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Does Naltrexone Cause Weight Loss?

Clinically Reviewed by: Charee Marquez, LMFT

As you embark on your journey towards recovery from addiction or dependence, you may encounter various treatment options, including medication-assisted therapy. Naltrexone is one such medication commonly used in the management of opioid and alcohol dependence. Its mechanism of action involves blocking opioid receptors in the brain, thereby reducing the rewarding effects of opioids and alcohol. This suppression of cravings and withdrawal symptoms plays a crucial role in preventing relapse and supporting long-term recovery. However, amidst its efficacy in addressing substance use disorders, questions inevitably arise regarding its potential impact on body weight. While the primary focus of naltrexone treatment is on addiction management, its secondary effects on weight regulation have garnered attention among both healthcare providers and individuals undergoing treatment. In this guide, we delve deep into the question: Does naltrexone cause weight loss? If you’re considering naltrexone as part of your treatment plan and have concerns or questions about its potential effects on weight, continue reading to gain a thorough understanding of this complex topic. Our team at California Prime Recovery is here to provide support and guidance throughout your recovery journey. Contact us today at 866-208-2390 to learn more about our treatment options and how we can assist you in achieving lasting sobriety and wellness. Your well-being is our priority.

Understanding Naltrexone

Before delving into the potential effects of naltrexone on body weight, it’s essential to grasp its mechanism of action. Naltrexone, classified as an opioid antagonist, blocks opioid receptors in the brain, disrupting the rewarding effects of opioids and alcohol, thereby reducing cravings and the likelihood of relapse. However, beyond receptor blockade, naltrexone may also influence neurotransmitter systems involved in reward processing, contributing to sustained abstinence. This complex interplay of neurobiological factors underscores the multifaceted nature of naltrexone’s therapeutic effects and its potential implications for body weight regulation. In the following sections, we will explore empirical evidence surrounding naltrexone’s effects on weight, dissecting findings from clinical studies and elucidating underlying mechanisms to provide a comprehensive understanding of its impact on weight regulation and patient care.

What Is Naltrexone?

Naltrexone is a medication used to treat opioid and alcohol dependence. It belongs to a class of drugs known as opioid receptor antagonists. Naltrexone works by blocking the effects of opioids and reducing the desire for alcohol.

Naltrexone Types and Dosages

The dosages and types of naltrexone can vary based on the specific formulation and the condition being treated. Here are the common types and dosages of naltrexone:

  1. Oral Naltrexone (ReVia, Depade):

    • Treatment for Alcohol Dependence:
      • Initial Dosage: 25 mg once daily.
      • Maintenance Dosage: Typically 50 mg once daily, although some individuals may benefit from higher doses.
    • Dosage for Opioid Dependence:
      • Naltrexone is not typically used during the acute withdrawal phase. Individuals should be opioid-free for 7-10 days before starting naltrexone.
  2. Extended-Release Injectable Naltrexone (Vivitrol):

    • Treatment for Alcohol Dependence:
      • Administered as a monthly injection.
      • The recommended dose is 380 mg injected intramuscularly.
    • Treatment for Opioid Dependence:
      • Administered as a monthly injection.
      • The recommended dose is 380 mg injected intramuscularly.
  3. Naltrexone Implants:

    • Implants release naltrexone slowly over an extended period, often lasting for several months.
    • Dosages can vary based on the specific implant used.

Naltrexone Dosage Guidelines

Naltrexone is a medication used to help individuals with opioid or alcohol dependence by reducing cravings and the rewarding effects of these substances. The dosage of naltrexone can vary depending on the specific formulation and the individual’s response to the treatment. Here are some general guidelines for naltrexone dosage:

For Alcohol Dependence:

  1. Oral Tablet (ReVia):

    • The typical starting dose is 25 mg once daily for the first few days.
    • The maintenance dose is usually 50 mg once daily. Some individuals may respond better to 100 mg once daily.
  2. Extended-Release Injectable (Vivitrol):

    • The recommended dose is 380 mg administered intramuscularly once a month. The first injection should be given after a person has abstained from opioids for a minimum of 7-10 days.

