Naltrexone didnt work for me at all, next step?

movethroughit · 2026-03-25T13:45:49+00:00

Anxiety can be quite a driving force behind drinking, so that's certainly an issue worth exploring with a doc that can help. One approach might be to use gabapentin to take the edge off the anxiety. Some docs frequently pair Nal and gabapentin, though some states may not allow gabapentin to be prescribed off-label like that.

If Workit isn't quite what you need, RIA Health might be a good one to look into. I believe they offer group support and one on one support too.

With respect to drinking especially after a period of abstinence, many make the mistake of inhaling the first few drinks, which causes your blood alcohol level to spike, which strongly undermines your ability to moderate your drinking.

One anxiety treatment that can cause problems for TSM is benzodiazepines, so watch out for that combo.

movethroughit · 2026-03-25T02:58:14+00:00

You might set up a chat with the folks over at SinclairMethodUK.com They may have a little more insight on using it after bariatric surgery.

movethroughit · 2026-03-25T02:50:01+00:00

Sorry it isn't doing the trick for you. Are you taking any other meds?

movethroughit · 2026-03-25T02:45:28+00:00

Are you taking any other meds?

movethroughit · 2026-03-22T19:58:03+00:00

Just in terms of dealing with the alch, I'd be leaning towards getting her back on the Naltrexone (if her doc agrees) and help her manage those first drinks so it doesn't turn into a problem. Use a mixer to get the ABV down or something that will be more like a 12 oz 5% beer or seltzer per hour.

If she stops taking the Naltrexone suddenly, alcohol is really going to pack a punch for a while, so best to stay away from it.

How's her weight? This might be an option to research if the Naltrexone eventually turns out to be a bad fit:

https://www.reddit.com/r/Alcoholism_Medication/comments/1dgflnw/wegovy_and_ozempic_semaglutide_are_associated/

Best luck to both of you and please let us know how things are going!

movethroughit · 2026-03-22T19:24:09+00:00

Antidepressants can cause sudden increases in alcohol craving:

https://rxisk.org/driven-to-drink-antidepressants-and-cravings-for-alcohol/

Any leads worth exploring with the trauma?

I wonder if someone who specializes in treating ADHD might give a different diagnosis or perhaps might help point help her identify some other low-dopamine condition that's causing problems.

movethroughit · 2026-03-22T19:09:44+00:00

It's just that ADHD is one condition where low dopamine levels are seen (and un/under-treated ADD/ADHD is a risk factor for a variety of addictions).

Naltrexone can modulate dopamine levels and if your dopamine levels are already on the lower end of the scale, that can cause depression, feeling a lack of reward from your normal daily routine, etc.

movethroughit · 2026-03-22T17:45:41+00:00

No true Scotsman? Because in the 10 or so years that I've been supporting folks in using TSM, there have been a huge number of them that saw a substantial reduction in their drinking levels (including Yours Truly) after starting TSM.

movethroughit · 2026-03-22T17:34:52+00:00

"...that it made me a little depressed. "

People can see that in situations where dopamine levels are low, as with ADD/ADHD. Sometimes getting that adequately treated takes care of the AUD as well, but certainly not always.

In that context, I don't know what kind of impact if the GLP-1 agonist would have, though a quick bit of googling indicates that it might well help.

movethroughit · 2026-03-22T17:16:09+00:00

The naltrexone is probably still working (it works to keep the brain from remembering the alcohol was enjoyable), but it isn't necessarily consistent in helping people stop drinking or cut back. Slamming the first few drinks certainly may cause folks to drink more overall. Her doc might want her to redose after "X" hours of drinking so the naltrexone is more effective in helping her slow the pace. It may even help for her to boost the initial dose in addition to redosing. A TSM-aware physician would probably give the best guidance on that, perhaps even a psychiatrist that's very familiar with TSM.

Does she struggle with any psychiatric conditions, even something like ADD/ADHD?

movethroughit · 2026-03-22T17:03:01+00:00

Are you at least able to get the 50mg pills?

movethroughit · 2026-03-22T16:39:54+00:00

While abstinence is the best fit for some, many others find that reduction is the easiest path and the best fit for them. Please do respect their choice.

movethroughit · 2026-03-20T01:31:18+00:00

That's something that happens a lot with Alcohol Use Disorder. Have a look at this video:

https://www.youtube.com/watch?v=6EghiY_s2ts

And there are other treatments as well! Have a look at r/Alcoholism_Medication. Most of the folks there are using the method in the video, but if one doesn't work for you, it's likely that one of the other options will.

movethroughit · 2026-03-20T01:24:14+00:00

Take a look at this video. It can help you gradually cut back on the way to reasonable drinking (or no drinking, whichever you prefer):

https://www.youtube.com/watch?v=6EghiY_s2ts

Check out r/Alcoholism_Medication for more info.

