I am not sure if this has been posted in this thread before, but I recently discovered this group:


@Utsikt, there is also a specific page where they collect all the trials. I'm sure you could contact them if you're looking for current trials: https://ldnresearchtrust.org/ldn-clinical-trials

PS. This is not specific for ME/CFS, it's focused on LDN for various diseases and chronic illnesses.
 
See thread: Low-Dose Naltrexone: What is the Evidence? A Narrative Review, 2026, Gouda
A total of 105 studies were reviewed, including 15 randomised controlled trials (RCTs) in chronic pain, autoimmune and neuroimmune disorders, gastrointestinal disease, dermatological conditions, post-infectious syndromes, mental health and oncology.

Across these fields, early positive findings from uncontrolled studies were rarely replicated in placebo-controlled trials. Most available evidence consists of case reports and small feasibility studies that are prone to publication bias and rely heavily on subjective outcomes.

LDN is generally safe, inexpensive and well tolerated, with most studies using a daily dose of 4.5 mg.

Although these features contribute to its appeal, current evidence does not support routine clinical use.
 
Results are out from a decent study of LDN for fibromyalgia:


They concluded LDN is not an effective treatment for fibromyalgia.
 
Evaluating the Therapeutic Benefits of Naltrexone in ME/CFS and Long Covid Patients: A Systematic Literature Review (P9-2.002)
Manso, Karla Rodriguez; Saint-Felix, Marcos
Objective
Synthesize current data about using low dose Naltrexone in symptom management for ME/CFS and long COVID.

Background
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Post-Covid fatigue are two debilitating disorders causing symptoms like persistent fatigue, cognitive impairment, and pain through unknown mechanisms involving neuroinflammatory mechanisms. As relatively new pathologies, they lack research and appropriate treatment regimen needed for patient improvement.

Naltrexone, an opioid receptor antagonist (usually used for opioid and alcohol dependence), has proposed in low doses an immunomodulatory effect suppressing microglial activation and reducing inflammatory cytokines which can decrease the symptom severity experienced by many patients.

Design/Methods
We conducted a systematic literature review following PRISMA protocols. PubMed database was searched with keywords "naltrexone," “long Covid” and "ME/CFS". Resulting in 26 studies. We evaluated age, sex, dose, symptom progression, and side effects.

Results
We included 9 studies reporting 1,449 patients with a mean age of 46.4 years. From those 36 (2.4%) diagnosed with ME/CFS and 1,413 (97.5%) long covid patients. The distribution is as follows 75.8% were female, and 24.2% male. Treatment dose varied from 3–4 mg/day (44%), 4–5 mg/day (44%), and 5–6 mg/day (12%) over an average period of 7 months.

Improvement was shown after the allotted times showing decreased fatigue (66%), brain fog (44%), dysautonomia (11%), shortness of breath (11%), sleep (33%), pain (56%), and mood (22%). Dosage didn’t present a significant change in the symptom management. 100% of the studies reported minimal patients presenting diarrhea and fatigue. Of the 9 studies, 1 study involving ten patients didn’t provide any change to symptom severity.

Conclusions
Naltrexone in low doses can help improve the quality of life of patients living with ME/CFS and Post Covid Fatigue syndrome reducing the major symptoms like brain fog, fatigue, sleep disturbances, and mood. Due to increase incidence post-COVID, further research is imperative for innovative and personalized patient management.
Web | DOI | Neurology | 2026 | Abstract only
 
Evaluating the Therapeutic Benefits of Naltrexone in ME/CFS and Long Covid Patients: A Systematic Literature Review (P9-2.002)
Manso, Karla Rodriguez; Saint-Felix, Marcos
Objective
Synthesize current data about using low dose Naltrexone in symptom management for ME/CFS and long COVID.

Background
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Post-Covid fatigue are two debilitating disorders causing symptoms like persistent fatigue, cognitive impairment, and pain through unknown mechanisms involving neuroinflammatory mechanisms. As relatively new pathologies, they lack research and appropriate treatment regimen needed for patient improvement.

Naltrexone, an opioid receptor antagonist (usually used for opioid and alcohol dependence), has proposed in low doses an immunomodulatory effect suppressing microglial activation and reducing inflammatory cytokines which can decrease the symptom severity experienced by many patients.

Design/Methods
We conducted a systematic literature review following PRISMA protocols. PubMed database was searched with keywords "naltrexone," “long Covid” and "ME/CFS". Resulting in 26 studies. We evaluated age, sex, dose, symptom progression, and side effects.

Results
We included 9 studies reporting 1,449 patients with a mean age of 46.4 years. From those 36 (2.4%) diagnosed with ME/CFS and 1,413 (97.5%) long covid patients. The distribution is as follows 75.8% were female, and 24.2% male. Treatment dose varied from 3–4 mg/day (44%), 4–5 mg/day (44%), and 5–6 mg/day (12%) over an average period of 7 months.

Improvement was shown after the allotted times showing decreased fatigue (66%), brain fog (44%), dysautonomia (11%), shortness of breath (11%), sleep (33%), pain (56%), and mood (22%). Dosage didn’t present a significant change in the symptom management. 100% of the studies reported minimal patients presenting diarrhea and fatigue. Of the 9 studies, 1 study involving ten patients didn’t provide any change to symptom severity.

Conclusions
Naltrexone in low doses can help improve the quality of life of patients living with ME/CFS and Post Covid Fatigue syndrome reducing the major symptoms like brain fog, fatigue, sleep disturbances, and mood. Due to increase incidence post-COVID, further research is imperative for innovative and personalized patient management.
Web | DOI | Neurology | 2026 | Abstract only
No mention of control groups or the quality of the evidence makes me concerned these are not RCTs.
 
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