Just to add my 2 cents worth: I agree completely with the observation made by StV in his post about Nal making us perceive alcohol in a fashion similar to that of "normal" people (i.e. those that don't have a tendency to abuse alcohol).
I just started taking Nal on Feb 10 and had side effects for a few days. But I quickly realized that some of what I thought were side effects were caused by me trying to "force" myself to drink quantities of alcohol similar to what I was drinking before going on Nal. When taking Nal my tolerance has gone down, and if I try to drink my old pre-Nal amounts I feel pretty bad, and tend to get nasty hangovers.
So now I just try to take it easy, and when I notice that I'm getting disgusted with what I'm drinking I quit - even though I may have had considerably less to drink that I "usually" have. This has definitely helped!! So now a week later I can say that I seem to be over the NAL "side effects".

Amy, it sounds like you are getting good advice RE the side effects. This forum was invaluable to me wen it came to the side effects....without it, i would have been afraid to continue. But, all are gone now, and have been gone since about 10 days in.

Like so many others, I find I cannot tolerate much alcohol, though. I think I was luckier than you, because that quick route to tipsy didn't start for about 3 weeks, so I had time to see some natural reduction in urges and get some new habits formed.

Now, I will NOT drink more than 3 glasses of wine because I know for certain I won't sleep well, so will want to sleep all day, and will have a headache and feel hung over--all on 4 glasses of wine. That one more glass is just plain NOT worth it

Good for the cure! I had other strange side effects, but have learned some of those are not NAL, but alcohol withdrawal. I drank about the same as you posted pre-TSM, and in those days didn't feel tipsy until after at least 5 drinks.

You appear to be someone who will work with the method and make it work for you. NAL does some of the work but we have to do our part too. Good luck! We are all pulling for you!

Just a heads up for those who immediately can't drink that much after starting TSM. Our collective experience here says that this is fleeting and almost always does not last: it's your body acclimating to drinking on Naltrexone. I immediately lost interest in drinking in the first few weeks and thought I was "cured" and then resumed to pre-TSM drinking for five months or so. And most of us here have returned to our pre-TSM levels, or close to it, and have a spike or "extinction burst" after the initial Naltrexone "honeymoon." If this happens, mix patience into the equation and think 6-12 months to regaining control. Three to four months to a fabled "cure" is bullshit. The great news is that of the over 700 here, I have never once read someone report that TSM didn't dramatically change their life for the better after having the "honeymoon" and subsequent spike.

My best,

Nick

Thanks Nick - that is a very valuable nugget of information!
I'll keep it mind as I progress.
I've taken the mindset that I'm really not planning to be "cured". I've resigned myself to the fact that I will always need Nal - it's really a chronic condition. If I drink I will always take the pill. This mental approach helps me stay calm as I accept that there is no end to the process.

I do have the goal of getting down to a level of drinking that will not damage my health.

Thanks so much for your replies minneapolisnick, gain control and NYGuy. I am listening and really relying on this group. I made it through my girl's dinner last night, although it was oddly stressful. Had 4 glasses of wine over a 4-hour period, didn't sleep well and feel tired now but I didn't lose control in the way I feared I would. That was reassuring. But I still ordered that last glass of wine, when I'm sure I would feel better if I stopped at 3.

Until now I thought that my drinking wasn't excessive enough to result in alcohol withdrawal symptoms (my doctor gave me this impression), but perhaps I am wrong about that. Gain control -- you mention that you had other SEs that were actually withdrawal -- can you share some examples?

Again, my assumption is that since we are tapering off we also would not have withdrawal symptoms, but perhaps that also is not true? I don't think I have found any good links on alcohol withdrawal on Google, in case someone has any.

Finally, I have stayed on 25 mg of nal due to side effects, but I wonder if by next week I should change to 50? Since my doctor doesn't have any experience with TSM, he can't weigh in. I'm an average-sized woman. Has anyone stayed on 25mg? is there a way to know that I should up the dose or stay the same?

Amy, I was able to successfully take Naltrexone every day for about three months, but after a six week break I went back to try the Naltrexone again and have had worse side effects than those that you describe. I'd say your side effects should be gone soon.

Thanks, Lucky Star. I read your post about the renewed side-effects issue, and I was sorry to hear it. Looks like some of us might need to be glad to rather painlessly get to abstinence, and then figure that we'll have to stay there, rather than drinking infrequently. There are worse things in life, that is for sure. Perhaps when you tried nal again after 6 weeks you needed to go back to the 25mg dose?
My assumption is that you had strong side effects when you initially took nal also?

I am dancing a proverbial jig as I write this -- my side effects are finally gone and I feel so great!!!
I went to my first dinner party since starting TSM last night, and while I drank 4 drinks, I stopped at that and continued to talk and socialize without drinking myself into a blackout. I have managed this in the past, but not without being very uncomfortable because I was forcing myself not to have another drink when I really, really wanted one. Last night i had the sense that I'd had enough. What a concept.
I hear St. V that this may be a temporary reduction, but of course I pray it isn't so, because it feels so much better to be able to stop.
I'm still taking 25mg of nal, and I wonder if I should try to raise it, but maybe I won't yet, because I don't want to head back into side effects.
Those side effects continued until day 13 and then Poof! Thank you to all of you for helping me stick with it.

Hi Amy - Good for you. Those early changes, although small really do keep you going. Keep tracking and noticing the small changes and don't expect too much too soon. I started TSM and was just sure that I would be cured in 3 months and here I am in week 13 still drinking 5 glasses of wine a night. After about 5-6 weeks I realized that I would have to strap in for the long haul, but I was wowed immediately by the small changes that took place each week. One of those for me was being out to dinner and having only one glass of wine which I left on the table after drinking only 3/4 of it. That was when I realized that it was working and that I would need to be patient. Thanks for your post.

The strange thing is, when I first took Nal I started with 50mg and the only side effects I had was feeling quite sleepy for the first week. The only difference this time is that I took the Nal after not drinking for six weeks, and the result was a hangover that lasted three days. Perhaps being someone who is accustomed to heavy drinking helps to ease the side effects that person experiences, or maybe drinking the day after taking Nal eases the side effects (I didn't do that this time).

Whatever the explanation is, I am glad that you are no longer experiencing side effects.