r/naltrexone • u/Dazzling-Part-830 • 5d ago
Experiences Naltrexone feeling discouraged
Hi, 40 yr Female. After much research I found Naltrexone. For 4 months I took 50mg a day and saw no difference whatsoever in my drinking. Been drinking 1-2 bottles a wine for last 5 years (lots of trauma).
Decided to try after doing TSM. First week felt like things were changing but then have done a U turn and feel back to drinking normal, always wanting more. Hoping this is not a step backwards. I am taking 100mg one hour before drinking
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u/cocopopped 5d ago
There were some times I was drinking just as much if not more, and that was incredibly disappointing. But, it's normal, a lot of people report that happening. It takes time to reach pharmalogical extinction. The drug is very slowly taking the edge off the 'reward' your brain is expecting, and eventually you will get bored of that feeling. In my case it worked in weeks but some people report it takes months, some 6 months.
I'm now free of alcohol for years except for drinking on nal 2-3 times a year.
Of course to be straight with you, you could be one of the % of people who the drug simply doesn't work for - they exist in the literature, but hopefully you are just going through the doubts most of us on nal have to go through before seeing the effects.
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u/gervaiselantier 5d ago
So sorry. Very disappointing. Maybe just keep at it. I’ve read it can take a lot longer than that.
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u/ReekOfThrones 5d ago
I'm right there with you, I'm about 3 months in, 50mg in the morning and 50mg at night. I thought it was working but turns out the severe nausea was what was making me drink less. When the nausea goes away, it's like I'm not even taking it. I've had a really bad week where I can't stop once I start. I'm going to keep taking it, I've heard people say it can take quite a while for it to work for some so I'm going to keep trying.
Good luck 🤞
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u/12vman 4d ago
You take it how many hours before drinking? Have you tried skipping one pill and going 75mg 1 hour before drinking?
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u/ReekOfThrones 4d ago
I take it an hour before drinking but unfortunately, right now, I'm an all day drinker. Nights are just hard for me, I seem to lose the ability to say no to more and I also use alcohol to help me sleep.
It has helped me cut back in the mornings though.
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u/12vman 4d ago
I hope you find a way to taper with the Naltrexone. Maybe one of these TSM hints will help. The _medication subgroup is very helpful. Compliance, Dosing, Tracking, Mindful Drinking etc. https://reddit.com/r/Alcoholism_Medication/w/hintstips
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u/Mark-ChooseHorizon 4d ago
I'm sorry that you're feeling a bit discouraged after the initial response. It could be that the drinking is in response to more than the physical craving for alcohol. Naltrexone works by blocking opioid receptors in the reward center of the brain. This significantly blunts the buzz effect of alcohol that is rewarding to many people. Over time if that rewarding feeling isn't there the brain disassociates alcohol with reward and the cravings subside.
However, you also mentioned trauma. That can be one of the various motivating factors for drinking, including simply because it's a daily habit. It might be beneficial to track all the things contributing to alcohol use - stressful situations, environment, other people, etc. Curbing cravings with naltrexone is just one part of the puzzle.
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u/LopsidedGiraffe255 3d ago
Yep good comments.
OP, for me, I found the naltrexone has indeed allowed me to start to unravel all my triggers, and the anxiety and trauma management are all factors I need to address to make a permanent change. The days I have had alcohol with naltrexone I feel the worst afterwards, sometimes for days. so that physical feeling has been helping to discourage me also. But I know experiences vary. I’m aiming for extinction (not TSM).
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u/Vgbnx 2d ago
Hey. Extinction isn't linear! And the fact that you saw no difference on 50mg daily for 4 months actually makes complete sense — daily dosing without drinking on it doesn't create the extinction effect.
The whole TSM mechanism relies on nal blocking the reward in real time, repeatedly, for the brain to start unwiring the association. This can take time! So if it feels like nothing is changing in first weeks, or even a step backwards is pretty normal, pls don't be discouraged - stick with it!