For Opioid Dependence:

  1. Oral Tablet (ReVia):

    • The typical starting dose is 25 mg once daily, gradually increasing to 50 mg once daily.
    • Higher doses may be needed in some cases, up to 100 mg once daily.
  2. Extended-Release Injectable (Vivitrol):

    • The recommended dose is 380 mg administered intramuscularly once a month. Individuals should be opioid-free for a minimum of 7-10 days before starting Vivitrol.

It’s important to note that naltrexone should only be used under the supervision of a healthcare provider. Additionally, individuals should be opioid-free for a specific period before starting naltrexone to avoid precipitating opioid withdrawal.

Naltrexone Uses

Naltrexone is used for the treatment of conditions related to opioid and alcohol dependence. Here are the primary uses of naltrexone:

  1. Alcohol Dependence:

    • Naltrexone is used as part of a comprehensive treatment plan for individuals with alcohol dependence.
    • It helps reduce the craving for alcohol by blocking opioid receptors, which are involved in the rewarding effects of alcohol.
    • The goal is to support individuals in maintaining abstinence from alcohol.
  2. Opioid Dependence:

    • Naltrexone is used for individuals who have successfully detoxified from opioids and are committed to maintaining abstinence.
    • It works by blocking the effects of opioids, reducing the euphoria associated with opioid use.
    • Naltrexone is not used during the acute withdrawal phase but is initiated after a period of opioid abstinence.
  3. Extended-Release Injectable Naltrexone (Vivitrol):

    • Vivitrol, the extended-release injectable form of naltrexone, is used for both alcohol and opioid dependence.
    • The injectable form offers a longer duration of action, typically administered once a month, improving medication adherence.

How Long Does Naltrexone Stay in Your System?

The elimination half-life of naltrexone can vary based on the specific formulation and route of administration. Here are the approximate half-lives for the two common formulations:

  1. Oral Naltrexone (ReVia):

    • The oral formulation of naltrexone has a relatively short elimination half-life, ranging from 4 to 13 hours. This means it takes about 4 to 13 hours for half of the administered dose to be eliminated from the body.
  2. Extended-Release Injectable Naltrexone (Vivitrol):

    • The extended-release injectable form of naltrexone, administered as a once-monthly injection (Vivitrol), has a longer elimination half-life. The half-life for Vivitrol is approximately 5 to 10 days.

The extended-release formulation provides a sustained release of naltrexone over an extended period, allowing for monthly administration. This can be beneficial in promoting treatment adherence and reducing the risk of relapse in individuals with opioid or alcohol dependence.

It’s important to note that the half-life is just one factor in determining the appropriate dosing schedule for naltrexone. The choice between the oral and injectable formulations depends on individual circumstances, including patient preference, treatment goals, and adherence considerations.

Naltrexone Onset and Duration

The onset and duration of action of naltrexone can vary based on the specific formulation used. Here are general considerations for different forms of naltrexone:

  1. Oral Naltrexone:

    • Onset: After oral administration, naltrexone is typically absorbed within one hour.
    • Duration: The effects of oral naltrexone can last for approximately 24 hours, and it is usually taken once daily.
  2. Extended-Release Injectable Naltrexone (Vivitrol):

    • Onset: The onset of action for the injectable form is immediate after administration.
    • Duration: Vivitrol is an extended-release formulation designed to provide a sustained effect for approximately one month. Therefore, it is administered once a month.
  3. Naltrexone Implants:

    • Naltrexone implants release the medication gradually over an extended period, often lasting for several months.
    • The onset and duration can vary based on the specific type of implant used.

It’s important to note that the duration of action does not imply that the effects of naltrexone are constant throughout the entire period. Instead, it reflects the time during which the medication is active in the body.

Naltrexone Efficacy

Naltrexone is an opioid receptor antagonist used to treat individuals with alcohol or opioid dependence. Its efficacy is well-established, and it plays a role in the comprehensive treatment of substance use disorders. Here are key points regarding the efficacy of naltrexone:

  1. Alcohol Dependence:

    • Naltrexone has been shown to reduce alcohol cravings and the rewarding effects of alcohol. It works by blocking opioid receptors, which are involved in the pleasure and reward pathways associated with alcohol consumption.
    • Studies have demonstrated that individuals with alcohol dependence who take naltrexone, particularly in combination with counseling or psychosocial support, may have a reduced risk of relapse and a decrease in heavy drinking days.
  2. Opioid Dependence:

