@lizzywhizzy @Sushi
I tried it once as it seemed harmless and my doc recommended it (he uses it on a lot of his patients). I didn't really seem to experience any benefit at all despite taking it for a long time (can't remember now but over a year I think). I am skeptical that it is really bioactive in the way that has been hypothesized, but I don't know. In my case I didn't really notice anything obvious when I started it or stopped it, and I didn't notice it led to a long term improvement.
Based on my understanding of the theory, if the LDN people are right, it MUST be taken at night to work. Don't do other than your doc says without asking, but you can raise the question with the doc after getting informed. The idea is that your body produces endorphines at night, and that blocking certain opioid receptors prevents feedback inhibition. You then want the effect to disappear before the actual endorphines your body makes are meant to exert an effect, as naltrexone blocks both the feedback inhibition and the receptors that would allow the endorphines to work. Taking in the morning would therefore be counterproductive.
Truth be told, I'm not sure any of it is valid - but I strongly suspect that if it is, it must be done at night. Just because it did jack for me doesn't mean it would do nothing for others. I think I did 4 or 4.5 mg per night. I didn't have to ramp because I never felt anything either way.
Be careful on the dilution of a pill in water. Solubility is a concern - sometimes the bioactive medication may be a small fraction of the pill, and may have poor solubility in water. In these cases, you won't have an even distribution of the chemical in the water. It may work just fine, and rxlist.com says that the hydrochloride salt of naltrexone is soluble in water at about 100mg/ml, which would imply a 50mg pill would be easily dissolved in 100ml of water - but I'd run this by a doctor or preferably a pharmacist (and even more preferably a compounding one). I used to take mine to a compounding pharmacy and he'd make capsules for me. It was about $25/month or so all in, usually 100 at a time. Sushi's method may work just fine here, just pointing out that dilution in aqueous solution is not always that simple and you need to understand what you're diluting, its solubility, etc. - and get advice from someone trained to do that if you are not qualified yourself. (For starters, check if everything appears to fully dissolve - if it doesn't, that's definitely a concern, as you probably can't tell if it's the active chemical, binders, coatings, or whatever else.)
Lastly, naltrexone was a med that Dr. Jay Goldstein used to use sometimes. I always turn to Dr. Goldstein's works when I want to understand psychoneuroimmunologic mechanisms, as his understanding of psychoneuropharmacology in ME and related illnesses was unparalleled.
A few things he mentions (from Tuning the Brain):
(OXT = oxytocin)
He also references a paper that describes that naltrexone may inhibit activity and alter expression of alpha7 and alpha4beta2 nicotinic acetylcholine receptors in hippocampal neurons.
Dr. Goldstein also used naloxone extensively, which is also an opioid receptor blocker, as it relieves constipation very effectively, regardless of the cause. (This makes sense - immodium AD which is taken for diarrhea is an opioid blocker.) However, naloxone (per Dr. Goldstein) isn't well absorbed through the gastointestinal tract.
