Hi,

I am taking 1/2 a pill a day and have just recently started. My prescription is for 50 mg but I broke the pills in half to begin with. I've noticed a very slight decrease in consumption (3/4 a bottle of wine as opposed to the whole thing for example). Will the 50 mg cut this back even more? And, is the effect of this medication cumulative?

If you're feeling ok on 25mg, bump it up to a full pill. To my knowledge, Nal doesn't build up in your system, it's more that it blocks the brain from remembering that you had fun drinking. Every time you do that, the memory that alcohol is "fun" or "pleasurable" begins to fade within the addicted part of your brain. Without the daily reinforcement, that memory becomes more and more silent, while the memory that alcohol feels lousy becomes more and more prominent, so it's cumulative in that sense.

Dr. Eskapa's book does a good job explaining this process. Although I think his book could have been a quarter of the length because a lot of the information is repeated over and over.

randompost,
Another way to look at dosages is this -- you have X number of receptors. All Naltrexone does and can do is "occupy" those receptors, thus doing its thing. 50mg is recommended because that is the agree-upon amount whereby the average person will have enough of their receptors blocked to accomplish the goal of Naltrexone. If 25mg sufficiently blocks your receptors (it sure seems to for me), then anything above and beyond that will have no effect. The molecules will find no receptors to occupy, so they'll just move on their merry way. That's why, theoretically, 200mg shouldn't be any more effective than 50mg for the average person.