Here’s my story in brief ... discovered TSM in July last year. Followed the golden rule with good results. By October I was around safe drinking levels. Then I was hit by a speeding car while riding my motorcycle. 8 weeks in hospital and on opioid pain killers followed. Stupidly when I came off the pain killers I started drinking without Nal. I thought ‘I’ve been through a tough time, I deserve a bit of enjoyment before going back on TSM’. Typical.

To cut to the chase ... the upshot is that I now have depression and am on Venlafaxine, an SSRI anti-depressant. What I want to know is ... does TSM work while on SSRI’s? After 30 yrs of heavy drinking I felt so close to being cured when the accident happened. It has really thrown me, and I’m desperate to get back on track.

I can’t find a medical professional where I live who can give me advice. Can anyone help?

Sutt, it just seems to depend on the individual. Some people start craving alcohol more when they're on a particular SSRI, but another person taking the very same SSRI will cut back their drinking or stop entirely (or there will be no change in their drinking at all), even without TSM in the picture. If you think the venlafaxine may be making you crave alcohol, talk to your doc about it ASAP, as they may want to switch you out to a different antidepressant.

Some have noticed that their progress with TSM is slowed when using one or the other SSRI and when their doctor puts them on a different one, they start making progress again. Paroxetine lists alcohol abuse as one of the possible side effects, but I'm afraid it's a bit of a crapshoot and not everybody gets that side effect from it. It just seems to depend on your own particular chemistry.

Thanks Joe. I’m going to let the anti depressants kick in and then go back to TSM, see how it goes. Surely loads of people who have been through TSM were on anti depressants, given that AUD causes depression. I’m going to try and stay positive... I believe AUD causes my depression, and TSM gives me a way out of both. I feel I deserve some luck, so hopefully I can successfully do TSM, and when my drinking is back to normal levels I can wean myself off the anti depressants again and be ok, and follow TSM through to extinction.

Sounds like a good plan. Just keep an eye on craving levels after starting the antidepressant or increasing the dose to make sure, all things considered, that particular antidepressant is a good fit for you.

I just realised that the anti depressant I’m on is an SNRI, not a SSRI. But I imagine in terms of TSM they’re much the same thing?

From what I've seen, it's mainly the SSRI's that have this effect (again, whether TSM is in the picture or not), but no matter what the medication, if you notice that your drinking increased around when you started it or increased the dosage then it would be good to run it by your doc.