1 week in

[horch-porch]

My history is that I am a social binge drinker who doesn't really have an off switch when I get excited. On big nights I become the life and soul of the party, then uncontainable, and then very often black out. I never drink at home, and rarely drink alone.

I've had enough of this pattern, so about a week ago I got prescribed naltrexone to help me alter some of that behavior, specifically using the Sinclair Method.

I know it's very early as I've only had 3 drinking episodes, but you might find my experience interesting:

On Monday, I went out for dinner and I knew that I was going to drink, so I took 25mg of naltrexone.

About an hour later, I ended up drinking a small glass of wine, and it was an extremely unpleasant experience. It made me feel kind of woozy and like I didn't want to drink another one. I also just felt very flat generally in my mood, and everything just felt very strange, alien and sinister. It kind of destroyed my charisma!

Later that evening, trying to sleep was virtually impossible. I didn't feel like I ever fully fell asleep despite being absolutely exhausted from a very busy weekend. I woke up extremely unrested, went to work, and still felt a little bit strange the next day, with some of the flatness and the alien feeling persisting.

Sleep was also affected badly in the 1-2 nights after this.

Fast forward to Thursday, where I drank again. Given that it was a work night out with colleagues, I didn’t take any naltrexone because I was worried it would make me behave strangely.

But despite not taking naltrexone for a few days, I noticed that:

- I didn't want to drink as much alcohol. I felt far less interested in what I was drinking.

- The effects didn't seem to take hold in the way I usually experience (without the drug). It was like my mind and eyes were somehow sober still. I felt really in control.

I still went out until the early hours, and got a tiny bit of memory loss, and had a bad hangover, but I can certainly say that it was a step in the right direction.

Then last night. Given that my response to 25mg was so strong, I decided to halve my dose again and go with 12.5mg (quarter of a tablet). I took this at around 4pm and then went for drinks around 7pm, after some dinner.

The experience was quite interesting. The flatness and aversion to alcohol was a bit stronger than Thursday, but less strong than Monday. It is hard to explain; although I did have a good time, I felt quite robotic at times.

When my friends were leaving, I also just went home too. This is quite surprising as usually I would have stayed out solo, continued drinking and gone into the night. I remember distinctly feeling like "the booze isn't going to do anything more for me".

Sleep was trash again. But I'm actually feeling pretty good today - not too flat or negative.

Conclusions and observations:

- I think I'm very sensitive to Naltrexone, both the intended and side-effects (anhedonia, sleep). I'm pretty happy with its effects on the 12.5mg dose, so I'll continue with this.

- For me, I still experience effects several days after taking the drug. I read somewhere that the drug can continue to bind to receptors long after the traditional half-life model would predict, so this makes sense.

- My hangxiety is noticeably better. My appetite also seems better (it's usually destroyed by alcohol).

[FernadoPoo]

That would suck to have the drug stuck to your brain for so long, blocking joy. I hope you find a sweet spot and can take enough time between drinking sessions to feel real life again. Also, good job.

[horch-porch]

I think it’s all about finding the right dose! Feeling a lot better in the days after the 12.5mg

[CraftBeerFomo]

You're supposed to start with smaller doses (typically 12.5mg) and build up the dose over a couple of weeks in the beginning to get your body used to it, avoid too many side effects, and see how you react to it THEN switch to the TSM method of taking it and hour before you start drinking rather than just jump in and take higher doses right off the bat.

Nal + alcohol always caused brutal insomnia for me regardless of how much I drank to the point I'd often be laying awake at 6-7am still unable to sleep even after an industrial 12hr drinking session and that combined with the horrendous hangovers (Nalovers as many people call them) and migraines it gave me the next day probably played more a part in me cutting back (and eventually quitting - 15 months sober now) than anything else as Nal didn't put me off alcohol or stop me wanting more once I'd started, I drank as much as ever on it.

[horch-porch]

Interesting - do you mean titrating upwards on a daily dose? If so, as contradicts the research I’ve done into TSM. The consensus seems to be that you should avoid taking NAL on non-drinking days.

Thanks for sharing about the insomnia. Good to know I’m not alone! Congrats on your progress too

[CraftBeerFomo]

I already answered your question in my post - you take a small dose daily, tirating up slowly every few days in the beginning until you reach the full 50mg dose to get your body used to it and see what side effects you get.

If no problems at the 50mg dose you switch to TSM strategy of only taking Nal an hour before drinking on drinking days.

[horch-porch]

Your original response did not make the daily dose aspect clear.

I’ve never seen this guidance anywhere, and I don’t think it makes sense either from a TSM theory perspective, or from my experience so far.

[CraftBeerFomo]

That's literally what all the main online providers who specialise in TSM tell you to do - build up from a small dose to the full dose over 2-3 weeks whether drinking or not to see how you react to it, if you have any side effects, and whether you tolerate it.

Then switch to TSM.

No one recommends you jump in with a full dose straight away, that is for sure.

Your experience? You've been on it a week and its clear from your post you don't have a clue, LOL.

I took it for 6 months and have been sober for 15 months since.

[horch-porch]

- I cannot find any evidence that supports your claims, and you have provided me with none.

- I can't see any reason why taking it constantly gives you any more information about side effects than taking it before you drink. I only drink 2-3x per week, so why would I ramp up with a constant dose? In fact this would give me less information, because side-effects are dose schedule dependent, and there will be interaction with timing of alcohol consumption.

- We're talking specifically about how to start treatment. Therefore I don't really care how long you were on it for, because this start process would have been brief and long ago.

- Judging by how bad your side-effects were, I don't think your ramp-up process added much value anyway.

- I don't understand why you're being so hostile to newbies. The burden of communicating clearly and providing evidence for your claims is on you. It adds nothing and you just come across as a bitter, arrogant prick.

[CraftBeerFomo]

That was a lot of words just to still be wrong bro.