    • Naltrexone is used to prevent relapse in individuals who have successfully detoxified from opioids. It works by blocking the effects of opioids, reducing cravings and the reinforcing effects of opioid use.
    • The extended-release injectable form of naltrexone (Vivitrol) is administered monthly, providing sustained opioid receptor blockade.
  3. Combination with Psychosocial Interventions:

    • Naltrexone is often most effective when used as part of a comprehensive treatment plan that includes counseling, behavioral therapies, and support groups.
    • Psychosocial interventions can address the underlying factors contributing to substance use disorders, while naltrexone helps reduce the reinforcing effects of alcohol or opioids.
  4. Patient Adherence and Monitoring:

    • Adherence to naltrexone treatment is crucial for its efficacy. The extended-release injectable form (Vivitrol) can improve adherence by providing a month-long sustained release.
    • Regular medical monitoring and follow-up are important to assess treatment progress, address any side effects, and adjust the treatment plan as needed.

It’s important to note that individual responses to naltrexone can vary, and its efficacy may depend on factors such as motivation for treatment, psychosocial support, and the specific characteristics of the substance use disorder.

As with any medication, individuals considering naltrexone should work closely with a healthcare provider to develop a personalized treatment plan. The decision to use naltrexone, the choice of formulation, and the overall treatment approach should be tailored to the individual’s needs and circumstances.

How Does Naltrexone Work in the Brain and Body?

Naltrexone is an opioid receptor antagonist, meaning it blocks the effects of opioids by binding to and inhibiting the activity of opioid receptors in the brain and body. The primary mechanism of action of naltrexone involves its interaction with these opioid receptors. Here’s how naltrexone works in the brain and body:

  1. Opioid Receptor Blockade:

    • Naltrexone binds to and blocks opioid receptors in the brain. There are different types of opioid receptors, including mu, delta, and kappa receptors, and naltrexone has a high affinity for mu receptors.
  2. Reduction of Reinforcing Effects:

    • By blocking mu opioid receptors, naltrexone reduces the reinforcing effects of opioids. Opioids typically bind to mu receptors to produce feelings of pleasure and reward, contributing to the addictive nature of opioids.
  3. Craving Reduction:

    • Naltrexone helps reduce cravings for opioids or alcohol by interfering with the neural pathways involved in addiction. It dampens the desire to use substances by preventing the activation of opioid receptors.
  4. Prevention of Relapse:

    • In individuals with opioid or alcohol dependence, naltrexone can be used to prevent relapse. By blocking the effects of opioids or alcohol, it reduces the likelihood of relapse even if an individual is exposed to these substances.
  5. Extended-Release Formulation (Vivitrol):

    • The extended-release injectable form of naltrexone, known as Vivitrol, provides sustained opioid receptor blockade over an extended period. This monthly injection helps improve medication adherence and reduces the risk of relapse.

Naltrexone Side Effects

Naltrexone, like any medication, can have side effects. These side effects can vary in intensity and duration. It’s important to note that not everyone will experience these side effects, and some individuals may tolerate the medication well. Here are potential short-term and long-term side effects associated with naltrexone:

Short-Term Side Effects:

  1. Nausea: Nausea is a common short-term side effect that may occur shortly after taking naltrexone.
  2. Headache: Some individuals may experience headaches as a side effect.
  3. Fatigue: Feeling tired or experiencing fatigue can be a short-term side effect.
  4. Dizziness: Some individuals may feel lightheaded or dizzy.

These short-term side effects are generally mild and tend to subside as the body adjusts to the medication. If these side effects persist or worsen, it’s essential to consult with a healthcare provider.

Long-Term Side Effects:

  1. Liver Function: In rare cases, naltrexone has been associated with liver function abnormalities. Regular monitoring of liver function may be recommended.
  2. Allergic Reactions: Although uncommon, allergic reactions are possible. Signs of an allergic reaction may include rash, itching, swelling, severe dizziness, or difficulty breathing.

It’s important to be aware that long-term side effects are generally less common, and naltrexone is considered safe when used as prescribed under the supervision of a healthcare provider.

