and neurocognitive disturbances. This series of three case reports compiled by people with long-term ill-health due to chronic fatigue syndrome shows the range of responses they observed when taking LDN, from life changing to a reduction in some symptoms only. Treatment doses ranged from 4 to 12 mg. Clinical trials may be warranted to explore the potential use of naltrexone in people with these debilitating illnesses which currently have no licensed treatments available.

  • drugs and medicines
  • general practice/family medicine

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  • Contributors MJB and HVM conceived the case series. MJB contacted likely contributors and drafted the initial article. MJB, 'case 2' and BPC wrote their individual case histories for which they are guarantors. Case histories were edited by MJB and checked with prescribing doctors in each case. All authors commented on draft versions and approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.