Naltrexone is a medication often prescribed to support individuals in their recovery from substance use disorders. A common question that arises for those considering or currently taking Naltrexone is its potential effect on anxiety levels. This article explores the relationship between Naltrexone and anxiety, providing insights into how it works and what to expect.
What is Naltrexone?
Naltrexone is a medication approved by the Food and Drug Administration (FDA) for the treatment of opioid use disorder (OUD) and alcohol use disorder (AUD). It is an opioid antagonist, meaning it works by blocking opioid receptors in the brain. These receptors are activated by opioids, including illicit drugs, prescription pain relievers, and the body’s natural opioids, endorphins.
By binding to these receptors, Naltrexone prevents opioids from producing their euphoric and sedative effects. This action helps to reduce cravings for alcohol and opioids, making it less rewarding if a person consumes these substances. Naltrexone is available in oral tablet form, taken once daily, and as an extended-release injectable administered monthly. It is not addictive and does not cause withdrawal symptoms in individuals who are not physically dependent on opioids or alcohol.
Naltrexone and Anxiety
Anxiety is a reported side effect of Naltrexone. Individuals taking the medication may experience increased nervousness, generalized anxiety, or even panic attacks. Anxiety has been noted as a side effect in clinical studies, particularly in patients with opioid use disorder, and is frequently mentioned in user reviews.
Anxiety can manifest differently, ranging from mild feelings of unease to more intense symptoms like heightened sensitivity to stress, restlessness, increased heart rate, or difficulty sleeping. These anxiety symptoms may be temporary, subsiding within a few days to weeks after starting the medication. However, if anxiety persists or becomes severe, it warrants discussion with a healthcare provider.
Understanding How Anxiety May Arise
The mechanism by which Naltrexone can contribute to anxiety is complex and relates to its interaction with the body’s opioid system. Naltrexone blocks opioid receptors, including mu-opioid receptors, which are involved in pleasure and pain regulation. By blocking these receptors, Naltrexone can interfere with the normal functioning of the endorphin system, which plays a role in mood and stress regulation. This interference can lead to temporary mood changes or increased sensitivity to stress.
In individuals with opioid dependence, starting Naltrexone too soon after opioid use can precipitate severe withdrawal symptoms, including agitation and anxiety. This occurs because Naltrexone rapidly displaces any opioids still present in the system, leading to a sudden onset of withdrawal. Even in those without overt opioid dependence, Naltrexone’s effects on neurochemical pathways, such as dopamine and serotonin, could indirectly influence anxiety levels. Additionally, Naltrexone may influence the hypothalamic-pituitary-adrenal (HPA) axis, which is the body’s central stress response system, potentially leading to increased cortisol levels and contributing to anxiety.
Managing Anxiety While on Naltrexone
Anxiety can occur while taking Naltrexone, but effective strategies exist to manage these symptoms. Communicate openly with a healthcare provider about any anxiety experienced. They can assess the severity of symptoms and determine if dosage adjustments are appropriate. Starting with a lower dose and gradually increasing it can help the body adjust, reducing initial anxiety.
Healthcare providers might also recommend behavioral therapies or counseling to help manage anxiety. Lifestyle changes also help, including regular physical activity, relaxation techniques like deep breathing or meditation, and adequate sleep. Do not discontinue Naltrexone without medical guidance, as stopping the medication abruptly can have unintended consequences, particularly in the context of substance use disorders. Collaboration with a healthcare team ensures a safe and effective treatment plan.