Have you ever used low-dose naltrexone for patients with a history of depression or low motivation in order to help with compliance for diet and lifestyle changes?

Dr. Amy Nett: I have not. I haven’t seen that as an indication for low-dose naltrexone. No. I’m just sort of thinking about the mechanism of low-dose naltrexone. It increases endorphins, so it’s not unreasonable. It’s just something that I haven’t tried using before. With depression, I tend to go more down the pathway of decreasing inflammation. Of course, you’re looking for sources of inflammation, so we might be treating the gut, lowering metal toxicity, something like that, also using maybe fish oil, curcumin. Sometimes I use CBD. I am getting into cannabidiol a little bit more and using that for patients who have depression, migraines, anxiety—the sort of neuroinflammatory conditions—but I haven’t tried low-dose naltrexone in that setting. It could be worth a try. I think the side effects of low-dose naltrexone are really so minimal that if you have an inkling that it might work, then go for it. More often than not, I see that low-dose naltrexone overall just doesn’t have much of a benefit for patients, but again, there’s a low enough side effect profile that it’s worth a try.