Evidence map›Paper›PMID 40491623›Full record

ArticleCureus2025

Low-Dose Naltrexone for Severe Fibromyalgia Syndrome: A Report of a Case With Two-Year Follow-Up.

Ulrich Moser

Abstract readCase Reports
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

1 author.

Ulrich MoserPain Management, German Pain Association, Mönchberg, DEU.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Fibromyalgia syndrome (FMS) is characterized by diffuse musculoskeletal pain associated with daytime fatigue, sleep disturbance, cognitive deficits, and often further somatic symptoms. While some patients with FMS respond to standard treatment with amitriptyline, pregabalin, or duloxetine in combination with outpatient multimodal pain management, there are still many who do not benefit sufficiently from this treatment or suffer intolerable side effects. Effective treatment options are therefore needed to supplement conventional therapies. Naltrexone is used in many countries as an off-label therapy in low doses for several chronic immunomodulatory disorders, including FMS. However, the strength of evidence from previous randomized controlled trials is low. I report a patient with severe FMS who did not respond to conventional therapy. Instead, low-dose naltrexone (LDN) (4.5 milligrams per day) resulted in a significant and sustained improvement in most FMS symptoms. The results of this case report suggest that an off-label use of LDN in severe refractory FMS may be a viable option. However, the information base is currently limited, and studies are conflicting.

Indexed as

fatiguefibromyalgianeurologyneurophysiologypain managementpharmacologysleep disorderwidespread pain

Identifiers

PMID40491623
PMCPMC12146906

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.