I was prescribed Nal (50 mg) for the first time yesterday and found it pretty unpleasant. It definitely affected my experience with alcohol. In contrast with my usual two bottles, I struggled to finish two glasses of wine and had no interest whatsoever in drinking more. Went to bed, however, could not sleep at all. I felt like I was awake all night, experienced night sweats, some nausea, clenched teeth. Ugh. I haven't read many reports of unpleasant affects from Nal, so I was surprised. Anyone else experience this, particularly the insomnia?

I did not take the dose until about 10 p.m. and did not drink until shortly after 11 p.m. In contrast with what I've read about TSM, my doc recommended taking it in the morning, with food. He did suggest taking a 1/2 dose at the beginning, and I will definitely try that.

Definitely start with 25mg.

I get drowsy sometimes on NAL. So no to insomnia. Give it some time.

I'm gonna suggest AGAINST taking in the morning-- then you're just experiencing more of whatever side effects you experience. Take in the evening. Maybe cause you took it so late and went to bed soon after, the drug was releasing while you were trying to sleep.

Groucho

I started at 50mgs from the start..I generally take to medicine well. Yep had the insomnia..some of the worst in my life...felt like a zombie for like 3-4 days...but to me the side affects of naltrexone are mild compared to the side effects of alcohol...liver disease, black-outs, the wacky behavior, heart disease, depression, destroyed relationships...and on and on...

I think AJ made a good point with the insomnia...I was drinking at bizzare levels like 20+ and from the very begining nal obliterayed my tolerance to 1/3 of my usual on average. I never thought about the point AJ made but it makes sense as insomnia is a common alcohol withdrawl symptom.

Thanks folks. It's been a while since I checked in, so I thought I'd post a little bit about my experience so far. I followed my doc's advice, which was to stop drinking altogether for a week or so before trying the Nal again. Usually that would be a huge deal for me, but I felt so bad the day I started this thread, and for several days that followed, that I didn't even want it.

I have been taking 25 mg doses for about a week, and have not had the same side effects or experienced any significant insomnia. I started back on sertraline (generic of Zoloft) the same day I started this thread, so I am wondering if that played a role in my weird reaction too. Having said that, I don't feel in any hurry to jump up to the full 50 mg dose.

Before starting, I was averaging about two bottles of wine a night. Since taking Nal, my urge to drink has dropped in a huge way. I've only drank once - a little more than a bottle of white wine Sunday night, which was more a matter of curiosity to see the effects of drinking on Nal than actual craving for it. I did not get much of the usual emotional lift from it, and almost had to force myself through the first couple of glasses (at which point habit/training took over). I haven't had anything to drink since, and haven't missed it much.

I understand this is not the TSM approach to things. Candidly, I am so flipping sick of drinking that the idea of forcing myself to drink in order to correct the wiring in my brain has no appeal to me at all. I'm just grateful as hell to have had a week or so where I'm not drinking and not constantly obsessing about when I am going to fall off the wagon. I guess the only dis-ease I feel right now is just a profound sense of exhaustion. That may just be my body's way of asking me to start catching up on all the sleep I've missed over the years to stay up and drink.

Hey, whatever works for you!

Don't start drinking again just to go through the "extinguish" part of TSM. Just take NAL every time you drink-- however often or rare that is--

Thanks Nemo. That's my thinking exactly. I'm just happy as hell not to feel the need right now.

I took 50mg for my first dose and felt as though I had been run over by a Mack truck. I was terrified to take 25 mg the next day, but to my surprise had no side effects at all.

For some, it does take a few days. Sleep disturbance and bizarre dreams seems to be the most stubborn side effect for those who experience these. But these too fade quickly.

The good news is that a rough start with naltrexone appears anecdotally here to be a reliable predictor of success with TSM.

I wish I could say the side effects go away after a week or so. I am almost at a month, and I still feel awful. I stop at three glasses of wine a night and I still wake up with a terrible headche. if I exceed that, I am very sick the next day, and this is on 25mg! I don't know if I am going to be able to keep this up for 6-9 months. I am tired of being so sick!

We have someone posting here who is helping her boyfriend. He had a very bad case of side effects. They started him on very small doses and worked up gradually. He's doing great now. Her name is nmarie. You might want to read her posts. It would be a shame to get discouraged and give up because of side effects. Let us know how you're doing.

I just went through my first week of NAL at 50mg and experienced much of what ya'll are experiencing. I think I should have humbly started at 25 mg a night and worked myself up to 50mg....ah well, lesson learned.

Here's the link to my thread where I go into a bit more detail about the first week I had on NAL. Hang in there!!

viewtopic.php?f=9&t=1373&p=17384&sid=995b8c403d1fb1daa92ee26da5db140f#p17384