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 Post subject: Re: Campral PLUS Naltrexone
PostPosted: Mon Jul 07, 2014 4:00 pm 
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Posts: 27
melissa1928 wrote:
They work by different means. Which method is most effective for you will depend on the specifics of your addiction.

As to how it could hurt, think of it this way -- if a craving is squelched by an outside force, that's a lost opportunity to retrain your brain not to crave.

Baclofen is taken daily at a high dose, until the point of indifference (to alcohol, of course) is reached. It's not something you grab on "those days." Because the dose is high, much higher than for its on-label usage, it's ramped up gradually and must also be ramped down gradually should you need to go off it. It's not an at-need drug.

I'm less familiar with Campral. I suppose it might work as an at-need drug. Looks like the dosage is frequent and not as high, so perhaps you could hop on and off it. That's assuming it even works for you, of course, but you wouldn't know that until you tried it.

What are you currently doing on days when you absolutely mustn't drink?


Hi Melissa,

On days that I must not drink, I don't drink. Sometimes I don't drink because I don't feel like it. I'm not sure what ,kind of alcholic I am. Anyhoo, I was drinking when I wrote this post but I did think that the Campral was taken when you wanted to reduce cravings and only then.

Got our pills today though. :)

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 Post subject: Re: Campral PLUS Naltrexone
PostPosted: Mon Jul 07, 2014 4:59 pm 
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Posts: 190
Aren't we overlooking the possibility that some people drink for GABA effects AND the dopamine hit? Or for some other reason altogether?

I'm not convinced that the GABA folks are the minority. From my research (I'll look up the studies I found again), they are the majority. If you don't have at least one copy of the A118G allele, then you're not getting any dopamine (endogenous, produced through the opioid system) at all and could only be addicted via GABA.

That said, my casual perusal of studies leads me to believe that if you are drinking for the GABA (or for both GABA and dopamine) that baclofen is more effective than Campral.

GABA is also available OTC (amino acid). It supposedly doesn't cross the blood-brain barrier, but some clinicians (notably Julia Ross) dispute this. I think if you're GABA deficient it would be worth a try, but it doesn't look promising. There is a form of it that definitely crosses the BBB (phenibut), but tolerance to it builds fast and withdrawal is scary. It's chemically very similar to baclofen. Since tolerance and withdrawal are common to both baclofen and phenibut and they are so similar, I wonder if there is a manageable daily dose of phenibut (which is MUCH cheaper than baclofen and available OTC) to combat alcoholism. There are lots of scary phenibut withdrawal stories, but they are from the internet, so who knows? Caution is definitely indicated. I've tried it (as a baclofen alternative). Like baclofen, for me all it did was potentiate alcohol impairment, but not the high. NOT GOOD.

Alcohol also increases available serotonin. Circulating levels are easily increased by taking 5-HTP or l-tryptophan, which are also inexpensive and available OTC. Again, from my casual perusal of the literature, it seems that you can't drink on them or they are rendered ineffective. Might be good for someone drinking for the serotonin who can also abstain. SSRI's do the same. Drinking to combat depression would be a clue that serotonin might be the problem. Another clue would be substituting sweets or binge eating for alcohol.

Alcohol also acts as an antidepressant for people who are GLA deficient (it makes the PGE1 - an endogenous anti-depressant - in the body available to the brain). GLA deficiency is treatable with evening primrose oil, which is also available inexpensively OTC.

Long (loooooong) story short: if you're drinking for the dopamine, adding Campral is not going to do anything but drain your wallet. If you're drinking for the GABA, same for naltrexone. If you're the rare snowflake who drinks for both, Campral + naltrexone may just be the thing. If you're drinking for other rewards, neither will help at all.

Thinking about why you drink and what you feel when you drink are, IMHO, helpful. Genetic testing would be more helpful, but I think subjective experience is quite telling.

Sorry for the ridiculously long post, but this is interesting stuff. ;)


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 Post subject: Re: Campral PLUS Naltrexone
PostPosted: Mon Jul 07, 2014 6:24 pm 
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Magda wrote:
Aren't we overlooking the possibility that some people drink for GABA effects AND the dopamine hit? Or for some other reason altogether?

I'm not convinced that the GABA folks are the minority. From my research (I'll look up the studies I found again), they are the majority. If you don't have at least one copy of the A118G allele, then you're not getting any dopamine (endogenous, produced through the opioid system) at all and could only be addicted via GABA.


I think you are maybe conflating dopamine and opiates.

Dopamine comes into play as our general achievement/reward system. We get a shot of that whenever we accomplish anything, including the pitiful accomplishment of obtaining our drug, but it's not an inherent effect of the drug.

