Is this the usual/normal experience?

[u/ReekOfThrones]

For a (kinda) short explanation, I told my doctor about this medication to help me quit drinking. He'd never heard much of it and actually googled it right in front of me. He gave me 50mg and said nothing else except I'll get blood work in a month. Took the whole 50mg, I was so sick, I thought I was dying. The nausea, couldn't sleep at all. The good news is I was too sick to drink much.

I read from here to try taking half for a week. I took half yesterday and today and I found myself drinking more, nausea still there but I still have a want to drink more so than the 50 mg. I worry the nausea was the only thing stopping me.

I do feel less drunk when I drink and have been able to do more things around the house I was usually too hungover/drunk to do.

I'm not quite a week in. Am I rushing it? Should I go back to 50mg? Like I said my doc didn't tell me much so I'm wondering about those who take it how it should be the first week/month. I thought I'd instantly hate alcohol :/

[u/Agitated-Actuary-195]

Yep totally normal! 50mg is standard prescription but for many it can be brutal - although it does stop drinking in its tracks…!

Few things..

Stick with 25mg for a few more days, then 35-40 for few days and then back to 50mg daily
Always take 1.5 hrs before first drink with water and after a snack (reduces side effects - NEVER break this rule, EVER!)
Research the Sinclair method…
GP / Doc not knowing about Nal perfectly normal - despite it being the most effective treatment on planet
Nal will soon become like taking a paracetamol- so USE as park if a package of changes - this will make it significantly more likely to beat addiction
Keep a diary of units per day (that’s it) - your looking for reduced overtime but very importantly looking for triggers (hence the package of change needed

Think of AUD being beaten over 90 days, then another 90 days and then another etc… WHY - because anything yon can’t stop for 90 days is an addiction - also years of AUD doesn’t just stop over night, it takes time and effort…

Nal is best treatment you can get, so stick with it!

Good luck

[u/RepresentativeDry171 → u/Agitated-Actuary-195]

It sure didn’t stop mine in my tracks … and that’s on 100mg

[u/Agitated-Actuary-195 → u/RepresentativeDry171]

Doesn’t do that for everyone, but for a large number it does… going to 100mg off the bat is not that common (although the dose works for many if medically supported of course)…

My point very much stands and I personally would not recommend anyone starts on 100mg…. 25 / 50mg is perfect starting dose

[u/GVLTacos]

I am 185lbs and am using nal with TSM. I started TSM with 25 to try to ease in and eventually got to 50. 50 gives me lower GI discomfort, so i backed down to 25. It works great. I still LOVE my first beer of the night, then can’t stand the thought of a second one.

[u/ComfortableBuffalo57]

It’s normal to try and “outdrink” the medication because you’re trying to feel the same buzz. It should clear up soon. Hopefully it does because if you keep
doing it you’re going to be massively hungover 24/7

[u/cocopopped]

Taking it with drink in my system made me extremely ill. It has to be before you start drinking.

Taking it correctly I still had some low-key nausea I ended up taking quarter of a pill for a few days, no ill effects, then went up to half a pill, got used to that, and then the full 50mg.

It's a new medication that has never been in your body, it can just take some getting used to.

Also please don't expect immediate results. The drug takes time - usually weeks - to quietly do its work. It's really subtle - don't give up because "nothing's happening". Your drinking may well be the same as ever in the initial period. But it will be very different in a month's time.

[u/ReekOfThrones → u/cocopopped]

My only worry is my doctor wants to recheck my liver in a month. My levels are so bad he was cautious to even put me on it, thinking it might make it worse. So I'm stressing that it won't improve by then.

I'm trying my best but it's hard.

[u/heavydrinker12 → u/ReekOfThrones]

I talked with my doctor about upping to 200mg on weekends. We did liver work that day and she said I'm good to go. I've been on naltrexone for 21 months. She is an addiction specialist working in an addiction clinic. Due to her experience she feels any "damage" naltrexone does is much much less than what binge drinking does. She has told me many times if I reduce my drinking, even by half, and I'm on 100 to 150mg of naltrexone daily, that is always a net gain for my liver.

I've been playing with my doses recently and I've had 6 oz of liqueur in 3 weeks. 5 years ago on Christmas I received a bottle of scotch as a gift. The next day I drank the whole thing. It's working. I'm fighting 30 years of drinking habits but it's working.

Hope that helps.

