Longtime reader, first time posting.

Hi All! I've been on Nal for about a month now with great success. My units have dropped in half, my AF days have doubled and I definitely feel less drive to drink. I've been so impressed with this drug and all the benefits. I can honestly say that I'm starting to get excited about the possibility of life as a non-alcoholic. The side effects that I've experienced have been--for the most part--manageable. The Nal makes me pretty tired and the 2 Nal-overs I've had were basically hell.

But I'm experiencing a side effect that I'm not sure is the result of the Nal or just my body's gradual detox from alcohol. Emotionally, I'm kind of a wreck. I've never dealt with depression or anything of the like, but I find lately that when I'm either on a Nal-over or having an AF day, I can go from feeling just fine to having an unstoppable crying jag in a heartbeat. Sometimes I'm inconsolably sad or just inexplicably anxious. My poor hubby and kids--I have to go hide in my room and cry at times so they don't worry. The doc who prescribed my Nal (who I found on this site and was basically awesome) also gave me a sample of a drug called Nuedexta (sp?) that he said was supposed to help with mood swings. I haven't taken it because when I read about it online, it said one of the contraindications to using this drug was using alcohol. Heh. Probably not a great choice for someone like me.

Has anyone else ever experienced this? When will it go away? I feel like I'm losing my mind. Thanks in advance, guys.

BurbsMama -

I only been on the board for a few months, but I haven't heard of anything like that. A quick look at info on Nuedexta says it could cause dizziness if used with alcohol. As I understand it, it's basically the active ingredient in cough syrup (dextromethorphan), with something added to increase the bio availability of the dextromethorphan by keeping your enzymes from breaking it down so quickly. You might want to discuss it with your pharmacist, just for another point of view on it.

After a brief look, from what I see, you should avoid it if you've ever had QT problems (possibly heart problems in general). Low magnesium can cause QT problems and alcohol can cause the kidneys to waste magnesium. Unless you've been told otherwise or know that you're taking some medication that precludes taking supplemental magnesium, you may want to start taking some extra magnesium anyway. Some forms may be more absorbable (magnesium citrate, for example) than others (Philip's Milk of Magnesia - aka Magnesium Hydroxide). Some say that is bunk and if you have any stomach acid at all, it gets turned into Magnesium Chloride anyway. Philips works by making it's way into your colon, where it attracts water to counter constipation. Supposedly, the more absorbable forms are more likely to make it into your bloodstream, but in any case, what your body figures it can't use (for whatever reason) will end up in your colon where it will attract water and cause a laxative effect, so just be aware of that.

No, I'm not a doctor or healthcare professional of any sort. I'm just another guy on the internet.

Others will probably post on this, perhaps they've experienced or heard of such things, but in the meantime perhaps give us a bit of background on your drinking style/history and how much you're drinking now.

Also, are you taking any other meds or supplements?

All that aside, welcome to the board and congratulations on cutting your drinking in half! That's a great response to the Nal so far, I'm sure the AF days must feel great too!

BTW, you might also want to bounce your question off of Joanna@CThreeEurope.com , she's a certified alch counselor that's a TSM'er herself. Let me know if you email her and don't hear back.

Wow! Thanks for all the great info, Joe! (or Mr. Pack.) You may not be a doctor but you're obviously smarter than the average online bear and I appreciate your knowledge.

As for the emotional side effects I've been experiencing, I googled naltrexone side effects (AFTER writing my original post, of course) and found this:
http://www.everydayhealth.com/drugs/nal ... ideeffects

Essentially, it confirms that I'm not crazy and "tearfulness" is actually a side effect. I could have sworn I looked up all this stuff before jumping in to TSM but I must've forgotten. Or I was drunk when I looked up side effects originally. Totally possible.

As for my story and background, it's frighteningly similar to all the rest of the booze hounds here. I come from a long line of problem drinkers and I've always been able to hold my liquor and drink with the boys, but nothing too crazy. About 3 years ago while dealing with a family crisis, my drinking started to amp up and become less of a choice, less fun but more...needed. The last year especially has been filled with blackouts and regretful mornings-after. I've hidden my drinking from everyone. My husband had no idea that when he'd come home after work, the bottle of wine I was cracking open was my second one of the day. I'm now 40. It's time for a change. I will NOT be the parent who has kids who when they're grown, only recall their mom as a drunk. Can't do it.

So I was at 40-50 units/wk pre-Nal, with maybe 1 AF day. The first 3 weeks on Nal, my weekly numbers were in the teens, my AF days were either 3 or 4 and I felt great. Slipped a bit the 4th week and logged 33 units. In the middle of week 5. Eventually, I'll get around to putting it all in my siggy.

Anyways, it's been a long time coming. I'm glad to be here. I feel like I already know a lot of you through being a lookie-loo. I'm really hoping to experience the level of success and freedom that I see here so much. Thanks for reading.

--BM (probably shoulda thought about what my initials would be when I came up with the pseudonym--hehehe.)

Glad I could help. I don't recall seeing that SE for Naltrexone, glad you dug that up!