Adverse Effects and Considerations:

  • Naltrexone is contraindicated in individuals with acute hepatitis or liver failure.
  • It’s crucial for individuals to inform their healthcare provider of any pre-existing liver conditions or other medical conditions before starting naltrexone.
  • Adherence to the prescribed dosage and regular medical follow-ups are important to monitor for any potential side effects.

As with any medication, individuals should promptly report any unusual or severe side effects to their healthcare provider.

Naltrexone Risks

Naltrexone, like any medication, comes with potential risks and side effects. It’s important to be aware of these risks and discuss them with your healthcare provider before starting treatment. Here are some potential risks associated with naltrexone:

  1. Opioid Withdrawal:

    • If someone is physically dependent on opioids and starts naltrexone without first undergoing a proper detoxification, it can precipitate opioid withdrawal symptoms. This is why individuals need to be opioid-free for a specific period before starting naltrexone.
  2. Hepatotoxicity:

    • In rare cases, naltrexone has been associated with liver enzyme elevations. Regular monitoring of liver function may be recommended during treatment, especially in individuals with pre-existing liver conditions.
  3. Allergic Reactions:

    • Although uncommon, allergic reactions to naltrexone can occur. Seek medical attention if you experience symptoms such as rash, itching, swelling, severe dizziness, or difficulty breathing.
  4. Injection Site Reactions (Vivitrol):

    • The extended-release injectable form of naltrexone (Vivitrol) is administered by injection. Injection site reactions, such as pain, tenderness, swelling, or redness, may occur.
  5. Depression and Suicidal Thoughts:

    • Some individuals may experience mood changes, including depression or suicidal thoughts, while taking naltrexone. It’s essential to promptly report any changes in mood to a healthcare provider.
  6. Interaction with Opioids:

    • Since naltrexone blocks the effects of opioids, it may reduce the effectiveness of opioid-containing medications, including pain relievers. Inform healthcare providers about naltrexone use before any surgical or medical procedures.
  7. Adherence Challenges:

    • Adherence to naltrexone treatment is crucial for its effectiveness. Missed doses can reduce its effectiveness in preventing relapse.

It’s important to remember that the benefits of naltrexone, particularly in reducing the risk of relapse for individuals with alcohol or opioid dependence, often outweigh the potential risks. However, the decision to use naltrexone should be made in consultation with a healthcare provider who can assess your individual health status, provide guidance, and monitor your response to the medication.

Prescription

Obtaining a prescription for naltrexone or any medication involves several steps and requires the involvement of a qualified healthcare professional. Here is a general guide on how to obtain a prescription:

  1. Consultation with a Healthcare Provider:

    • Schedule an appointment with a healthcare provider, such as a primary care physician, addiction specialist, psychiatrist, or other qualified medical professional.
  2. Medical Evaluation:

    • During the appointment, discuss your medical history, including any history of substance use, alcohol dependence, or other relevant information.
    • Be open and honest about your health concerns and goals.
  3. Clinical Assessment:

    • The healthcare provider will assess your individual needs, considering factors like the severity of alcohol dependence or opioid use disorder.
    • They may perform necessary examinations and tests to determine the most appropriate treatment plan.
  4. Discussion of Treatment Options:

    • If naltrexone is deemed appropriate for your situation, the healthcare provider will discuss the potential benefits, risks, and side effects of the medication.
    • Alternative treatment options may also be considered.
  5. Prescription Issuance:

    • If the healthcare provider determines that naltrexone is suitable for you, they will issue a prescription.
    • The prescription will include details such as the medication name, dosage, and instructions for use.
  6. Follow-Up Appointments:

    • Regular follow-up appointments may be scheduled to monitor your progress, assess any side effects, and make adjustments to the treatment plan if necessary.
  7. Pharmacy Visit:

    • Take the prescription to a pharmacy to have it filled.
    • Pharmacists can provide additional information about the medication, potential interactions, and instructions for use.
  8. Adherence to Treatment Plan:

    • Follow the prescribed dosage and instructions as directed by the healthcare provider.
    • Attend follow-up appointments and communicate any concerns or changes in your health status.

It’s important to note that obtaining a prescription involves a personalized and collaborative process with a healthcare provider. Naltrexone, in particular, is often prescribed as part of a comprehensive treatment plan that may include counseling, support groups, and behavioral interventions.

