First time taking nal last night and lost my appetite so I googled and found this:

http://www.businessweek.com/ap/2014-06- ... tics-slips

Google Contrave for more info.

I'm already taking Wellbutrin for depression, and I just ordered my first batch of Naltrexone today. It'll be interesting to see if the combination leads to weight loss. I've gained more than 35 lbs. over the last two years due to my love of wine.

I've taken Wellbutrin in the past and quit recently....

I asked my doctor about naltrexone and he knew very little but was impressed at the knowledge I had brought him. He did know about Contrave so since I have 20 lbs to lose, he suggested I refill my Wellbutrin script. Am down about 4 lbs this month.... Much more likely due to drinking.... I don't know ONE HUNDRED BEERS less!

My girlfriend drinks quite a bit and had gained about 40 lbs in the last 2.5 years since she quit working in the bar where she walked miles a night, quit smoking ( by using Wellbutrin) and moved in with me .... And can now afford to go out more often.

She does not want to cut back drinking... But should. She is smoking hot, minus the extra few lbs and she is super fun and even when drinking incredibly responsible.... But she drinks a lot and i am concerned that she will lose that ability. She is much younger than me. She is interested in losing weight and interested in Contrave. So she is renewing her Wellbutrin and will use some of my NAL. We have discussed the importance of always taking NAL an hour before drinking to make sure she is not reinforcing a bad habit.

I have a feeling that if she commits, she will find herself slimming up and drinking much less. She already drinks a little less since I am not a solid drinking partner anymore. Adding regular naltrexone with her family history will certainly cause less drinking.

I'll keep you all updated. Pretty interesting stuff.

ObnoxiousNomore,

That is how I was able to get on nal. without telling my doctor about my drinking, for I was already on Wellbutrin for seasonal affective disorder. It does work; however, I would use caution with using the nal., for if she has alcoholism in her family and she is already showing alcoholic tendency, unless she is willing to use nal for the rest of her life anytime she drinks, she may be setting herself up to go into that downward spiral.

I might be wrong, but the theory behind using nal. blocks our receptors. In blocking our receptors our bodies start producing more receptors (why low dose nal is being used for other afflictions), so using nal for weight loss might set you up to become an alcoholic now that you have an overload of receptors.

Like I said I might be wrong, for I have no clue what would happen to someone that takes nal. and has no alcoholic tendency or alcoholism in their family. BUT I think if you dig in anyones family you will find some type of AUD or addiction.

I would just make sure that she understands the risk.

Contrave is a new drug out on the market, and now I have been on nal for a while, feel it may be pulled off the shelves if alcoholism increases in people who take it (the time limit that most doctors will have you on a diet aid is about 6 months).

Again, I am not a medical professional, so take what I post with a grain of salt.

Jaba

JABA,

You are right. That was one of our conversations. She can't miss and if she wants to quit taking, needs to wait for several days after for her receptors to calm....

I belief as you that Contrave could present a problem for heavy drinkers. It is one of the things he patients are supposed to tell their doctors.

I would love to believe that people do, but people lie...I did, and now that I have control I am going to try it get my nal. from another doctor. The doctor I got it from for weight loss only allowed me to have it for 6 months. Why wasn't I honest? I guess saying that I was a drunk, and I found not having a nightly drink close to impossible (once I started close to impossible to stop) harder to admit to than I need to lose a couple pounds...

Is your GF willing to be on nal. knowing what she is going to miss? I think sometimes vanity rules; however, not experiencing that "ah moment" for weight loss is something that would be missed if she likes to party, for I would have in my younger years.

Jaba

That is a good question . she has the pills, but has not taken them.

The ahh moment is interesting I took a whole pill yesterday morning then a half last night. All told I only had 7.5 yesterday. Would have had less, but had a couple of shots as people came by our house.

I had a lot of fun.... Felt a buzz but also felt totally in control. We had so much fun and for me this time, was not aimi g for more drinks..

I want her to think this through....

