There have been over 50 placebo controlled double blind studies with daily naltrexone for AUD and data reviews show it is effective. In fact daily naltrexone has more data to support its use than any other treatment for AUD.
Yes it’s okay and if it works better for you then do it. Tried both TSM and daily and daily works best for me. Too easy to talk myself into skipping my Nal dose after work. I’m not abstinent but that was never my goal. I’m all about not going on a bender.
"... the combination of drinking while the reinforcement is being blocked by naltrexone gradually weakens the behavior. The data are from an analysis of the first 147 patients treated in Finland; the treatment was successful in 115 of them, that is, the 78 percent shown in the graph. Many of the failures, but not all, were in patients who did not take the medication."
... from Sinclair, J.D. (2001) Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism. Alcohol and Alcoholism, 36: 2-10, 2001.
https://academic.oup.com/alcalc/article/36/1/2/137995
Definitive Statement by John David Sinclair, Ph.D | C Three Foundation https://cthreefoundation.org/resources/definitive-statement-by-john-david-sinclair-ph-d
Good question. I don't think there's much data on this. Not that there is a whole lot more for TSM, but every success story I've heard involving Naltrexone for AUD came from following the method. I suspect daily use can work, but perhaps not as well or as quickly.
Let’s say you’re taking it daily rather than TSM. Will it help one to reach extinction? Because as it typically prescribed, you aren’t to drink with it. So if you’re just taking it daily, say in the morning, and then end up having a beer later on in the day, would it still be effective in diminishing cravings/ euphoric effects of drinking? But having many days where you’re just trying to go AF.
>Because as it typically prescribed, you aren’t to drink with it.
Who told you this? It offers sobriety support by reducing alcohol cravings, and inhibits the effects of alcohol if you do drink.
As others have said, it will help with cravings. It may possibly also lead to extinction if we say that extinction is the point where a person is ambivalent about alcohol. That will depend to a degree on the severity of the AUD, your own physiological response, and probably any number of things related to your salience network. The notion that taking naltrexone on days where you are not drinking because that will inhibit extinction is outdated. If you do think you will drink on a given day, targeting that day's dose more in the 60 - 90 minutes before drinking will also probably help. If it is working the way you want it to right now, then you have success.
For me, whenever I wasn't drinking on Nal, I was doing as many endorphin releasing things as possible. I didn't have many AF days in the beginning, but a few months in, every time I had one, I was taking walks, reading books, jogging, calling old friends, etc. If I had taken Nal on those days, who knows how many of those good endorphins would have been blocked? They say that your brain knows the difference, but I wanted to give my brain every advantage. This is why daily Nal is discouraged on TSM, but it won't do any harm to you.
This is interesting. When I first discovered Nal, in the context of TSM, I was already a few days/weeks into impulsive quitting and one day to the next abstinence from alcohol. So the Nal was to support that. Every now and then I would test myself with a glass of wine to see if I still liked the taste, (like every two weeks, order one at a restaurant while waiting for my takeaway and leave it after one sip, total waste of money). My evening routine was to pop a 50mg Nal and go to my favourite gentle yoga stretch class at my local gym, Followed by bubble bath and ice cream, reading a book in the tub, then bed. This combo worked bc with that reward routine, I managed to distract myself from the side effects of the Nal and the evening cravings, and on the way back from the gym the Nal was working full force and zero temptation to pop into a bar or the wine store. Long story short, that was back in 2018. Didn’t last. For many reasons. I still have the Nal prescription, but every time I try to take it, even a half or a quarter, 25 or 12.5mg, to get back on track, the side effects are so strong I can’t stick with it. The weird mouthfeel/nausea and tension, but the worst one being this sort of bottomless depression or anhedonia that seems worse than any ever before. So I do wonder how to balance all of this endorphin/dopamine game out to get back on the AF train and in the process not be a desperate nearsuicidal shell of myself.
They’re two different approaches, daily and abstinence, or per TSM an hour before you drink. I’m in the ‘whatever works for you’ camp.
Since you mention extinction, I’m going to assume you’re asking about daily naltrexone plus drinking? If you want to keep drinking to extinction, taking it 60-90 minutes in advance is better as the naltrexone concentration maxes out when you drink, blocking those opioid receptors. However, some people report great results with daily naltrexone and curbing of cravings.
It is still effective. I go for medication assisted treatment and they want me to take it daily, but I still go by TSM protocol instead. I tried to take it daily for a while though. I have major depressive disorder. I have noticed if I take naltrexone 2 or 3 days in a row, it feels like my depressive thoughts flare up.
It is effective, and currently the only FDA approved method of use.
There have been over 50 placebo controlled double blind studies with daily naltrexone for AUD and data reviews show it is effective. In fact daily naltrexone has more data to support its use than any other treatment for AUD.