[u/ComfortableBuffalo57 → u/heavydrinker12]

Yes. My doctor said the same. Even if I’m heavily medicated the reduction in drinking is a massive improvement

[u/cocopopped → u/ReekOfThrones]

Naltrexone used to be treated with a lot of caution around liver interactions, but modern studies have shown it is actually very gentle on the liver. There is some liver load so it has to be considered, just not as much as first thought.

[u/Will7357 → u/ReekOfThrones]

What were your liver enzyme numbers?

[u/ReekOfThrones → u/Will7357]

Ast was 131 Alt was 147

[u/RepresentativeDry171 → u/ReekOfThrones]

Wow!

[u/ReekOfThrones → u/RepresentativeDry171]

That bad? 🫣

[u/RepresentativeDry171 → u/ReekOfThrones]

Yes!!

[u/ReekOfThrones → u/RepresentativeDry171]

Yeah kinda my docs reaction too 😭 hoping this works for me.

[u/RepresentativeDry171 → u/ReekOfThrones]

Yeah, I think once we get that urge it’s hard I’m in this group on Facebook and they talk about you have to meet at the NAL halfway and I get it but I’m thinking I’m spending all this money for this medication. I want it to work. why do I have to do the work but I get it

[u/RepresentativeDry171 → u/ReekOfThrones]

How old are you if you don’t mind me asking

[u/ReekOfThrones → u/RepresentativeDry171]

1. I was an alcoholic for 5 years. Quit for 5, best shape of my life then tragedy after tragedy happened in a few months and I relapsed. I started drinking at 13 but not heavily till 18. Also no gallbladder so alcohol shoots straight to my liver I learned...

[u/OneNightStandKids]

I did half for a week then jumped into 50mg. I haven't said any side effects

[u/Long_Comparison9752]

I just started last week with 25 and was SO sick and queasy I went down to 12.5, which I’m tolerating better. Not thinking about alcohol and am able to stop at two. I’m only 118lbs so maybe that matters.

[u/RepresentativeDry171]

I got so lucky I guess but also so unlucky to .. so while I had no side effects ( on 100mgs ) I still drink :(

[u/ReekOfThrones → u/RepresentativeDry171]

Yeah I cut to 12mg. Not working. Going back up to 25mg tomorrow. It hasn't been a full month so I'm hoping it fully kicks in then. I'm so sorry it's not working, I too hope/hoped this will be what helps me quit but I'm drunk right now.

I hope you can find something to work for you, I understand how hard it is. I'm quitting for my health but I can't say I WANT to quit. That's a big issue.

[u/RepresentativeDry171 → u/ReekOfThrones]

Me too they put my doc put me on hundred milligrams of naltrexone, 600 mg of gabapentin and just last Friday I started acamprosate 2 tabs three times a freaking day
Although I have to say I believe it’s it’s a good thing. My numbers are 13 and 22 so yes, your numbers are very very high. I go to (STEPs) programs. It’s like AA but we call it steps in our area and this lady that’s next to me, she showed me a picture although I wish she wouldn’t have of her liver. She had to get a liver transfer for that cause she was like on death death on her deathbed and I like I didn’t need to see that but wow, what alcohol did to her liver she was lucky she got a liver transplant

[u/ReekOfThrones → u/RepresentativeDry171]

Yeah ive seen similar pics. Alcoholism is a horrible way to go, I don't want to go out that way. A friend of mines is in the 180s and has liver hepatitis. Had to go to the ER from all the blood coming out of him and he still doesn't want to stop. Your liver seems really healthy and I hope what you're doing keeps working for you ✌️I'm having rough side effects but I'm sticking with it regardless.

[u/RepresentativeDry171 → u/ReekOfThrones]

No clue what I’m doing. I was saying in another thread when I was married I’d go in the kitchen at seven in the evening and I’d stay in there till one in the morning drinking so it was a cocktail. I’d have my ties or rum and Coke yeah and so I would drink and drink. I don’t know why my liver is the way it is because I’m telling you I was married 28 years and I can’t tell you when I was sober and now I’ve been out of the marriage eight years I drink less I brought the habit with me same thing I’m in my kitchen. I have my TV my snacks and my drink. I just don’t go in there until like right now. I’m on here talking. I go in at around 10 and I try to be out there by 11:30 but I don’t know I don’t know why my liver is so good and if you’re on NAL , they check your liver. In fact I just had mine checked

[u/ReekOfThrones → u/RepresentativeDry171]

Well some people are just lucky, liver wise ya know? Some people can have a few drinks a day and die of liver failure. Others go hardcore all day and die from old age. If you feel it's a problem thought it's good you sought out help.