I tried TSM a little over a year ago and seemed to see progress but eventually slid back because I wasn't compliant in taking the naltrexone everytime. Anyhow, then things obviously declined, and I've been through a couple extended periods of abstinence (1 month to 3 months) intertwined with longer periods where I'll basically binge one night a week. I've started back on TSM to give it another shot and I want to stick with it, however the biggest problem lately is the nausea.

I know it's supposed to be a temporary side effect that you adjust to if you're taking it daily or several times during the week, but if you are only taking the naltrexone once every week or two do you ever really get adjusted to where you're not getting these side effects? Thanks in advance for any comments.

Good for you getting back on it Sideshow.

I have been in the exact same place myself: seeing progress, doing a sloppy job of TSM, then sliding all over the shop and having the odd bit of abstinence interspersed with heavier drinking than ever. It is definitely worth trying again. It seems a lot of effort to record your drinks, wait for an hour, remember your pills etc... but surely no more effort than I've expended trying to manage my life on the drunk/ hungover rollercoaster! I find the main obstacle to be the preparation and conscious effort involved, which is the antithesis of my regular non-TSM drinking behaviour. So I'm waiting a little while to start drinking again.

I have found the less frequently I take NAL, the more severe the side effects are. I hesitate to encourage anyone to drink more if they don't feel like it, but is it worth taking half a pill followed by only one or two drinks on the odd night when you don't feel like it... just to get accustomed to the NAL? The nausea definitely goes away after a week or so in my experience. Otherwise it might just be the price you have to pay unfortunately. Taking it with something substantial to eat helps though.

Best of luck, and keep posting no matter what your success with the method is - it's quite therapeutic

I don't always drink just because I've taken Nal, I drink when or if I feel like it and any AF day is a bonus in my eyes. Sometimes I've actually taken Nal, decide I really don't want the after effects of alcohol and gone to bed to avoid drinking. I will take Nal if I think I might drink, because I've never drunk without it since I started (closest I came was one unplanned midday drink on holiday but I think I was just about covered from previous day, and I took another pill asap).

Some say this isn't perfect TSM, but it appears to have worked very well for me.

Also I recorded my drinks daily in a work diary that I had to fill in anyway, just put the numbers by the side of the day - no one knows what they mean.

Hope this helps in some way.

I have to say that unfortunately for me, the nausea has not really ever gone away. (I'm 28+ weeks in, if I remember correctly). It's not terrible every time, but it's usually there, especially if I take a full dose. My remedy has often been to take 25mg but it is a dangerous road because that doesn't always cover me completely. The way I look at it, I spent a lot of time feeling nauseous when I was disastrously hungover all the time before, so this is kind of just a trade-off. It really depends how committed you are to TSM. If you really want to get your drinking under control, some nausea is a small price to pay for the long term extinction of those cravings.

Welcome back SS! Hope the side effects abate.

I forgot to add that I generally don't get any nausea any more. I did for the first two weeks, back then I was taking 50mg every day and did so for the first month or so. I now take it perhaps 2 or 3 times a week, although might only drink on 1 or 2 of those occasions.

Hi Sideshow and welcome back to TSM. I'm nine weeks in, and don't drink every night. The first week I had mild nausea on the nights I took nal and drank. Then I went for a few weeks where I had no SE's at all. Now, over the past couple of weeks, I've had some nal-nights where I've had NO side effects and some nights where I've gotten REALLY sick - it's very weird. Definitely the roller coaster ride everyone warns us about!

I, too, wonder about the fact that since I don't drink every night will this be a problem on TSM or take longer. My PA didn't think so when I first met with her for my nal prescription. I see her again next week and I'll she what she thinks, but my plan for now is to stick with the the Sinclair Method - only take nal on the nights I drink.

Good luck and keep us posted!