Everyone gets an opioid hit from alcohol. This is the "innate reward" we hear about. What's the diff in people who've got the gene? We don't know -- maybe it's more intense or maybe it's less intense (so that they need more) -- but they're not getting anything that the rest of us just plain aren't. Alcohol triggers the release of endorphins, natural opiates, which bind to the opiate receptors. That's just one of the things it does.

Everyone gets a GABA hit as well. That's another of the things it does.

We train ourselves to get the dopamine reward by seeking alcohol for other reasons. Once we've already learned to like it and enjoy it, then the dopamine reward kicks in. Dopamine's involved for everyone, but it's not the base problem for anyone because it doesn't factor in until we've already trained ourselves to seek alcohol.

More to follow . . . I want to write a thoughtful response to your main points, but I wanted to get that correction out there for the folks at home.

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 Post subject: Re: Campral PLUS Naltrexone
PostPosted: Mon Jul 07, 2014 7:05 pm 
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Magda, I'd like to work on this with you backchannel. We've done separate but overlapping research, and I think we could put it together into some really good stuff. PM me if you're interested.

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I'm bloggin' it up! Check out Naltrexone Key:
http://naltrexonekey.blogspot.com/
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 Post subject: Re: Campral PLUS Naltrexone
PostPosted: Mon Jul 07, 2014 9:33 pm 
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Joined: Thu Jun 19, 2014 1:40 am
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PM sent.

melissa1928 wrote:
I think you are maybe conflating dopamine and opiates.


I don't think so. Example: http://www.ncbi.nlm.nih.gov/pubmed/20479755

Quote:
A striatal dopamine response to alcohol was restricted to carriers of the minor 118G allele.


melissa1928 wrote:
Dopamine comes into play as our general achievement/reward system. We get a shot of that whenever we accomplish anything, including the pitiful accomplishment of obtaining our drug, but it's not an inherent effect of the drug.


Some drugs (e.g. cocaine, meth) give all users a dopamine hit, but alcohol does give some users a huge hit right in the reward center of the brain. It's these drinkers that I think are the best candidates for TSM, since the µ opioid receptor (the one blocked by naltrexone) is the major determinant of the dopamine response to alcohol.

melissa1928 wrote:
Everyone gets an opioid hit from alcohol. This is the "innate reward" we hear about. What's the diff in people who've got the gene?


See the above response. People with the variant get dopamine delivered directly into the reward center of the brain. People without the variant get, as you correctly stated, NO dopamine. Everyone gets endorphins with opiate-like effects (which bind to the µ receptor), so naltrexone would block those, but I suspect that the endorphin release is not the problem per se in alcoholics, since, as you correctly stated, alcohol causes that release in everyone, yet most people can easily drink in moderation. In other words, I don't think it's the direct opiate effects that cause problem drinkers to lose control.

http://www.sciencedaily.com/releases/20 ... 190945.htm

Quote:
"This variant of the opiate receptor gene is the exact same one that predicts naltrexone response," said Anton... The data support the idea that alcohol might work through the brain opiate system to hypothetically increase dopamine and thereby lead to perceived positive aspects of alcohol consumption.
[emphasis mine]
The increase in dopamine is no longer hypothetical. I'll have to find the newer studies.

melissa1928 wrote:
Everyone gets a GABA hit as well. That's another of the things it does.

True, but even there, some people (carriers of the GAD1 gene variant) are more vulnerable to the GABA effects of alcohol. They release GABA more slowly after ingesting alcohol and therefore are compelled to ingest more. Couple this with inherent low levels of GABA, and it's a pretty good recipe for alcohol dependence. It's these folks who I believe are good candidates for baclofen or Campral.


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 Post subject: Re: Campral PLUS Naltrexone
PostPosted: Mon Jul 07, 2014 10:57 pm 
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Posts: 190
An old article that sums up the dopamine thing nicely: http://www.post-gazette.com/news/health ... 1006300241

Quote:
Dr. Neil Capretto, medical director at Gateway Rehabilitation Center, said a subgroup of 20 percent of the people who receive [naltrexone] have an 80 percent success rate, while the remaining 80 percent have only a 20 percent success rate.


Quote:
"People who have the genetic variant release substantial amounts of dopamine exactly in [the brain's] reward center. People who don't have the variant don't release any dopamine whatsoever," Dr. Heilig said.

To confirm that the 118G allele was truly the gene variant causing the disparity in dopamine response, researchers took the allele and inserted it into the genome of mice. They once again analyzed the levels of dopamine in the brain in these mice, this time using a device called a microdialysis probe. They found that mice with the human 118G allele had a dopamine response that was four times greater than their non-variant carrying counterparts, confirming the role of the 118G allele in dopamine release.


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 Post subject: Re: Campral PLUS Naltrexone
PostPosted: Fri Jul 10, 2015 4:01 am 
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Welcome to this community.
Good to hear from you. :)


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