Prevalence

Opiate Use:

According to the CDC more than 1 million people have died since 1999 from a drug overdose.1 More than 75% of drug overdose deaths in 2021 involved an opioid.2 Opioids are substances that work in the nervous system of the body or in specific receptors in the brain to reduce the intensity of pain.

The number of overdose deaths involving opioids, including prescription opioidsheroin, and synthetic opioids (like fentanyl), in 2021 was 10 times the number in 1999.1 Overdoses involving opioids killed more than 80,000 people in 2021, and nearly 88% of those deaths involved synthetic opioids.2

Alcohol Use:

People Ages 12 and Older

According to the NIAAA, according to the 2022 National Survey on Drug Use and Health (NSDUH), 29.5 million people ages 12 and older (10.5% in this age group) had AUD (Alcohol Use Disorder) in the past year.

Naltrexone Storage and Disposal

Storage:

  • Store naltrexone at room temperature, away from moisture and heat.
  • Keep the medication in its original packaging or container.
  • Do not freeze the medication.

Disposal:

  • Follow any specific disposal instructions provided by your healthcare provider or pharmacist.
  • Do not flush naltrexone down the toilet or pour it into a drain unless instructed to do so.
  • If you have unused or expired naltrexone, consult with your pharmacist or local waste disposal facility on the proper disposal method in your area.

For detailed and specific information on storage and disposal, it’s always advisable to refer to the medication guide provided by the manufacturer or consult with your healthcare provider or pharmacist. They can offer guidance tailored to your specific medication and circumstances.

Does Naltrexone Cause Weight Loss?

Naltrexone itself is not typically prescribed for the primary purpose of weight loss. Its primary use is in the treatment of opioid and alcohol dependence. However, some studies and clinical observations have suggested that naltrexone may have secondary effects on weight or eating behaviors in certain individuals. Here are some considerations:

  1. Reduction in Cravings:

    • Naltrexone, by blocking opioid receptors, may reduce cravings for certain substances, including food.
    • Some individuals who struggle with food cravings or compulsive eating behaviors may find that naltrexone helps in moderating these impulses.
  2. Effects on Food Reward Pathways:

    • Opioid receptors are involved in the brain’s reward system, which includes the pleasure associated with eating.
    • Blocking these receptors with naltrexone could potentially influence the reward pathways related to food.
  3. Clinical Studies:

    • Some clinical studies have explored the use of naltrexone in combination with bupropion (a medication that affects neurotransmitters involved in appetite regulation) for weight management.
    • The combination of naltrexone and bupropion is available as a medication called Contrave, which is FDA-approved for weight loss.
  4. Individual Responses Vary:

    • Responses to medications, including naltrexone, can vary widely among individuals.
    • Weight changes or effects on eating behaviors are not universal, and the impact of naltrexone on weight may be more pronounced in some individuals than others.

It’s crucial to note that the use of medications for weight loss should be approached under the guidance of a healthcare professional, and individual factors should be considered.

Naltrexone Clinical Studies

Numerous clinical studies have attempted to elucidate the connection between naltrexone and weight changes. While findings have been varied, several studies have indicated a potential association between naltrexone use and weight loss, particularly in individuals with alcohol or opioid dependence.

  • A study published in the journal Addiction found that individuals receiving naltrexone treatment for alcohol dependence experienced modest weight loss over a 12-week period compared to those receiving a placebo.
  • Similarly, a meta-analysis published in the American Journal of Psychiatry suggested that naltrexone treatment may be associated with weight loss, particularly in patients with alcohol use disorder.

However, it’s essential to note that not all studies have reported significant weight changes associated with naltrexone use. Some studies have shown no significant difference in weight between naltrexone and placebo groups, indicating the need for further research and consideration of individual factors.

Are There Side Effects If I Use Naltrexone for Weight Loss?

