I had my first real Nal hangover yesterday. On Wednesday I had 5 drinks, which is about half of what I'd have on a big night pre-Nal. There have been a couple of nights where I've had 5 drinks and had NO hangover, but then I was only taking 25mg, and Wednesday I had the full-dose. I have a few takeaways from this...
First, 50mg seems like a large dose right now. Maybe it's that my body is not used to it yet. Maybe it really is, in fact, a lot. I am not sure. But at 25mg the entire TSM experience was smooth for me (and definitely had an effect). So far 50 is a little more taxing on me. This is not a huge deal, but I note it.
Second, the hangover I had on Thursday morning was (oddly enough)
better than the hangovers I had pre-TSM even though I got a little sick. Strange how I never put together how the panic attacks I had when I was hungover pre-TSM were related to
how much I drank the night before. On TSM, I have yet to have a single anxiety attack, including Thursday. My best guess at this point is that TSM has me drinking less alcohol, so even though I'm hungover, I'm not having panic attacks.
Odd (and maybe even a little sad) to be picking between hangovers -

- but seriously, I'll take a TSM-no-panic-attack-hangover over the alternative any day of the week!
Last, I had an appointment with my substance abuse counselor on Monday. It was interesting. I showed him the data I'd collected so far. For the 5 weeks prior to starting TSM I'd averaged 36 units/week, and the two full weeks of TSM data was ALOT less than that.
His reaction, btw, when I first came to him was literally to laugh at TSM, saying he thought it was "complete bunk." After looking at the (honeymoon) data, he wasn't laughing anymore. It was a little fun to watch him squirm a little.
He did say a few odd things. Like he basically said that TSM may in fact work for me, but I am in a tiny niche category, and am not a normal case of someone who comes seeking help with alcohol. His "normal" patient, is someone who's either compelled to come see him (like by a judge) or is so deep into alcoholism that they have no medical choice.
I find that sad, and told him so. I have issues with alcohol and have for 20 years. I may not have a DUI, marriage problems, or whatever, but I still have an issue with it. Basically he was telling me he has a one size fits all approach to deal with his patients: abstinence, AA, maybe Antibuse, and talk therapy.
I challenged him to think about TSM more and think of it as one more tool in the toolbox. We'll see if he changes his tune or not. Like I said, seeing as he was a little patronizing at the beginning it is kind of fun to watch him squirm a little.

But at the same time, I really don't care what he thinks. I only care if TSM is really working or not, and so far, it is.