Hi,

Just started Nal, (10 days ago)but confused how to take it. Due to stress and emotional issues and anxiety I started drinking constantly all day long..(vodka).to ease my nerves for the last few years. I could have gone to a medical dr for anxiety meds, but I didn't and instead developed a habit of drinking straight vodka constantly throughout the day....starting around 10am. Now it is a habit and I think of liquor all day. It's terrible and I know I can quit with this method, but concerned I am doing it wrong. . I just don't know how to dose myself. If I take it at 9 am do I take it again around 5pm? I ordered through alldaychemist, but it is expensive. I am currently taking 25 mg in morn and 25 early evening. The first few days were brutal w nausea and feeling "disconnected", which has gone away. Am I taking too much or not enough? I am a very social person with a social life. I've noticed I'm drinking much less during the evening when out w coworkers, friends, and partner, but during the day.....I feel the urge around 10am.

If you are an all day drinker, how do you work out the dosage? I'm 5'5, small frame, and 110lb, so I don't want to take too much and it is expensive. Please help or advise. Thanks. I also take xanex (about 5mg) per day for anxiety- after the drinking habit developed, then another 5mg at night for sleep....and my dreams have become very strange lately.

Any advice please!!!!

L

I just reread the literature and a document that Joanna sent me (a doc drafted by Eskapa). In sum, as I understand it, you should be fine, because the half-life of 25 mg is 6 hours. But if you are continuously drinking wouldn't it be easier to take 50 mg at 9 a.m.? (A set it and forget it approach.) It sounds like you're over the adjustment period. Doing so insures compliance with the protocol.

I don't know if there is a conflict with Xanax or like medicines, however. You should read around on that, or perhaps someone else knows.

I looked up "interactions" with naltrexone and xanax on drugs.com and received this: "No results found - however, this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist." I have no training or insights beyond this, however.

I know Naltrexone / Narcan do nothing to reverse a Xanax high, so can't imagine what kind of interactions there would be. Still, it sounds like a mess and I hope it all works out for you. My "start time" went from a strict "no later than 5:00 PM" to as early as 1:00 PM. The time creep downward really opens up a whole new can of worms, doesn't it? I guess I would question BuenaVista's statement that 50mg in the morning would be as effective as 25mg in the morning and 25mg in the evening, since it doesn't matter the dosage in terms of half-life. 50mg wears off just as fast as 25mg. So, 25mg twice a day would be better. And, you call it "expensive," but isn't it just like $2 a pill from alldaychemist. Unless you're drinking some skanky vodka, you should at least be breaking even, right?

Thank you for the advice. i generally do not ever get a buzz from alcohol during the day as I drink a little all day long, which is why I'm not sure the Nal will work to block the high. Trying to stay positive. I just dont want to take it at 9am then it wears off and I am reversing the effect when i do have a few glasses of wine at night around between 8-10, and I don't want to take 100 mg a day. So Nal will work for 12 hrs? I will just will myself into not drinking before 12, then take 50 mg. My goal is to just be able to have a couple of social drinks per night and get my weekly unit count down to 14 units. I drink a 1.75 liter of vodka, prob-6 glasses of wine and a few beers per week. Prob about 50 units per week.

Amazing how this crept up on me and I self medicated my nerves by drinking.....I can control this- I know it. Thanks for the advice, I just want to make sure I am taking the Nal properly. I'm weaning myself off the xanax too so it shouldn't be an issue. Just wish there were more drs. that know of this as I live in the Pacific Northwest and can't find one.

Eskapa says:

There's no point in taking more than 50 mg per day.

50 mg is good for 24 hours.

Thank You! That is good to know. I must have missed this in the book- as I skipped around while reading it.

Kindly,

L

BV, where does Eskapa say that? That's surprising. Although, I know I can "feel" Naltrexone for 24-48 hours sometimes. Also, Olive, Naltrexone doesn't necessarily "take away the buzz." Its main power is subconscious so you may or may not feel different, even if it's working. Also, what's the point of simultaneously weaning off Xanax, which is hard enough as it is? And, what's your plan for "calming your nerves" when / if you achieve your goal? Few things are more powerful than anxiety to make one drink.

It's good that you're being positive and confident. It might also help to think that, in a twisted sort of way, drinking alcohol itself both relieves and causes anxiety. If you were stuck on an island with no booze or Xanax for months, you'd probably have quite a time while your body and mind adjusted, but you'd probably find that your "nerves" problem healed on its own. They've found the same with smoking (do you smoke also?). People think smoking RELIEVES their anxiety, but what they're actually anxious about is GETTING NICOTINE NOW!.

If you feel like sharing more with anonymous internet strangers, I'd be curious to hear more about your anxiety, what it feels like, your history of, etc...

Olive10, so I guess there are different ways to calculate "units." What you say you drink is actually about 10-12 drinks per day. I only point that out because that's high enough to give you all kind of withdrawals if you were to stop cold turkey; plus, enough to really cause some physical damage to organs and such. I'm also curious how much you drink "during the day" and how much you drink when you really get down to it in the evening.

BarryB, in one of his notes Eskapa says that there is a ceiling on nal effectiveness, and he's comfortable with 50 mg/24 hours. (The demonstrated half life of 50 mg is 12 hours.) My comment about taking it all at once in the morning is in response to her statement that she drinks all day. That is a recipe for noncompliance if she schedules a second dose after drinking for seven hours. Hence my comment 'set it and forget it.' YMMV.

Oh. I thought it was 6 hours. That makes sense now. I tended to be a quick binger (e.g. six quick drinks before dinner on an empty stomach), so it never really crossed my mind.