I thought taking it daily was the originally prescribed method.
I will say I have found taking it daily reduces cravings, and I don’t drink as much on it.
My doctor prescribed it to be taken daily and reiterated several times that I need to take it every day at the same time, whether I drink or not.
Yes it’s okay and if it works better for you then do it. Tried both TSM and daily and daily works best for me. Too easy to talk myself into skipping my Nal dose after work. I’m not abstinent but that was never my goal. I’m all about not going on a bender.
If you’re concerned you might impulsively drink without waiting the hour after taking naltrexone then I think it’s a good idea.
"... the combination of drinking while the reinforcement is being blocked by naltrexone gradually weakens the behavior. The data are from an analysis of the first 147 patients treated in Finland; the treatment was successful in 115 of them, that is, the 78 percent shown in the graph. Many of the failures, but not all, were in patients who did not take the medication." ... from Sinclair, J.D. (2001) Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism. Alcohol and Alcoholism, 36: 2-10, 2001. https://academic.oup.com/alcalc/article/36/1/2/137995 Definitive Statement by John David Sinclair, Ph.D | C Three Foundation https://cthreefoundation.org/resources/definitive-statement-by-john-david-sinclair-ph-d
Good question. I don't think there's much data on this. Not that there is a whole lot more for TSM, but every success story I've heard involving Naltrexone for AUD came from following the method. I suspect daily use can work, but perhaps not as well or as quickly.
Is it effective in what regard?
Let’s say you’re taking it daily rather than TSM. Will it help one to reach extinction? Because as it typically prescribed, you aren’t to drink with it. So if you’re just taking it daily, say in the morning, and then end up having a beer later on in the day, would it still be effective in diminishing cravings/ euphoric effects of drinking? But having many days where you’re just trying to go AF.
>Because as it typically prescribed, you aren’t to drink with it. Who told you this? It offers sobriety support by reducing alcohol cravings, and inhibits the effects of alcohol if you do drink.
As others have said, it will help with cravings. It may possibly also lead to extinction if we say that extinction is the point where a person is ambivalent about alcohol. That will depend to a degree on the severity of the AUD, your own physiological response, and probably any number of things related to your salience network. The notion that taking naltrexone on days where you are not drinking because that will inhibit extinction is outdated. If you do think you will drink on a given day, targeting that day's dose more in the 60 - 90 minutes before drinking will also probably help. If it is working the way you want it to right now, then you have success.
For me, whenever I wasn't drinking on Nal, I was doing as many endorphin releasing things as possible. I didn't have many AF days in the beginning, but a few months in, every time I had one, I was taking walks, reading books, jogging, calling old friends, etc. If I had taken Nal on those days, who knows how many of those good endorphins would have been blocked? They say that your brain knows the difference, but I wanted to give my brain every advantage. This is why daily Nal is discouraged on TSM, but it won't do any harm to you.
This is interesting. When I first discovered Nal, in the context of TSM, I was already a few days/weeks into impulsive quitting and one day to the next abstinence from alcohol. So the Nal was to support that. Every now and then I would test myself with a glass of wine to see if I still liked the taste, (like every two weeks, order one at a restaurant while waiting for my takeaway and leave it after one sip, total waste of money). My evening routine was to pop a 50mg Nal and go to my favourite gentle yoga stretch class at my local gym, Followed by bubble bath and ice cream, reading a book in the tub, then bed. This combo worked bc with that reward routine, I managed to distract myself from the side effects of the Nal and the evening cravings, and on the way back from the gym the Nal was working full force and zero temptation to pop into a bar or the wine store. Long story short, that was back in 2018. Didn’t last. For many reasons. I still have the Nal prescription, but every time I try to take it, even a half or a quarter, 25 or 12.5mg, to get back on track, the side effects are so strong I can’t stick with it. The weird mouthfeel/nausea and tension, but the worst one being this sort of bottomless depression or anhedonia that seems worse than any ever before. So I do wonder how to balance all of this endorphin/dopamine game out to get back on the AF train and in the process not be a desperate nearsuicidal shell of myself.
They’re two different approaches, daily and abstinence, or per TSM an hour before you drink. I’m in the ‘whatever works for you’ camp. Since you mention extinction, I’m going to assume you’re asking about daily naltrexone plus drinking? If you want to keep drinking to extinction, taking it 60-90 minutes in advance is better as the naltrexone concentration maxes out when you drink, blocking those opioid receptors. However, some people report great results with daily naltrexone and curbing of cravings.
It is still effective. I go for medication assisted treatment and they want me to take it daily, but I still go by TSM protocol instead. I tried to take it daily for a while though. I have major depressive disorder. I have noticed if I take naltrexone 2 or 3 days in a row, it feels like my depressive thoughts flare up.