9 10 Despite specialists, particularly in the USA, using a range of drugs in treatment, 11 12 very few of these have been subjected to clinical trials, and the outcomes of the few that have been done have often been inconclusive. There is a systematic lack of funding of research and specialist services for people with these conditions. 6–8 Much is unknown about the illness and even the names ascribed are controversial. The level of disability is greater than for most other chronic illnesses, and full recovery is rare. 1 The annual incidence is around 15–26 per 100 000 persons, 2 3 with a prevalence between 0.2% and 0.4%, 4 5 depending on the exact definition used and the country of study. 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.Ĭhronic fatigue syndrome and myalgic encephalomyelitis are chronic multisystem disorders characterised by profound fatigue and postexertional malaise with multiple other symptoms varying among individuals, including widespread pain, immune dysfunction and autonomic and neurocognitive symptoms. 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. This condition is characterised by chronic profound fatigue, postexertional malaise, pain and autonomic and neurocognitive disturbances.

Despite numerous internet reports of response to low-dose naltrexone (LDN), no clinical trials exist in people with chronic fatigue syndrome.

Although only small-scale clinical trials have been performed, these suggest efficacy in several diseases including Crohn’s disease, fibromyalgia and Gulf War Illness. Naltrexone is used as an off-label treatment in low doses for several chronic immune-modulated disorders in many countries.

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