Begin with 1.5 mg each evening, approximately 1 hour before bed. Stay at this dose for two weeks. Every two weeks, add a dose of 1.5 mg. Continue adding until you find the maintenance dose that is best suited to you.
Week 1 + 2: 1.5mg daily
Week 3 + 4: 3mg daily
Week 5 + 6: 4.5 mg daily
If you are beginning at a lower dose, the titration schedule remains the same- you increase by your beginning dose every two weeks until you find your optimal dose.
Keeping a symptom journal will help you to find the best dose. On day one, write down your top 3-5 symptoms and rate them on a scale of 1-10. Twice a week while increasing the naltrexone, rate your symptoms. When you find 100% symptom relief OR plateau at symptom relief, you have found your maintenance dose.
If you experience side effects such as nausea, headache, gas, diarrhea, insomnia, heightened anxiety, or vivid dreams or nightmares, they should be mild to moderate and should self-regulate in 3-5 days. If they do don’t go away by day 5, this indicates the 1.5 mg dose is too high for you to start with, and you should halve your dose to 0.75mg. In this case you will titrate more slowly, increasing every two weeks by 0.75 mg. If the only side effects you experience are insomnia or vivid dreams or nightmares, you may switch to taking the LDN during the day rather than at night.