houtx,

One more thing. I told my GP that I was experiencing persistent and very uncomfortable muscle tension, which in my case was 100% true. This allowed him to prescribe baclofen as a muscle relaxant which no doubt helped as far as insurance is concerned. I recommend that you tell your GP something similar. Muscle tension and depression are hallmark symptoms of alcohol withdrawal.

Best,
-wort

Hey wort -
Thx so much for all this info. The DR I use for NAL, though, is not my GP but a psychiatrist specializing in addiction. So I've probably already got the scarlet letters on my record. No doubt. That's why I am hesitant to get the prescription thru him as I do not want to have this ongoing affliction following me.

But it scares me to order medication and self-prescribe...I have been totally on the fence since my Feb 6th anniversary of being on TSM. PLus at our last meeting my doc wanted me to get a liver function test & other blood work I have put off. Not in fear, just putting it off. I have cut back to 50 mgs on NAL and continue to take it "just in case". Again, all this is new science and you never know...altho I really think I am in the 22% it doesn't work for.

I am watching your progress w/ great interest. Also worried about the sleepiness effects & my job. How have you coped with somnolence & working? Thanks again!

XO

Lena,

Opps, also a thank you - sorry to overlook your response, especiably from a "regular." Your posts are so very welcome; you are one of those saints that continue to encourage from evident altruisim. Thank you so very much; it is appreciated.

-wort

Hi houtx,

I've been off all week, so tomorrow will my first day back to work since starting baclofen. I too have a job where I have to be very up and very alert. So far, sleepiness has not been a big problem, despite my rapid titration. It's wierd - I tend to drift off while reading or sitting quietly, but as long as I am talking or doing something active I am perfectly alert and not sleepy at all. If anything, I am more focused and present. It's hard to describe.

-wort

Intersting - that's exactly what Dr. A and others have described - that if they are up and doing things, it's fine but if they are sitting then the sleepiness hits. Thanks and will continue to follow your progress.

All,

Units were up a bit over last week, but I can definitely tell that my urge to drink has diminshed. I think that I am drinking mostly from habit, but habits die hard. This week I have been waking up around 1:00a every night. I usually take 20mg of baclofen and pour one drink, and am usually back to sleep within an hour. This accounts for most of my increased units for this week. Once I get back to sleep I sleep very well.

Titration is up to 120 mg per day. My goal is to be at 160 mg/day by the end of this week. Dr. A stayed at 180 mg/day for a few months with no real drop in units, so perhaps my progress so far is OK. I continue to take nal one hour before drinking.

I think I posted it somewhere else on this site, but in case I did not, here is Ameisen's latest paper: (abstract only).

Best,
-wort

I am watching you very closely, my gf. Keep me/us posted. G'nite

XO

This has been a tough week. I was up to 120mg/day at the end of last week and was feeling no side effects. My idea was to ramp up quickly over the weekend when sleepiness would not be as much of an issue. On Saturday I took 140mg and on Sunday I took 160 (40mg 4 times per day), planning to stay there all week. I felt fine on Sunday, and in fact slept very soundly both nights. On Monday morning I took 40mg first thing and went to work. Less than an hour later the nausia hit, then confusion, disorientation - it was really bad. I did not take any at noon, but continued to feel bad. Afraid of withdrawal, I took 10 mg at 6:00 and at bedtime. Tuesday morning I started with 10mg, and again at noon, but the side effects continued. Toward the end of the day I started feeling a bit better, and finished the day with 20mg. On Wed I took 20 mg in the morning, and felt more or less back to normal, so continued with two 20mg doses. Today I have had 40mg so far, and will probably finish the day with 80mg. It will take a while to get back up to 120 mg.

The point is that baclofen is a hard drug to take. I have learned my lesson (the hard way), and will definitely not rush things from this point forward. I just hope that the side effects will finally go away.

Units are about the same this week. I can definitely detect an effect - nothing like hitting a switch, but I am certainly less interested in drinking.

-wort

MR wort -
Sorry you are having a hard time. I am following your progress and others very closely. Keeping a journal of notes in hope of avoiding the pain & pitfalls others have had. It's really scary these huge amounts of pills to keep track of. I ordered the usual 10 mg pills so the prospect of taking multiple ones/handfuls really and trying to keep track...I have gotten a pocket calendar...ugh!!

But if it works?? It's worth it & I can do it! There are 20mg tabs supposedly, if it comes to that. Soon, we shall see -

Baclofen seems to cause some to taper off quickly, but so far this is not the case for me. I'm actually sort of releived, since I am still optimistic that enough TSM extinction will occur by the time I hit my switch - if indeed that ever occurs.

I'm back up to 100mg/day. Over the next few weeks I intend to titrate up to 20mg, 40mg, 40mg, 40mg (140mg total/day). My day job changes around the first week in May, so then I can titrate on up to look for my switch. Until then, I am content to build on whatever extinction might be occuring.

I found an interesting patent application by Ameisen that concerns relapse intervention with baclofen. It gives some useful insights into what to expect after hitting the switch and then tapering back down to a maintenence dose. His patent involves "as needed" (p.r.n) doses of baclofen at the onset of craving - something folks at MWO have been advocating for quite some time.

-wort