Article Title:
Beta-naltrexol level predicts alcohol relapse
Author:
McCaul, M E
Journal Title:
Alcoholism: clinical and experimental research
ISSN:
0145-6008
Published:
1997 Volume: 21 Issue: 3 Page: 32A

"172 B-NALTREXOL LEVEL PREDICTS ALCOHOL RELAPSE

McC.ul. M.E., Wand. G.S.,S ullivut. J., Mumfad. G. Qugley. J.
Johns Hopkins University School of Medicine, Baltimore, MD 21205.

Recent studies have indicated that naltrexone decreases relapse in recently abstinent treated alcoholics. Present findings are based on a 6-rnonth, double-blind clinical trial of naltrexone (0, 50 and 100 mg). Subjects were alcohol dependent with comorbid opioid and/or cocaine abuse. They were recruited from admissions to an urban publicly-funded substance abuse day treatment program offering cognitive behavioral and 12-step services. Initial findings indicated that relapse rates. time to relapse, and self-reported alcohol consumption did not differ significantly across dosage groups. However, recent preliminary analyses suggest that blood level of B-naltrexol. a major metabolite of naltrexone may predict alcohol relapse. First, there was a significant negative relationship between number of drinks/month and B-naltrexol level; that is the higher the blood level, the lower the reported number of drinks. Second, there were no instances in which subjects with a monthly B-naltrexol level greater than 40 ng/ml experienced an alcohol relapse. Finally, when B-naltrexol assays were sorted into low, medium and high levels, there was a significant difference in number of drinks/month consumed by subjects with results in the low versus high group (3.58+-8.13 vs 0.27+-.73). Importantly, 79% of the low B-naltrexol levels were contributed by 50 mg group subjects, whereas 81% of the high levels were contributed by 100 mg group subjects. It is well-known that there are considerable individual differences in naltrexone metabolism. These individual metabolic differences in combination with differences in medication compliance may have contributed to the wide variability in B-naltrexol levels observed in the present study. The present findings suggest that B-naltrexol level may be an important predictor of alcohol relapse risk and that future clinical trials should explore minimurn effective blood levels."

Duh -- I did read it wrong so I deleted. And I hadn't even been drinking.

I think you're reading it wrong Lena. The 100mg group had higher B-nal levels and the 50mg group had lower levels.

I've seen many studies where they demonstrate that naltrexone metabolism has high individual variability, but this one shows regardless of that fact if you up your dose it'll be more effective.

The problem I see with this is I found it in a deep, dark corner of a supplement to the journal and they only published the abstract. So as far as we know this study could have had 15 subjects or their methods could be flawed in one of a hundred different retarded ways that I've seen recently.

100mg makes huge difference for me compared to 50mg.

First, on 100mg there is no stimulant effect from AL. It's as if you are drinking out of bottle with "make me tired" label.

Moreover, after 100mg in late afternoon, if I get couple big strong beers at lunch next day I still don't feel any high, same slighly numbed feeling of tiredness.

On 50mg I did get a bit of a buzz, so if say I drink 3 hours instead of 2, I don't get same high as without NAL, but I still get some, and I still feel I need it. Side effects are not worse with 100mg.

I practically have written off TSM and decided to try 100mg once, felt difference, decided to stick with 100mg little longer, did search on the board and found this thread. Thanks for posting the study Lo0p as always.