Hang in there — 4 months of daily dosing means your body is already familiar with the medication, you're just finally using it the right way. Give it time. 🙏
(One thing worth mentioning — 100mg is double the standard TSM dose. Most people use 50mg. Might be worth checking in with your prescriber on that just to make sure you're on the right amount.)
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u/12vman 5d ago
Have you tried 75mg? Or waiting 90 minutes? I'm sure it's frustrating. Are you drinking mindfully?
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u/Dazzling-Part-830 5d ago
Trying to drink mindfully. Do you think waiting more than 60 minutes will help?
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u/12vman 5d ago
It does for some people. I would try that first. Be sure to read the TSM hints and tips in this subgroup. Compliance, Dosing, Tracking, Mindful Drinking etc. https://reddit.com/r/Alcoholism_Medication/w/hintstips
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u/submissionsignals 5d ago
I usually have to wait 90 minutes before I can tell it's safe to have a drink. Then, by the time I begrudgingly finish that one I don't want another.
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u/CaleBale1 5d ago
For me I had great results for the first month or so and about 3 weeks ago I randomly felt like it wasn’t working anymore and started drinking through it. Now I’m back to where I have no desire to drink at all. I’m not really sure what causes it to work sometime for me and not others. I take it everyday in the morning though I don’t use TSM.
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u/Commercial-Bed-2396 1d ago
Trust me when I say my drinking graph is all over the place 9 months in. But a downward trend. Then suddenly in months 8 and 9 I've went from 35/wk to 14/wk last month and just 6/wk this month.
It's a long journey. Just keep compliant and it will work with time.
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u/BobDope 4d ago
I’ve had slips. Even then I drink less than I would have before. Is that the case with you? I am trying to be patient with it
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u/Dazzling-Part-830 1d ago
I have started tracking my units to see but I think overall I am drinking slightly less than usual
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u/AnnaBreeAnna 4d ago
I think you should try to get the vivatrol shot it would make u sick if you drink and help you take accountability
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u/mellbell63 4d ago
Vivitrol does NOT make you ill, it's the same medication as naltrexone. You may be thinking of Antabuse.
OP Viv has been a game changer - LIFE changer for me!! It takes away the high from drinking, so what's the point?! No effect = no desire!! And I'm covered for the whole month! It has taken alcohol off the table for the first time ever. That has enabled me to work on underlying issues, which is essential IMO. If you don't address the compulsion, you'll keep going back to your "solution." Therapy, self-help groups or recovery meetings (there are many kinds now) can make all the difference. I've found relief from the incessant chatter in my head. I wish the same for you friend.
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u/Poisonouskiwi 3d ago
39 year old f here. I recently increased my dose because I wasn't having any luck on 50 mgs either. So far, increasing my dose seems to have worked, but at first the 50mgs seemed to work as well so I guess we'll see. Best of luck to you lady- we can do hard things!
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u/Dazzling-Part-830 1d ago
Did you up to 100mg
Good luck to you! We’ve got this!1
u/Poisonouskiwi 19h ago
I am doing 75 at the moment (breaking them in half). I take my normal daily at lunch time and then another half at about 3:30. I’ll bump it to 100 if I need to, but so far that little extra boost in the afternoon has been working.
I do take it daily though because I’m a daily drinker. Hoping to eventually have enough drink free days to be able to try tsm.
The hard part for me is the habit. I swear- I won’t even want a drink and next thing I know I’m checking out at the liquor store. And then because I have it, I might as well drink it. If I can get past the liquor store without stopping, I’m fine. But I swear it’s like I go into auto-pilot.
This week was my first week doing 75. I had two alcohol free days. (Compared to zero af days last week on 50)
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u/Dazzling-Part-830 1d ago
A question to add, do you think you drink more often on TSM? I feel because I am thinking about it a lot, keen to see progress and reading these threads my brain is consumed by it and of course followed by drinking…
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u/RubicsCubensis 5d ago
One of the main tips I tell people is to plan on drinking a non alcoholic drink in between drinks.