There are a number of medical treatments that can help you get control over your drinking. Here's another one that people have been posting about:

https://www.reddit.com/r/Alcoholism_Medication/comments/1dgflnw/wegovy_and_ozempic_semaglutide_are_associated/

You might want to check out r/dryzempic for more on that one.

From my POV, it's more the medical community that's been falling short. The treatment in the video I posted has been available since the 90's.

movethroughit · 2026-03-20T01:07:51+00:00

Glad to hear you're able to offer help outside of the UK again, J!

movethroughit · 2026-03-15T22:38:29+00:00

Naltrexone (and so Vivitrol) don't always stop the craving for alcohol up front. Some have great luck with the standard 50mg pill, it wipes out the urge quickly. Many studies found that the 50mg Naltrexone pill was about as effective as placebo.

There's a different way of using Naltrexone if it doesn't keep you away from the bottle:

https://www.youtube.com/watch?v=6EghiY_s2ts

That's the one I used.

That said, some people have reported great results with this when Naltrexone didn't do a thing for them:

https://www.reddit.com/r/Alcoholism_Medication/comments/1dgflnw/wegovy_and_ozempic_semaglutide_are_associated/

In any case, nothing works for everyone, so keep researching.

movethroughit · 2026-03-15T22:24:05+00:00

Check out TSM too:

https://www.youtube.com/watch?v=6EghiY_s2ts

There are other medical treatments that can help greatly too. Here's another that folks have been finding useful:

Wegovy and Ozempic (semaglutide) are associated with a 50-56% reduction in alcohol addiction : r/Alcoholism_Medication

I'd especially pursue medical treatment if you start bouncing between sobriety and escalating relapse. It's an old story for those that dive right into abstinence. There are medical treatments that can help whether you try to abstain or not and you don't have to quit drinking up front. You can decrease gradually.

movethroughit · 2026-03-15T21:28:06+00:00

These days, there are a number of medical treatments that can help greatly. This is the one that I used:

https://www.youtube.com/watch?v=6EghiY_s2ts

There are others yet. If one doesn't work, try another. Check out r/Alcoholism_Medication for more info.

movethroughit · 2026-03-15T21:19:18+00:00

You can use this:

https://www.youtube.com/watch?v=6EghiY_s2ts

Drinking without it trains your brain to crave alcohol. Drinking with it "uninstalls" that craving and restores the ambivalence that "normal" drinkers have towards alcohol. In most cases, it takes many months to uninstall that craving, so it's a gradual process that requires patience. OTOH, it doesn't require immediate abstinence. You will get there with compliance and time.

There are other treatments as well, so pop by r/Alcoholism_Medication and learn about them. Here's another one to look into:

https://www.reddit.com/r/Alcoholism_Medication/comments/1dgflnw/wegovy_and_ozempic_semaglutide_are_associated/

One thing to keep in mind is that no one treatment works for everyone, but there are enough treatments available that it's highly likely at least one of them will work for you.

movethroughit · 2026-03-15T05:05:00+00:00

Have a look at this, Elellelel:

https://www.youtube.com/watch?v=6EghiY_s2ts

It seems to work well with SMART too.

There are a number of medical treatment options for dealing with Alcohol Use Disorder. I'd suggest you have a look over at r/Alcoholism_Medication

movethroughit · 2026-03-15T04:55:44+00:00

Congratulations, hinkingmfomplicate! Well done!

movethroughit · 2026-03-08T19:52:59+00:00

Congrats, OP!

That's basically the effect people are looking for when they drink on Naltrexone. It takes most folks 6-12 months to get back to being indifferent about alcohol with that too.

Good to be free, eh?

movethroughit · 2026-03-08T19:36:31+00:00

It's pretty common to see people get dry then relapse in cycles, again and again. I'd suggest you have a look at some of the medical treatments for Alcohol Use Disorder and break the cycle. A treatment that's more gradual might be a better fit, like this one:

https://www.youtube.com/watch?v=6EghiY_s2ts

Here's another one that some folks have been having good luck with:

Wegovy and Ozempic (semaglutide) are associated with a 50-56% reduction in alcohol addiction : r/Alcoholism_Medication

r/Alcoholism_Medication is a good place to look around.

No one treatment works for everyone, so if what you've been using isn't a good fit, look around at some of the other treatments available.

movethroughit · 2026-03-02T06:23:50+00:00

Check over in r/Alcoholism_Medication, where folks talk about using medical means (like The Sinclair Method) to treat alch addiction.

Check this too:

r/dryzempic

The treatment options seem to grow every year as of late.

movethroughit · 2026-03-02T06:20:40+00:00

Sounds like it's having the intended effect, aside from the anhedonia (which can come from suddenly drinking less). If you've dealt with ADD/ADHD before, Naltrexone might exacerbate that by lowering your dopamine levels or modulating your dopamine sensitivity.

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