The use of naltrexone for weight loss is generally associated with specific formulations, particularly when it is combined with another medication, bupropion, as in the case of the medication Contrave. While naltrexone itself is not primarily prescribed for weight loss, the combination of naltrexone and bupropion has been approved by the U.S. Food and Drug Administration (FDA) for this purpose. Here are some considerations regarding potential side effects:

  1. Common Side Effects:

    • Like any medication, Contrave may cause common side effects, which can include nausea, headache, constipation, dizziness, insomnia, and increased blood pressure.
  2. Gastrointestinal Effects:

    • Nausea is one of the most commonly reported side effects, and it may occur especially during the initial period of use.
    • Other gastrointestinal effects, such as constipation, can also occur.
  3. Central Nervous System Effects:

    • Bupropion, one of the components in Contrave, is an antidepressant that affects neurotransmitters in the brain. As such, it may cause central nervous system effects like insomnia, anxiety, and dizziness.
  4. Cardiovascular Effects:

    • Contrave can lead to an increase in blood pressure and heart rate, and individuals with cardiovascular concerns should be monitored closely.
  5. Seizures:

    • Bupropion has been associated with an increased risk of seizures. The risk may be higher in individuals with a history of seizures or certain medical conditions.

It’s important to note that the side effects mentioned above are associated with the combination medication Contrave, not naltrexone alone. If a healthcare provider is considering the use of naltrexone for weight loss, they may prescribe a specific formulation tailored to the individual’s needs.

Mechanisms Underlying Weight Changes

The precise mechanisms by which naltrexone may influence body weight are not fully understood. However, several hypotheses have been proposed:

  1. Appetite Regulation: Naltrexone may impact appetite regulation by modulating neurotransmitters involved in hunger and satiety pathways. By altering the brain’s response to food cues, it may lead to reduced food intake and subsequent weight loss.
  2. Metabolic Effects: Some researchers suggest that naltrexone may have metabolic effects, such as increasing energy expenditure or altering nutrient absorption, which could contribute to weight changes.
  3. Behavioral Changes: The reduction in cravings and addictive behaviors associated with naltrexone treatment may indirectly influence weight by promoting healthier lifestyle choices, such as improved dietary habits and increased physical activity.

Factors Influencing Individual Responses

While naltrexone may exert effects on body weight, individual responses can vary significantly. Several factors may influence the likelihood and magnitude of weight changes:

  • Dosage: The dosage of naltrexone prescribed may play a role in its effects on body weight. Higher doses may potentially have a more pronounced impact.
  • Baseline Weight: Individuals starting naltrexone treatment with higher baseline weights may be more likely to experience weight loss compared to those with lower starting weights.
  • Coexisting Conditions: Concurrent medical conditions, such as metabolic disorders or psychiatric illnesses, may influence how the body responds to naltrexone treatment and its effects on weight.
  • Concomitant Medications: The use of other medications alongside naltrexone can interact and affect weight changes. It’s essential to consider potential drug interactions and their impact on treatment outcomes.
  • Lifestyle Factors: Dietary habits, physical activity levels, and overall lifestyle choices can significantly influence weight changes while using naltrexone. Adopting a balanced and healthy lifestyle can complement the effects of medication therapy.

Seeking Treatment? We Can Help!

The question of whether naltrexone causes weight loss lacks a simple answer. While some evidence suggests a potential link between naltrexone use and weight reduction, individual responses are influenced by various factors, including dosage, baseline weight, coexisting conditions, and lifestyle choices. As you consider naltrexone as part of your treatment plan, it’s essential to have an open and informed discussion with your healthcare provider to address any concerns or questions you may have.

At California Prime Recovery, as an in-network provider we work with most insurance plans, such as:

If you or a loved one are struggling with mental health challenges or substance abuse, reach out to California Prime Recovery today. Our team of compassionate professionals is here to support your journey towards lasting well-being. Give us a call at 866-208-2390

 Also, check out our blogs posted weekly on Medium.

FAQs

While some studies suggest a potential for weight loss, individual responses to naltrexone treatment can vary, and weight gain is also a possibility.

The timeline for experiencing weight changes with naltrexone can vary among individuals and may depend on factors such as dosage, baseline weight, and lifestyle habits.

Adopting a healthy lifestyle that includes balanced nutrition, regular physical activity, and stress management techniques can complement the effects of naltrexone treatment on weight management.

Naltrexone is primarily indicated for the treatment of opioid and alcohol dependence. While some healthcare providers may prescribe it off-label for weight management, individual considerations and close monitoring are essential.

Common side effects of naltrexone may include nausea, headache, dizziness, fatigue, and insomnia. It’s essential to discuss any concerns or adverse reactions with your healthcare provider.

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