Hi everyone,
This is my first post after discovering the "Sinclair Method" online a couple days ago, and I'm so glad this forum exists. Before I take the plunge, however I have a few questions. I have a talk therapist and a psychiatrist to deal with generalized anxiety, but I haven't mentioned anything about alcohol to either of them. I'm terrified about being labeled an alcoholic, getting insurance down the road, etc. But if naltrexone works as well as the studies show, I might have to reconsider my reluctance.

My first concern is insomnia. I have a terrible time sleeping, and have for years. Alcohol has been the 'cure,' but of course now that is a problem. I started taking ambien a few years ago and it works great. No booze 3-5 nights per week, and I sleep fine. Will naltrexone interfere with ambien's effectiveness? I fear that terrible sleeplessness will prevent any meaningful recovery.

My second question is the "brain receptors" this pill works on. I've read on here that when taking naltrexone these receptors can be increased in the brain. Will this mean that if naltrexone doesn't work for me my affinity for alcohol will be increased if I stop taking the pill? That's a terrifying prospect if so.

Finally, since I suffer from anxiety, is there a greater chance that my problem is GABA related? If so, does that mean naltrexone won't work for me? I have ocd symptoms as well, and I actually think my drinking is a compulsion. The hope is that by reducing the pleasurable feeling associated with fulfilling the compulsion I'll be able to get back on the right course.


Sorry for all the questions! If you have thoughts on any of them please let me know. For a little personal history (if it helps), I've probably had a real drinking problem for 5-7 years. For about 4 years it was daily (7-9 unites at night before bed). Realizing last year that this made anxiety worse I resolved to cut down. With the help of ambien (and the occasional ativan) I usually go 3-4 days/week without booze, or with a single glass of beer or wine with dinner. However, those other days I'm still at 6-9 drinks, and cannot sleep with fewer.

Thanks again for any and all suggestions!

Welcome, picabia!

Insomnia: For me, before Nal, it had become a revolving door of alcohol and sleeping pills (Temazepam). I have always had trouble sleeping and medicated this with alcohol, then pills as the alcohol caused rebound insomnia (i.e., insomnia caused/exacerbated by the original "cure"). Finally, I began to get rebound insomnia from the pills (i.e., couldn't sleep without either one or the other). I am now completely off prescription sleep aids with the occasional Unisom. I have never felt better. Sleep DOES come back after a few bad nights, it seems, if given a chance. I believe that the change in my chemistry due to Nal has allowed me to do a U-turn on the rebound insomnia from both pills and booze. This may not be true for everyone, but it is for me.

I have no experience with OCD, etc. so will not attempt to address that part of your post.

Some here have had excellent results with Nal while on drugs like Ambien. Some have felt (with some backing from Dr. Eskapa) that benzos have slowed down or stopped their progress. Ambien is not a benzo; it is a sedative-hypnotic. I don't know how this category of drugs relates to GABA -- might be something there, might not. So far, I have seen some improvement in my units (i.e., fewer) since I stopped taking prescription (benzo) sleep aids. But I am not sure if the ceasing of the sleep aids had a direct relationship to the lowering of units (post hoc ergo propter hoc). My completely non-medical, personal and unofficial opinion is that the more naturally you can get your sleep, the better -- the fewer substances in your body, the more you can narrow down what is and isn't working toward health for you.

My understanding of receptors: Yes, your receptors will increase when you take Nal because your brain will try desperately to reproduce the "glow" or euphoria that existed when it received alcohol pre-Nal. The good news is that if you stop taking Nal and continue drinking, the receptors will go back to "normal" levels after a while (not sure how long this takes) because the euphoria will return.

Yogagirl put up a great post here a couple of days ago about the wide variety of experiences people have on Nal. It is impossible to predict with 100% certainty how ANYONE will do on Nal.... Some people have no "honeymoon" yet have great success; others take sleep aids and have great success; others have a honeymoon yet struggle with increasing units; etc. The only way to know is to do it and to GIVE IT TIME. LOTS OF TIME.