I agree about people lying to their doc. I have had a long history with mine and it was incredibly difficult to talk to him about this. But he knows how long I have been Abstinence's and also know some stressful time in my family and was open to helping. Actually he was more concerned about my blood pressure..... I didn't tell him how hungover I was and knew that that along with not being able to take my blood pressure meds was the reason..

I do think Contrave could be a good thing for heavy drinkers in the sense that shedding a few lbs with medication is so acceptable and I think more doctors will get experience and knowledge with NAl .... That is what happened for you and I.

Enjoy the day.

Wow, Jaba, I see your point. Not only regarding alcohol, but regarding weight loss. Suddenly my candy metaphor in the other thread is reality.

I know I sound like a broken record, but if the goal is extinction of any opoid rewarded behavior, like drinking OR eating, then exposure to the reward on an intermittent basis is going to strengthen the behavior. It's literally creating the opposite of permanent extinction.

So yeah, you can probably train someone to quit chocolate ice cream because it's not rewarding while on Nal. But after they lose 50 lbs, and stop taking the Contrave, then unless they avoid chocolate ice cream forever, they will just be rewarded again.

Honest to pete, as an animal trainer, this is HOW you train a strong, motivated behavior that is highly resistant to extinction--you reward it in on a random, long interval schedule of positive reinforcement.

It's kind of starting to drive me nuts. I realize most doctors probably don't get the educational background to understand this, but psychologists should know it inside and out. To create a medication for weight loss without taking it into account is pretty whacked, imo.

IF Nal is only blocking reward (and that's what we're told over and over in the research) then using it HAS to be a behavioral training intervention. So it has to follow the well understood decades of research on training in the lab, not to mention the dogs that do the hula and the killer whales that splash the audience on cue and the dolphins who plant underwater mines for the Navy. We know this stuff! We know how it works in practice! It's not magic.

I read the forum and I see how hard you all are trying, and how desperately you want to succeed, and the same confusion and difficulties in so many threads, it really kinda pisses me off that you can't get the clear help you need but have to struggle along trying to figure it out by yourselves, or even get misled by the instructions from the doctors.

Sorry for the rant, but I'd never heard of Contrave and after checking it out from this thread, I'm just gobsmacked by the lack of basic behavioral understanding that it indicates.

Truffle,

You and I both have the same feelings about Contrave; however, we both know it is all about the money! Wellbutrin and nal. are no longer drugs that make money, but combine the 2 and you have a new class of drug that will be able to produce millions to that drug manufacturer. Is it unethical knowing the ramifications? I am sure they will deny any culpability.

I agree with about 90 percentish of these concerns and ramifications.... Yet there are some good things here.
First, NAL has not received a lot of attention because it is a generic. I think Contrave could help NAL get much more exposure and use in AUDs.

Second.... While I understand the process of extinction, positive reinforcement, and the importance of random, intermittent rewards, there is more here. Receptors are not hypersensitive forever after discontinuing NAL. So while there is a period that negative reinforcers should be avoided it does diminish.

I do agree, that this is the importance of education of the patient and doctors. Whether or not people are comfortable telling there doctor certain things, the literature clearly states that people who drink heavily should let their doctor know.

I wouldn't want to deny people who seek to lose weight the opportunity to use these drugs just as I don't want my opportunity lost just because some people don't always take the pill before drinking and end up reinforcing that behavior.

I also wonder if the endorphins released from food, sex etc are not as long lasting as with alcohol. Alcohol is a powerful substance and it takes lengthy while for it to be metabolized, whereas sex, food exercise has an initial burst, then is over but the euphoria of alcohol remains. So eating reinforcement may be dulleded when on Contrave but may not have as strong of a reinforcing concept as does alcohol when the receptors are supersensitive.

NAL is also given at much lower doses at least in the first few weeks and at most is only about 32 mg.

I do agree that doctors and drug makers do need to more strongly educate on the ramifications of missing doses and reinforcing certain behaviors such as drinking when not on Contrave.

My GF has not started taking "home mixture" of Contrave, partly because she does not like pills and partly because she forgets.....hence the concern as listed above.

Ben