Hi, I ordered the book and I am going to ask my Dr to prescribe Nal.I'm wondering if I should take a pill before each drink or just the first drink. If the latter, how many hours will the Nal work?I know I could wait until I read the book but I'm seeing my Dr on Mon and want to know enough to answer questions she may ask. Is this the same drug being used experimentally to treat MS?

Hi Annel,

I just started TSM a month ago. My doctor recommended 25mg for the first two weeks, 50 mg for the next two weeks, and just increased to 75mg today (starting my fifth week.)

You take the pill one hour before the first drink, and it is "protective" for a period of time after that, but I am not sure how long that is. I found the following quote on rxmed.com:

"Clinical studies indicate that 50 mg of naltrexone will block the pharmacologic effects of 25 mg of i.v. administered heroin for periods as long as 24 hours. Other data suggest that doubling the dose of naltrexone provides blockade for 48 hours, and tripling the dose of naltrexone provides blockade for about 72 hours."

It seems logical to assume that blockade time would be the same for alcohol.

In the book, the rule is very clear: ALWAYS take Naltrexone (whatever the dose you are using at the time) one hour before drinking. NEVER drink without Naltrexone.

Good luck with your doctor! -YG