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Thanks guys. I'm still very nervous about bringing this option up to my psychiatrist. We actually just met and he gave me a benzo script for anxiety. We haven't discussed alcohol. This certainly has a "too good to be true" feeling, in particular I'm worried that while taking nal I won't get endorphins from booze but still get the anti-anxiety effects and sleep aid, which is really what I'm after. Also really concerned about being labeled with my insurance.

Hi picabia!

I have OCD and hypo-mania (very similar to GAD). I was told that my Valium regimen (for anxiety) may interfere with TSM, so I titrated the Valium down slowly over many many weeks during my treatment. After I was cured, I was surprised that I didn't need as much Valium as I had needed to treat the mania anymore. 10 months have now passed since being cured of alcohol addiction and my Valium usage has slowly increased, but it is still one half of the amount I needed when I was an alcoholic. During that entire time my OCD medication remained unchanged. Whatever causes OCD seems unaffected by alcohol or Benzos.

Today, I rarely drink except in social or business situations where it would be awkward not to. My OCD is still under control as is my hypo-mania.

I never had any long term sleep problems, so I cannot address that, except to say I have taken ambien about twice over the past year and it worked fine with no interference from Naltrexone.

Please understand that the above paragraphs are my personal experience and not medical advice.

Bob

Wow Bob, if I can say what you're saying a year from now I'd be thrilled. I'm happy to hear that after 10 months your drinking is still controlled. That's very encouraging.

I know you'll be thrilled, if you have or develop patience. It's a long journey and it's not normally a linear decline. That's the hardest part of TSM is the waiting.

Also, not only is my drinking still controlled, but the average alcohol intake continues to decline. In Eskapa's book, there is a reference to patient's AL intake continuing to decline even after 3 years of treatment.

Bob

Hi again p., a couple more thoughts....

1. I think I noted above that yogagirl put up the "snowflake" post about the WIDE variety of TSM experiences. I believe it was actually Toxicgirl who posted that. Sorry, so many articulate people here, sometimes I get confused about who's being brilliant at the moment!

2. Your quote: "This certainly has a 'too good to be true' feeling, in particular I'm worried that while taking nal I won't get endorphins from booze but still get the anti-anxiety effects and sleep aid, which is really what I'm after." -- Not sure I'm reading you right, but if you're asking if drinking still lowers anxiety and helps sleep on Nal: For me, yes. And even better, because there is no longer the euphoria (again, for me), it takes FAR less alcohol than before to feel relaxed and sleepy. In fact, I often feel relaxed and sleepy at appropriate times with no alcohol at all (I think because the rebound effect has mostly gone away). For the last month or so, I've been taking occasional daytime naps -- totally unheard of for years before Nal.

Worth noting, as always here, that this is not medical advice but anecdotal sharing. Best to you!

Thanks for the input everyone. Regarding my anxiety about alcohol's continued anxiolytic effects on nal, my concern is actually that it may keep me drinking. But your experiences make sense Seeking1, and if that were the case for me I could certainly see this being a positive experience.

The contributors here seem extremely thoughtful and educated in their opinions, so on that note I have one other reservation along the "too good to be true" lines. As far as I've read, the "Sinclair Method" as it is called here was popularized in the US by both the Eskapa book and a certified addiction specialist who wrote an e-book. The latter has me very concerned. I certainly can't go to my doctor with an "e-book," and moreover, it would seem that such a cure for alcohol dependence would have widespread use amongst practicing psychiatrists rather than non-MD web writers. Now I've read all the reasons why it hasn't caught on (and many do make sense), however, are there more popular media reports out of Finland? I've read claims online (including wiki) that "tens of thousands" of people in Europe have been helped with nal. With those numbers it certainly should be all over the EU press. Is there anything I should look for (aside from the Combine study, and the other study by Sinclair?). I was thinking of calling the Finland drug and alcohol research centers to see what they have to see (for example, is nal standard practice for all of Finnish outpatient alcohol programs?). Has anyone else done this?

Thanks!

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