2 Responses to “Bipolar Disorder Treatment Resistant – Responds to Oxytocin & Ketamine”

  1. Edmond O`Flaherty Says:

    Dear Dr Sajben,
    Many thanks for providing this website and its wonderful knowledge. It has helped many of my patients and you have utterly changed their lives. I am sorry to hear about you conditions and hope that the future will be joyful.
    I hope that the knowledge will still be available on the net as it is invaluable.
    Incidentally I played a part in a Norwegian TV program on LDN. It is on the first page of the American website http://www.lowdosenaltrexone.org
    Edmond O`Flaherty, Dublin physician (MD in USA).

    • Nancy Sajben MD Says:

      Congratulations. It is shocking that such an important medication gets so little medical attention.

      LDN is an essential glial modulator, one of a handful. I view it unhealthy that the focus of mechanisms continues to be on endorphins rather than the other receptor where it has even more profound effect: the TLR4 receptor on the microglia, neuro-inflammation and the innate immune system that has been the focus since the early 2000’s (Watkins, Hutchinson, Peter Grace, many others).

      Timing of dose is irrelevant, depending on side effects if any. If insomnia when taking at night, then take in AM. If sleepy when taken in AM, take at night.

      Dose ranges I’ve prescribed since about 2003:

      – 10 mcg TID for those on significant opioid dose,

      – 400 mcg *orally* Q6 hr for opioid induced constipation, NOT SL.

      – 1 to 4.5 mg for MS, must be titrated slowly and carefully to avoid increase in spasticity and many cannot take a dose as high as 4.5 mg, the dose that internet dogma continues to warn not to exceed.

      – 12.5 or 15 mg once daily, for anti-inflammatory and/or analgesic doses. Chop 50 mg tablet into 4 or compound 15 mg. If constipation, then limit to 4.5 mg. It profoundly helps my asthma, not 100%.

      – 25 mg for weight loss, which is simply half a 50 mg tablet, close enough to 28 mg published for weight loss, is helping one patient who had little relief from gastric bypass. We cannot measure what little she is able to absorb but these patients are warned to avoid NSAIDs.

      Of course, detailed attention to the list of medications, supplements on Nov 6, 2016:
      https://painsandiego.com/2016/11/06/medication-summary-for-intractable-pain-crpsrsd/

      Don’t forget obesity and inflammation.

      The RSDSA may continue to make important pages of this site available after I’m gone.

      Your rheumatology colleague telephoned on January 26 and I am delighted to hear his interest in LDN.

      Re Skyping – I don’t. Unwilling to take on more software glitches with any new improved tools.

      Hopefully by late February/March, time will permit for teaching to add to the long list of regulatory tasks after closing practice.

      Best wishes to you.


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