Hello everyone,
I started TSM yesterday with 25mg of Nal. The eagerly-awaited tablets had just arrived from River Pharmacy in India. Following the knowledge I gained from this site and other sources, I took it exactly 1 hour before my first drink... I was fine, and reporting my friends over the phone how differently and less drunk I was feeling (but all said I sounded as pissed as usual). I carried on drinking until I passed out in bed. Not many adverse side effects thus far....

... then BANG! I woke up around 1am (after a 2-hours sleep) with massive nausea. Dashed to the loo, and vomited whatever I had in my stomach. I had to choke several times to feel OK enough to go back to bed... and then again got up about an hour later.... then again, and again, roughly hourly, until about 7am. It was about 10am next time I got up, finally feeling OK enough to feed the cats who had been trying to murder me out of hunger for a good few hours!

It's about 2.30pm now, and I still feel pain in my stomach. My body is very tired all over, as if I was having cold or flu (which I am not). I was mentally prepared to have some side effects, but this is way worse than I thought I would. The vomiting sessions were not really anything like I'd experienced. And I have experienced quite few bad ones in my drinking life. The prominent difference was that I tasted the medicine or at least some very bitter chemical taste in my mouth with the sick. And the compulsion of vomiting was extremely violent. I really thought my stomach would break and be torn.

My question: should I continue? I so much want it to work. As with many of you here, I've tried many alternatives to reach this stage. Antabuse so far has been the best of all, but I've been struggling to use it properly. But as I write this, still being physically affected by the episode this morning, I am really scared of putting myself in the situation again.

I took 25mg of Nal. Should I try 12.5mg tonight? I am 162cm, 49kg, so, not quite massively-built. Perhaps 25mg was a bit too much for someone in my built? Also I have a very sensitive stomach (mainly due to both my genetics and drinking).

As for the amount of alcohol (wine), this morning I found I'd ended up drinking as much as I usually do (a bottle per night). But I felt different while drinking. More aware of my surroundings, maybe.

Would I waste my time last night if I skipped tonight? (would I go back to square 1 in terms of my physical tolerance?). I understand the majority of people experience some side effects. But is mine on a severe side? I am feeling weak and ill, so I am inclined to take a rest tonight (from both Nal and alcohol)...

Any input would be appreciated!

Anu

Welcome Anu! That sounds like it was brutal. I don't recall reading about anyone else having that severe of a reaction. Any chance you had some bad food/food poisoning?

Hi Squirrel
Thanks for your post! No, I don't think I had food poisoning... But actually I think my stomach was rather too empty when I drank last night, which probably contributed to the severe reaction...

Anu

I do know everyone says to take Nal on a FULL stomach. If you didn't and are sensitive to meds anyways that could have played a part.

Nothing in this post should be construed as medical advice. Please consult your physician or pharmacist for information about side effects of prescription drugs

If I were having such severe reactions to naltrexone and I wanted to try to minimize them I would try in this order:
1) have some food in my stomach
2) take 25mg or 12.5mg to start with until nausea subsided
3) be aware that the same amount of alcohol will cause worse hangovers, reduce the dose of alcohol using whatever harm reduction strategies and tricks at my disposal.
4) be prepared for side effects to persist for up to 2 weeks before giving up on the experiment.

Here is a discussion of why we get nausea on naltrexone. http://www.thesinclairmethod.net/community/viewtopic.php?f=6&t=2199&hilit=+nausea&sid=34be5f7b168c1f037ad0a14c2a7f6df1 In short it has to do with naltrexone creating a withdrawal like state by blocking your body's natural opiates (endorphins). Have you ever read a story of a heroin addict going cold-turkey and having withdrawal? Vomiting features prominently in the withdrawal. It's the same principle here only not as severe as what the heroin addict experiences since their vomiting lasts for days. I hope it gets better for you.

No one here is qualified to give medical advice. Your question regarding dosage and whether you should continue is purely a medical advice question. That being said, I have not heard of such a violent reaction to naltrexone and wonder if it's possible that you are having an allergic reaction. I strongly recommend you see an MD to address these issues.

My best,

Nick

Hey, thanks everyone for your reply.

Just to update: Things have been good since the nightmare Day 1.

Day 2: I took 12.5mg of Nal on a full stomach. While waiting for the hour to pass, I decided not to have drink after all, partly because my stomach was still painful, but mainly because I wanted to eliminate one factor each time in order to test whether I was allergic to Nal itself. I was totally fine during the night and next day.

Day 3: Took 12.5mg of Nal and 250ml of wine. Fine afterwards.

Day 4: Slight headache from last night. Took 25mg of Nal and 375ml of wine.

I am experiencing some relatively minor side effects - mainly headaches, stomach aches, spaced-out, 'not there' feelings, tiredness etc - but none of them is comparable with what I experienced on the first night. Looks like I definitely should keep an eye on my hunger level when I take Nal + alcohol. As for my cravings, I see significant differences.

I am really hopeful and optimistic about where this journey might take me. And this forum is fantastic!!

Thanks for your concerns once again!

Anu

Dear Anu,
I got massive nausea from the nal as well, and the first time that I drank through that and had more than 1-2 drinks, I ended up vomiting...kind of out of the blue as well, as I was not really drunk. I also have a weak stomach, genetics and years of drinking hehe. I am positive that I didn't have an allergic reaction though (I know what that feels like, having been the victim a few too many times...) so I kept on trucking. And now already, just after two weeks, it seems to be better.
Good luck!
But if you notice anything like hives, rashes, etc....it probably IS an allergic reaction!!!
EL

Hi EL
Thanks so much for your reply. Your conditions sound quite similar to mine. Glad to know you've been much better now!
Anu

Hi Anu,
I too suffered huge side effects with NAL, including vomiting, nausea, diarrhea, etc. It took weeks for it to calm down. I have never been able to get up to 50mg because of side effects. However, I have stuck with 25mg and doing pretty good. If 25mg is bothering you, try 12.5mg for a week or so. Move up to 25mg when you are ready and just listen to your body. It does help me to take the NAL with a carb like a piece of bread or some soda crackers. Just do what you can, don't give up, and listen to what your body is saying.

Good luck and welcome!

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