I got the book today and can not find where he talks about the honeymoon effect or a drop then increase in drinking. Can someone direct me to where that is mentioned. I have basically skimmed the book but just really want to read about this honeymoon effect so I can be prepared for it, it's been almost two weeks now since I started. I think I will also start taking the 50 mg a night, I am going to try to follow the method properly from now on. Thank you.

There is no direct mention of "the honeymoon effect" in the book -- it is something that we members came up with on the board after members repeatedly referenced an immediate drop and then eventual return to pre-TSM drinking levels. Somewhere in the book there is mention of the fact that naltrexone may cause a temporary reduction in drinking that is not true extinction.

As I mentioned in a post a few days ago, we are the ones who came up woth the term. Here's a cut-and-past from that post:

Here's what Eskapa says: "Be alert that, even very early in your treatment, you may occasionally experience a surprising ability to stop after only a couple of drinks. However, this decrease in drinking and craving is merely an artifact of the treatment. The naltrexone is blocking some of the effects of the first drink and from stimuli that have become conditioned to release endorphins; this helps block the 'first-drink effect.' It is a beneficial but weak effect. The powerful effects from pharmacological extinction develop much more slowly and cannot cure you in a week or two. It took you a long time to reach your current drinking levels, and it will take at least three to four months to reverse the addiction." (pp. 117-118; emphasis his).

Thanks Lena and Nick. I personally don't read that paragraph as meaning to have a honeymoon effects as you guys describe it. I read that paragraph as basically saying "in the beginning you may have a severe decrease in your alcohol consumption, that does not mean you are cured, the cure takes a long time."

In the book his graph show a downward curve, never a downward then upward then downward curve. (I am sure that is the not the technical way to describe graphs and curves).

My question than is why did this honeymoon effect not happen in the 70 clinical trials he talks about in the book? Why is it not mentioned in the book? Why is it happening so frequently with this group of people? It certainly would be an interesting question to pose to Dr. Eskapa.

He doesn't specifically say you go back up, but his point is not to declare victory early, or call it defeat if you go back up after an early dip. Almost all of the "real" people on this board have experienced the effect. That's a significant part of the value of this board: We view Eskapa's (and of course Sinclair's) statements about TSM in the context of our shared experiences. For example, Eskapa wasn't kidding when he says it takes at least three to four months. Many of us wish he would have been more clear that it can take considerably longer. We learned that here, from each othe


The curves in the diagrams in the book are trend lines, and as such would not show dips and spikes. You see this in some who are graphing on this board. Many show the raw numbers with sometimes wild swings day-to-day. The smoother line is the trend line.

It's possible to overthink this. You might be one who gets an early reduction and stays down. I hope so. Crown86 is an example of this. The point we are trying to make is not to be discouraged if, like most of us, you find your drinking spikes up. Most all of the cured have experienced dips and spikes before making the call. There's been such a wide variety of experiences reported here that there doesn't seem to be a "normal" way through the process.

It is SOOOOO tempting to try and analyze our results in real time - it's just human nature I think.

When I started I tried to use an analogy to give me the patience to take a long view and not think very much about what was happening day-to-day. My analogy was that of a walking journey across the country, from the East Coast to my home in Oregon. Knowing that it might take six months or more, I just decided after 2 months I could consider myself maybe a third of the way home. The local scenery where I was at the moment had nothing to do with my ultimate destination - it was just a place I had to pass through to get where I was going.

My doctor laughed (in a good way, I think) when during a follow-up appointment after starting on Nal I told her I figured I was about in Cleveland at the moment.

I know some people hate analogies, but I found it helpful for myself, anyway, particularly for the first few months. (The analogy breaks down closer to 'home.')

Perfect analogy. Along the way, there are mountains and deserts and everything in-between. The journey looks like your graph, PV!!