I really like your results so far. Your "slip" seems to be right in line with the Honeymoon Effect, just your brain's way of "amping it up" as it searches for it's "old friend" that doesn't seem to be coming around so much anymore. If it's a bit slower in dropping this time, don't get discouraged, it's par for the course. About the only way people "slip up" around here is not sticking to The Golden Rule and instead washing the pill down with their first drink of the day or the like. Also, if you're 12 hours out from your first pill and you're still drinking, take another and wait an hour before you resume.

I don't know if insurance is covering you on this, but if you're paying for the Nal out-of-pocket, look up GoodRx.com. I use their coupon to get Nal for $40/month around here, it may be even less in your neck of the woods.

Well, keep on posting and let us know how it works out with the Nuedexta! The more people post, the more it helps.

Welcome BurbsMama,

I just want to let you know that I did have the blues and would cry at the drop of a dime. It would come and go. I chalked it up to going through the change, but it was most likely the combo of alcohol, nal, and the change; however, there have been others that needed a break from the nal and/or nal and alcohol (I think it may be the two combined for some) to help their mood. I think the longer you take the nal the more your body (and moods) will adapt. It may help (if you can) to space your AF days and drinking days so you are not taking the nal for long periods of time.

Have you tried only taking the nal without drinking? It is only a suggestion, but if you did and you were weepy you would know it is just the nal and not the nal and alcohol (again only a suggestion).

It sounds like you are having amazing results!

I hope you keep us posted,

Jaba

Nuedexta is a newer drug. There is a review on it from drugs.com (if you haven't seen it), and if the crying is not from depression it may help.
http://www.drugs.com/comments/dextromet ... dexta.html

I think speaking to your pharmacist about it would be a really good idea.

Hmm. I haven't tried taking the NAL/alone just to see. Good idea! Thanks for the feedback, Jaba. I'm glad to know someone else experienced the same thing!

I've also been on nal for just over a month and am having excellent success. And I have noticed mild depression as an SE for sure. It's pretty common from what I've read various places.

I'm dealing with it via mindfulness meditation with really seems to work.

Also I would like to add that it may be way too soon for you to be taking AF days. That alone could be causing your depression because your bod isn't ready for that yet.

You're not supposed to force the AF periods when you don't feel like but feel like you should to follow the plan. Because, actually, as I'm reading it, that's NOT following the plan anyway. I believe you're not even supposed to take just ONE AF day for example. You're supposed to wait until you feel ready, plan ahead, and then take 3 days off of nal and booze. Friday last night of nal and booze. Saturday nal and booze free while everything gets out of your system. Sunday plan and partake in sensual activities other than drinking: things you love and make you happy whatever that might be: a massage, sex, an especially wonderful meal, exercise, whatever.

Then go back to the nal and alcohol regimen the next day.

I think if I tried to take an AF day right now, at my stage of the game, I'd get depressed and irritated, something that would typically happen to me in the past before nal every time I tried to stop drinking for awhile -- first couple of days? Not enjoyable.

So, although I have been able to cut intake in half over the past month, I still enjoy those two evening drinks a LOT even with the nal. And I would be unhappy at this point, to give that up. I ain't forcing it. And according to the Sinclair Method Letter of the Law, you're not supposed to force it.

In any case, be advised that I've read a number of places that depression is a fairly common SE with Nal. And I've definitely experienced it myself. Not quite to the extent that you're describing. But then I'm not going cold turkey AT ALL right now either.

Good Luck and keep us posted. Sounds like you're doing great except for the SE's.

The AF days I've had have ALL been by choice. Truly. I'm not forcing anything. I just don't feel like drinking on those days and so I don't. I've read the book and I'm familiar with the AF weekend concept but I wasn't aware it was a hard and fast rule. I wouldn't be down with that, frankly. I like the freedom to be able to take an AF day when I feel like it and drink when I feel like it too (always following the Golden Rule, mind you.) If any AF day HAS to be 3 AF days in a row, I'm out.

Actually, T.O., many do have single AF days before they attempt the Alcohol Free weekend. It's ok, just as long as you don't crave and stuff it. Bingers have an easier time of using the AF weekend technique as they don't drink every day anyway, and it doesn't have to be on a weekend, just 2 consecutive AF days.

This is what is so great about this forum, for we do what is needed to help us along and don't have to worry about the TSM police saying that isn't the TSM way.

We have to find what works for us!

What works for me may not work for anyone else but me, and what works for others may not help me.

AF days for some was a must for their spirits would be low on the nal, and those AF days were force. It did not harm that person, and they are still cured.

I could only have an AF day if it was because of a nal over, and the harder the nal over the longer the time away from nal and alcohol. I could not do an AF day until I was 16 weeks in, and then it was never 3 days. And those feel good endorphins, never happen with me regardless of how much time I am off the nal or what I do (however, one time I did have a rush while under stress).

This is a very personal experience. It is not a cut and dry or black and white approach to AUD regardless of what others have read, or have been told.

The main thing is to keep the golden rule (and even Dr. Eskapa posted 30 min to an hour on here, so this is a new process and we are the guinea pigs).

BurbsMama,

I am glad that you are not forcing anything and didn't feel like drinking, for that is awesome! I do hope that your progress continues, and I hope that you keep us posted.

Jaba