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The following article is reprinted from New Horizons newsletter, published by the Brewer Science Library. Single copies of the article may be printed for the reader's personal research and study. Reproduction in any other manner, format or location is expressly prohibited.

The following case was reported to me by a former patient of Dr. Bernard Bihari, a New York physician who has pioneered the use of low-doses of the drug naltrexone for over a decade.

DR. BIHARI'S WORK
Most of his work has been with HIV patients. He has a large group of them that have been stable with no disease progression for as long as eight years from taking a once daily evening dose of 3 mg of naltrexone. He has also tried naltrexone in other patients who suffered with different immune system disorders, whom he felt might benefit from its immune modulating actions.

HELP FOR MS
What follows is a truly remarkable story of the positive help naltrexone might provide to people with multiple sclerosis.

Over twelve years ago Dr. Bihari's daughter had a college friend who experienced three severe exacerbations in the first year of her recently diagnosed MS. She was hospitalized with two of them. These were episodes of transverse myelitis with the MS activity in her spinal cord mimicking severance of the cord. Two were at the waist level, affecting movement and sensation in her legs as well as bladder and bowel functions. She experienced a quick spontaneous recovery of 90-95% from each episode, being left with some residual numbness in her feet. The third attack was in her spinal cord at a high level in her neck. In this attack the numbness was throughout her whole body, from her feet up to her face, and was terrifying to her. Although she regained over ninety per cent of her physical functions after these severe attacks, she obviously was worried about the course of this illness. Dr. Bihari suggested she try low-dose naltrexone, 3 mg at night.

NO EXACERBATIONS
For the next several years she took naltrexone and experienced no exacerbations or deterioration in her condition, remaining quite physically active. In fact, she was doing so well she thought she probably didn't need the naltrexone any longer. So she stopped taking it. Several weeks after she had discontinued the naltrexone, she had an exacerbation with severe muscle spasms in her left arm causing her extreme pain.

MUSCLE SPASM RELIEF
She called Dr. Bihari in desperation and was again started back on naltrexone. She reported to him that the day after she took her first naltrexone pill again the muscle spasms in her arm decreased significantly and with continued use stopped altogether. She had some residual loss of nerve function in her left arm, but was able to adopt her active lifestyle again.

GREAT SUCCESS
She has now been on low-dose naltrexone for over 12 years, and continues to do very well. She reported to Dr. Bihari that occasionally she forgets to take her one naltrexone pill at night and the next day she might experience some muscle spasms. That reminds her exactly how helpful naltrexone is to her body.

This is certainly a very interesting story. Although some people may find it easy to negate this wonderful long-term success by suggesting that her MS just coincidentally remitted, that is certainly not what this young woman thinks. Without naltrexone her predicted progress in twelve years might have been directly to a wheelchair, considering the severity of her exacerbations in her twenties. The relief of muscle spasms alone would be considered beneficial by most MS patients.

FUTURE POSSIBILITIES
Intervention in this young woman's MS was begun very early in her disease process. Until a significant number of cases are followed and clinical trials are completed, it is unknown whether naltrexone can provide any help for individuals who have chronic progressive MS or whose disease process is much more advanced. A few other multiple sclerosis patients as well as patients with other autoimmune disorders have also responded positively to low-dose naltrexone.

IMMUNE MODULATOR
The small dose taken in the evening before bed indirectly results in the pituitary gland increasing its production of beta-endorphin during the middle of the night. It also causes a rise in the adrenal gland's production of metenkephalin, another type of endorphin. These endorphins have a modulating effect on the body's immune functions.

PERSONAL TRIAL
Some individuals who have experienced either no benefit or side effects from other MS therapies may request their doctor's cooperation in a personal trial of naltrexone.

REPORT YOUR RESULTS
Please contact Christina White at the Brewer Science Library (608) 647-6513 to report your results with naltrexone. This follow-up is important for other MS patients seeking ongoing information.

COMPOUNDING PHARMACIES are needed to make the 3 mg caps:

Bigelow (212) 533-2700
Prescription Center (800) 203-9066
Option Care Compounding Pharmacy (800) 679-4667

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