Well after several weeks I am starting to wonder if I will reach 'normal' levels of drinking. I have still maintained a reduction of about 40% thanks to TSM but after reading 50mg may metabolise quicker in some it started to make sense to increase to 75mg. There is a guy on Youtube who has had success on 75mg and I decided to give it a try last night. I have had encouraging results for 2 nights running so maybe 75mg is the best dose for me as I have not enjoyed alcohol on this dose. After all we are not all the same size, metabolic rate etc. and this may account for the 22%...

fingers crossed!

I did it for while and went back to 50 because my doc wasnt into it. I may ask her if I can bump up to 75 if I don't see a big drop soon. if it works, why not?

I just got bumped up to 75mg by my doc. she actually gave me enough so that I could go to 100 if I want so I may do that at some point, and if I'm still not "cured" or whatever you want to call it after a few months of that, well, I'll try something else. but with 50mg I've seen a huge drop, so I think if I up the ante, extinction will occur in earnest.

Nal is such a safe and innoccuous drug, and I don't have side effects (had them for like 3 days) so I'm not worried about it. I'm not a doctor though so take that for whatever it's worth

Joe, great to hear your doctor was finally willing to change your prescription!

I am on 100mg, but I am not really sure I need to be?!? I seem to have turned a corner, but I wonder if I would have anyway. I was on 75mg for 3 months, then just changed to 100mg last week. I have no way of knowing if I would be in the same place now had I stayed on 50mg the entire time. But, I can say going from 50mg to 75mg to 100mg was not a problem for me, as I tolerate the drug very well.

soon after increasing to 75mg i hit a spike in my drinking so i have gone back to 50mg. My drinking has decreased slightly again but dont think it's necessarily related to my dose. I may well go back to a higher dose some day.

It's a strange journey on nal. I do have faith in it though as my drinking has dropped from pre tsm so even if i don't get down to 'normal' levels i will continue on it for life as it is a damage limitation for me.

Thanks for your replies and it is interesting to see how others get on with higher doses.

i'm very interested to hear about a spike in units after an increase in nal. i have been concerned as i increased to 75mg over a week ago and have not seen a drop in units but have been applying effort to reduce. it has felt so crazy, like i am starting later, going slower, really actively delaying having the next one, and then when i count at the end of an evening or week, same as it ever was!
hopefully after some initial spike i will settle down and my effort will count for something... after that i will bump to 100, hope i don't have to go through this again
this really is a crazy process.
with fingers crossed,
path

Last year, there was a lot of discussion about dosage amounts that deviate from the book. We found that TSM doesn't appear to work any better on a higher dosage with regard to the time it takes for extinction to occur. Of course, all this was anecdotal evidence and not a controlled experiment.

Once you start having more and more AF days per week and your body develops a resistance to the Naltrexone side effects, some of us (such as me) would use 100mg with no apparent adverse reactions. Naltrexone is only damaging to the liver in high dosages (300+ on a consistent basis according to the literature, if I remember correctly), but you have to also account for the extra work your liver is doing to perform the alcohol metabolism too. So, be careful.

In my final hit and miss single-drinking-day weeks of June, July and my last 2 drinks in August 2010, I was taking 100mg per session. I do not know if that contributed to my total lack of desire for AL or not. I will never know.

Bob