Although the book doesn't specifically describe the research subject exclusion criteria, on page 29 you'll see the "y" axis (drinks per week) for 115 successful patients peaks at an average of about 37 drinks per week, flattening out around 9 after approx. 250 days. Similar data from the first 40 patients was published in 1997.

The following is extracted from a 2001 Sinclair Study supporting TSM, titled "Targeted Use of Naltrexone Without Prior Detoxification in the Treatment of Alcohol Dependence: A Factorial Double-Blind, Placebo-Controlled Trial" (REF: The Cure For Alcoholism, Appendix A, Note 32, Page 242). Research subject exclusion criteria is described therein:

The study subjects were persons seeking outpatient treatment for alcoholism who responded to advertisements for the research study. 326 individuals were screened over the telephone, and 302 were invited for in-person screening. Of these, 137 were screened in person, and 121 gave written informed consent and were randomized for the study after one week’s run-in trial with a riboflavin-marked placebo. The inclusion criteria were 1) age 21–65 years, 2) meeting the DSM-IV criteria for alcohol dependence, 3) consumption, on average, of five or more drinks per day in the last 30 days, and 4) a stable living situation and availability of a collateral reporter.

The exclusion criteria were 1) other current drug abuse or dependence (including marijuana), 2) ever having abused opiates, 3) a current major psychiatric disorder as determined by the Structured Clinical Interview for DSM IV (SCID), 4) a serious or unstable medical condition, 5) current use of psych-otropic or anti-seizure medications or disulfiram, 6) liver function test results (alanine aminotransferase and aspartate aminotransferase) greater than 250 (IU).

Each patient signed a written informed consent, and the study was conducted according ICH’s GCP (Good Clinical Practice) and Helsinki 1964 Declaration. Ethical permission for the study was granted by the A-Clinic Foundation Ethical Committee (permission #101096).

Reasons for nonparticipation among the 302 individuals invited to be screened in person included the following: 55% chose not to participate, 1% had other psychiatric diagnoses, 2% had exclusionary medical conditions, and 2% lacked social stability. 121 patients were included: 86 males (71.1%) and 35 females (28.9%). The mean age was 45.5 years (± 7.8).

Hi,

I don't fit the test group at all but I feel I am well on my way. Over the 25 years my levels have ranged from 60 units to well over 100 per week. I take an anti-siezure medication to stablize my moods (300mg of lamictal per day), I take 20 mg or Lexapro for anxiety, in the past I have take up to 100mg of Serequel to keep from jumping out of my skin, and I have had 3 severe brain injuries. So even if you're not a perfect speciman for a test, TSM can still work if you following two simple rules. Keep a journal and take Naltrexone 1 hour before you drink (and if you take Naltrexone make sure you drink).

Best Regards to all.


Pre: 46 – 80+ units
Wk/Units/Craving
1: ...44 .....10
2: .. 40......10..2 AF
3: ...40......9...3 AF
4: ...31......9...4 AF
5: ...20......7...5 AF
6.....33......7...2 AF
7.....44......7...3 AF
8....in progress

It's so important for folks like you to report in as an encouragement for those who aren't 'textbook examples' of those who meet TSM study criterion. I'm really betting that every single regular member of this MB who sticks with the program - indefinitely, if needed - is going to experience success. We just have to think of ourselves as a bunch of lab rats!

Hi netty,

Many thanks for answering my question.

All the best,

V.

Week 13 report: I experimented with reducing my dosage to 12.5mg this week. I noticed a marginal uptick in both my craving and consumption, and no AF days. I also noticed I didn't sleep as soundly, and didn't feel slightly inebriated as I usually do after taking 25mg naltrexone before drinking 1 or 2 beers. In fact, drinking had no effect on me whatsoever -- maybe that's why I wanted more than is (now) usual for me!

I'm going back to 25mg - since that appears to do the trick. As a result of my little experiment, it appears there's definitely more than pure endorphin-blocking involved with naltrexone. The drug (at least at 25mg and above) does potentiate the "inebriation" (versus endorphin buzz) aspect of alcohol for me, which consequently reduces both my craving and resultant consumption -- in other words, feeling drunk without feeling excited/buzzed just doesn't turn on the "more must be better" switch -- so stopping is a cinch after a couple beers (gee, that sounds an awful lot like what "normal" drinkers experience).

I'm guessing the "drunken feeling" that results from concurrent use of Naltrexone and (relatively) low levels of alcohol has nothing to do with duration of the resulting endorphin blockade (it fact, it's been proven that the opioid blockade lasts well past elimination of naltrexone from the blood) -- but rather has much to do with the level of Naltrexone's human metabolite (6beta-naltrexol) in the blood while consuming alcohol.


High Day: 3 units
AF Days: 0
Total Weekly Units:16
% Redux pre-NAL: 62%

Sorry Virgil, am only now seeing your question or I would have responded sooner and Netty answered it. In fact, I didn't recall the subject data details from reading the book the first time and was relying on Netty's claim that those on psychiatric meds were excluded from the study. But Netty confirmed the page site for us. I agree with G4M -- invaluable discussion, identifying key differing variables from TSM-ers here from those in the test groups.

Week 14 stats: 13 units, 1 AF day, 3 units max/day. Mabelee inspired me to publish my own progress graph, which I plan to update on a weekly basis: http://spreadsheets.google.com/pub?key= ... utput=html

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Hi Nick,

No worries. As you say, Netty answered my question.

All the best.

V.

Netty, not only is this great progress, but you are a 'poster child' for being much like Sinclair's research subjects - and enjoying approximately the same time frame for success. Congratulations!