Hello,
My husband started a week ago. I would describe him as a mid-stage functioning alcoholic approaching late-stage. He has been functional alc for about 17 years with long periods of abstinence. But in the past year, it has gotten away from him and seems to not be able to control his cravings anymore. We found TSM with great hope. I am very hopeful (as I usually am my nature) and he is skeptical but willing to try. He genuinely seems to want to cure it but thinks it too good to be true also he is terrified of a life without alcohol. Adding to this he has anxiety/depression disorder with occasional crippling panic attacks. He says the alcohol was the "perfect" medicine for his depression so he's scared to not have that anymore.
Couple questions:
- he has been having more anxiety/panic attacks this week than usual. Is this caused by the Naltrexone or is it maybe just his fear of change and that it could actually work?
- When he drinks on Nal he gets fuzzy, tired but no endorphins. This is normal, right?
- He got a hangover this morning for the first time in years (maybe ever)...is this normal?
- While I heard he can take Prozac while during TSM, he says that he shouldn't b/c he has been told not to take Prozac while drinking. Any thoughts on this?

Thank you so much for your help!
Frieda

Either of those could happen. If he produces a fair number of natural opioids, as some do, then simply taking nal can lead to a bit of opiate withdrawal and a bad feeling which could either seem like an attack or trigger one. His inner addiction monster will also be screaming in fear right about now, and that too could cause a temporary increase in the attacks.

The latter will go away, if that's the problem. The former . . . well, after he's cured and able to choose, he can decide whether a nal night is worth the limited pleasure alcohol now brings. Sometimes it might be, but he'll be able to refuse on those nights when it isn't, so it'll be under his control.

As an aside, I never found alcohol a good medicine for those things. Once, when out of Valium, I tried to use alcohol as a sole anxiety attack medicine . . . I had 6-7 beers and could still feel most of the attack.



Yes, both of those things are 100% normal.




Sorry, can't help with that one.

Welcome to the group.

Thanks Melissa.

I think he is a good candidate for TSM as he is still able to comply with the protocol. Generally, he drinks after work anyway so that time is already built in.
Also, his family has a long history of alcoholism so we think he must have the genetic predisposition.
It has only been a week, and he has already responded so effectively to the medicine...in that the nal has totally blocked his pleasure from drinking. He is drinking more than normal but getting nothing out of it except getting tired. He seems to be committed to the process. I think it freaks him out too.
I just hope, hope, hope that he sticks with it. He is already going back to the person I know and love before the craziness.

Frieda

I hope so too.

You said he was skeptical but willing to try. The skepticism usually goes away when the drinker feels the undeniable difference on nal -- maybe the willingness to try will turn into real commitment.

Thanks so much.
Another couple questions actually if you have a chance.
Will Naltrexone also remove interest in other good activities, like exercise and sex?
He exercises obsessively. Every morning he gets up at 5:30am to go to gym and run 5 miles and do weights, regardless of how much he has drunk. (Though he got a hangover for the first time ever yesterday and it was more challenging!). I think he is addicted to exercise and maybe also has an eating disorder, but i guess that's a topic for another board. But, all in all, it's a great habit that he loves and thrives on and I would hate for the Naltrexone to take away the pleasure he gets from exercise. If I tell him to hold off on working out on the Nal days, he would balk at that. Any thoughts on this?
Same goes for sex. He has a very hearty sex drive and we enjoy it a lot. Will the Nal also take away the endorphins he gets from sex and he'll lose interest. Again, if I say we can only have sex on non-drinking/Nal days, I'm afraid he'll freak out and stop taking the naltrexone.
He's not aware yet that the Nal can possibly remove pleasure in these other activities, but I don't want to tell him for fear he'll stop taking it altogether.
Thanks for any more advice!
Frieda

Hi Frieda,

Prozac is a Selective Seratonin Reuptake Inhibitor (SSRI), and has been studied to aid with stress and anxiety while also taking Naltrexone for curbing or abstaining from alcohol. While there appear to be no serious interactions, many individuals report fairly intense side affects, one of the most common is nausea.

I was prescribed what they call an Atypical Antidepressent, Welbutrin, for stress and anxiety when beginning Naltrexone and is has worked fine. I have never taken antidepressants or really had the need, so in my case this is a temporary aid.

There is a ton of information online as you can imagine, and if your husband has been on an SSRI under the care of a doctor for awhile, this obviously may affect how to proceed and where to get the best guidance. It goes without saying, please don't act solely on anything you read on a message board when it comes to interacting meds.

That said, Naltrexone can work wonders in individuals who are aware they have a problem and are ready to make a change.

... editing because I just saw the next post about exercise ... Probably goes without saying that not being hungover increases athletic performance significantly. I am an avid runner and gym rat and was worried Naltrexone would take the desire away too. It has not worked out to be the case at all. If he works out in the AM and a pill later in the day or afternoon before drinking, my experience has been that it does not have an adverse affect at all, quite the contrary. His results may vary, and there are those who have experienced a decrease in motivation if they take the pill and then try to exercise.

Wishing you change for the better.

I am also an athlete and I also found I was still able in train, in fact training with a clear head became an incentive not to drink!

Does he still think alcohol is the perfect medicine for his depression? Personally I have learned the hard way that the opposite is true. Temporary and transient relief perhaps, but progressively more depressed while waiting for the day(s) to pass so I could start drinking again. In reality it's nothing more than a viscous circle, that eventually bites your life in the ass, and calling it the perfect medicine is misguided. Has he changed his opinion over the last year and does he admit that he has lost control?

When I asked my wife for support with my TSM journey I told her there was only one thing I was at all concerned about and that was compliance. As it turns out compliance hasn't been an issue at all, far from it. I am (and many others here on this board are) overwhelmingly welcome of the practical, scientific and secular solution offered by TSM. If this is all I have to go through to save my life/marriage/health I say BRING IT ON! Anyway, as a spouse, I think compliance should be your #1 priority, making sure he follows a very simple rule, for the rest of his life if he continues to drink.

If you can accomplish just that one thing, the odds are stacked GREATLY in your favor.

Since he is terrified of life with out alcohol, you can point out to him that TSM doesn't require abstinence as the end goal. Occasional and/or social drinking is a perfectly acceptable result (provided he keeps following the golden rule). The goal is to regain control over drinking, and to be able to make the decision to drink or not without having to stuggle with the physical dependence.

Yeah, life without alcohol sounds impossible to some people. It sounds like an endless struggle against craving. The thing that's hard to explain is that the craving/obsession/etc. simply go away over time.

Some people start with a goal of moderate drinking and end up switching to teetotaling because moderate drinking no longer seems worth the bother after the addiction is cured. Others, many others, actually do drink moderately. There's no reason he couldn't be one of them.