A week or two after I had increased my dosage and felt results, someone mentioned that they had been told that women needed more naltrexone then men. I finally found a mention of that online. So the stronger effect is not just in my mind!

http://www.aca-usa.org/recoveryforum.htm

I read the link and it contains a lot of factually inaccurate information, including the absolute rule that women require a higher dosage than men: THIS IS FALSE. It may be true in some individual cases, but not in every case. Netty was cured on 25 mg; Lena is on the verge of being cured at 25 mg.

Here is some more false information from the link:

What most treatment professionals do not seem to comprehend is that Naltrexone is an extremely effective tool, when appropriately utilized, and that it is not a cure. The purpose of Naltrexone is to suppress the intense craving to consume alcohol, generated by alcohol compromised brain chemistry.

WRONG, naltrexone taken with the proper protocol (TSM) is, in fact, a cure for alcoholism. And the purpose of naltrexone is NOT to suppress the craving. The purpose of naltrexone taken consistent with TSM is to become de-addicted by the process of extinction. Cravings are not suppressed, the cravings are eliminated by extinction. I know the author of this post is a big whig, but when it comes to naltrexone and TSM, he does not now what he's talking about. That fact makes me highly dubious of his claim that women require a higher dosage of naltrexone. Perhaps most significantly, the unquestioned experts of TSM, Dr. Eskapa and Dr. Sinclair, do not arrive at this conclusion in their work.

And I'm not saying that folks like Houtx and WTE should not increase their dosage -- they probably should, given the length of time they've been at it with little or no success. I am just saying that dosages vary by individual and that gender is not the determining factor.

I just uncovered another error in the author's post where he discusses the efficacy of taking naltrexone combined with treatment. This is also an outdated opinion: recent studies have shown overwhelmingly that naltrexone taken without therapy is just as effective as taking naltrexone with therapy, making therapy no longer a requirement for successful treatment with naltrexone/TSM.

Lenore - Please don't misunderstand -- we all are happy for you that you feel that whatever you are doing is working for you. But I hope your readers don't take your generalization and needlessly increase their dosage. Some of us are getting results on less than fifty; some may require more. We all have decisions to make. I based my decision to reduce the dosage when my drinking time got compressed to a few short hours. But I based it on a question by Netty to Dr. Eskapa citing to a study published in a journal, and Dr. Eskapa's reply. Two of our members here have patiently waited for results for a time past what they rightfully should expect a significant change. One option is for them to try a higher dose; thankfully, Dr. Eskapa has actually spoken to one m.d. and the other has an m.d. willing to be supportive of this option. One of these members is a man and the other a woman. When asked about it, Eskapa relayed the question to Sinclair and he said they did not observe differences in how men or women reacted, but also said the studies were not designed to control for that either. You'll find it on the Ask Dr. Eskapa topic. I hope and pray those who try it, after careful consideration, do benefit.

The web site you cited to above is not a peer-reviewed publication. The author mentions naltrexone as a treatment, then describes it as an anti-craving med, which, studies show repeatedly, it is not. Then, in a separate article, there is mention of the COMBINE study, which first showed naltrexone is among the most effective treatments WITHOUT counseling. In other words, naltrexone alone, without counseling beyond basic medical management, can be primary alcoholism treatment, and it can be administered by a general practice m.d. with no specialized addiction training. This is the basis for the New York Times article you will find in the Naltrexone in the News topic on this board. The article on the website makes this far from clear.

It is so easy for people to get the facts wrong when they see things like the title you chose for this thread. WOMEN DO NOT NEED A HIGHER DOSE. At least one study has shown that SOME women MAY benefit from a higher dose. You could drive a Mac truck through the difference in those two statements. And Eskapa has allowed for the fact that SOME patients, be they men or women, may benefit from a higher dose. I hope and pray those who try it do benefit.

For such a simple method, TSM certainly has its fair share of nuances. It is vitally important that those of us doing TSM and participating in this board make responsible decisions about the information they acquire here. It is equally important that those of us who choose to share information be as accurate as they can.

With All Respect,

I don't think Lenore was misleading anyone to upping their dose hoping for better or faster results. Yes, the Subject should have been we MAY need a higher dose.

Dr. E has stated that they didn't not have a case study on gender specfic studies or trying a greater dose on the 12% that did not respond.

Also, the study did not take in account for
1. Heavy binge drinkers or people who are in the high unit (over 35 a week)
2. Age and on-set
3. Mental State (depression, stress and life changes)
4. Other meds taken
5. Physical or medical conditions (Such as my gastric bypass)

His case study was on a small number of people compared to other studies with other meds that found that age and gender do play a part in how a human processes meds.

I think it's a consideration for people and they should see that they may want to or need to go to 75mg to 100mg. I'm not saying that women or men should just jump into the 75 to 100mg at the beginning, but if you are not seeing results after the 16th or so week you should evaluate YOUR progress.

I have decided to up my dose based on advice from Dr. E, other sources and my doctor for reasons stated above.

I am in therapy and I do not feel that therapy does not have any more benefit with Nal then not being in therapy. Sure therapy helps with the underlying issues that I have in life and with life, but when I seperate my emotional state to my drinking they do not always go hand in hand.

The TSM is really a person by person treatment, we are not all having the same effect or success/failure rate at the same time or in the same way. If this was the case I would be calling this a failure at 22 weeks, but I will not, I'm willing to go further and maybe the few of us who have to up our doses can help someone in a few months who are at the same place we are now.

I am convinced that this will work for me and that TSM is right.

I don't see any inconsistency between what Lena just said and what Providence just said, namely, that as a rule, women do not require a larger dose of naltrexone. Success on TSM varies by individual and if the method is not working for you, you may want to consider a higher dose, regardless of your gender. (Preferably after a consultation with your physician.)