I live in a remote area in the US, everyone seems to know everyone elses business. I don't trust the medical community; the people in the doctors office meet you in the stores, restaurants and etc. At one point, I had a medical secretary ask me some very personal medical questions about myself that she had read in my medical charts; she did it in front of people in a restaurant. Therefore, I know I have a problem with alcohol, I drink 3-4 glasses a day; always after 7:30 pm. I'm very intriqued by what I have read about TSM, however, I would not dare to ask a doctor in this community or elsewhere to give me a prescription for Nal - first of all, because I'm a business professional in this community, I don't want people knowing I have a problem with alcohol. My husband, family and children know and that is enough; I don't need some loud mouth secretary running her mouth around town; also, I've seen that having substance abuse in your medical charts can get you denied insurance and I know it would affect the amount of medication I need that I would get.

I have suffered for over 30 years with depression and anxiety. My life has been sort of a mess the last three years; you don't need the details. I also had gastric bypass surgery in 2002 - it was in 2004 that my drinking really started to spike; a common side affect of GBS; addiction transferred. I have not gained any weight back since losing 100 lbs; even though I drink wine. My doctor, who knows little about my drinking behavior, subscribes me 20 0.5mg Xanax for a three month period and I'm to use them only when necessary. I generally cut them in half and only take them in when I'm really stressed out. He gives me 10 10mg Ambien tablets which are to last me for 30 days - I also cut them in half and use them as needed. I take Aciphex 20mg daily for acid reflux and 1 celexa 20mg daily for depression. I'm planning to get the book and I have ordered 50mg tablets of Nal from the India International Market 30 tablets for the costs of $113.00. The pills have arrived and I haven't started yet because I want to read the dosage recommendation for me; I thought I would start with .25mg because I am very sensitive to medication. I had blood work about six months ago and there was no sign of increased liver enzymes in my test results. Generally the only deficiency that I have is iron, B-12 and calcuim which I sometimes take; I should take everyday, but sometimes they cause me to have acid reflux so I'm not really good at taking them; although I'm trying different technics to get more vitamins and calcium.

I've read about the increased risk of liver problems with Nal, but I agree that the drinking will cause more damage than the Nal. Do you think the medicines I'm taking currently will be a safe combination with Nal?

Welcome!

I can't answer your questions about drug interactions but if you search the forum for Nal and anti depressants there is a wealth of info. As for dosage, stay with 25 mg until you know if you experience any side effects (SE) and then if you do, titrate up slowly. I experienced them and stayed at 25 for about a week then once I went to 50 mg, everything was fine.

I don't blame you for not wanting any of your nosey neighbors to know. It's a very private thing and congrats for taking the first step.

If you need more info on drug interactions, you can always call a pharmacy out of town or in another state if you can't find what you are looking for on the net.

Best of luck.