Hi There -

I started Nal 2 days ago after I decided to see an addiction specialist. I used to be a moderate drinker ( 1-2 glasses of red wine a day) and within the past ten years I slowly edged up to about a bottle a day. I was always honest with my doc. He suggested AA and put me on Prozac. (I also have anxiety issues). I've noticed since I've been on SSRI's I feel like I crave alcohol/drink more. I read some studies that suggested that might happen in some situations. SO, I thought the addiction specialist/Psychiatrist would know about it and perhaps try taking me off. He prescribed the Naltrexone and wants to keep me on Prozac. I'm just wondering if it's still going to work for me? The past 2 days on Naltrexone, my drinking has stayed fairly the same, but I can feel a sort of "blunting" of its effect.
BUT I still feel tipsy and good - also a little dizzy. Wondering if this is normal? Also wondering if all those chemicals bouncing around in my head from the Prozac is going to block its effects?

Sorry _ I know it's long, but I am a worry-wort. Any advice or experiences welcome! Just don't know what to expect!

Hi, Crock. If you are feeling that 'blunting effect' as you describe it the chances are very good NAL is going to work for you. Now you need to work with it. Namely, mindfulness practices will be your friend. This board is a great archival resource though its activity over the last year has waned. As such you'd do well to explore this group and perhaps cross-post there too moving forward:

http://optionssavelives.freeforums.net

With respect to your SSRI experience different people react different ways, but yes! Some (like myself) had their cravings for alcohol ramp up. When I was put on Zoloft years ago it was the first time I broke my 5pm rule and things only got worse from there over time. I'd say it's about a 99% chance your anxiety is directly tied to your alcohol consumption (as mine was though I had it from a very early age). To answer the other component of your question, no. I don't think I've read anything about Prozac inhibiting NAL's function.

Thank you so much Bardo! Good to hear of a similar experience out there. I will check out the link and report back.

HI Bardo -

One last question? Did you stay on the Zoloft while taking Naltrexone? If so, did the Naltrexone still work while you were on Zoloft?

Thanks Again!

He may have missed subscribing to this thread, Crockrock. Maybe shoot him a PM here or on the other board.

Thanks Joe - will do!

Hi, Crock. No. Years earlier I enlisted a psychiatrist who thought it was preposterous I was ever prescribed it in the first place. He actually was of the mind most SSRIs are a scam, but what bothered him was that alcohol intake renders any possible effect they might have totally moot. By the time I started TSM I had been misdiagnosed again and prescribed something much heavier which I weened off of before beginning TSM. I was on Wellbutrin XL during TSM in lieu of it and it was very effective for me and caused no complications. Better yet thanks to TSM I have no pharma running through my veins whatsoever now! Unless of course I want a drink in which case I'll take NAL, but it's been seven months since I last fancied anything to drink.

Thanks so much - that is such great news. I hope I can get there too at some point!

SSRIs are known to inhibit extinction learning in exposure protocols. For example, if you have a phobia of snakes, a prolonged exposure protocol would involve being safely exposed to snakes on a number of occasions. Over time, your fear of snakes would be extinguished as a result of extinction learning. SSRIs have been observed to inhibit this type of learning.

The type of learning process in TSM is different in that 1. it uses operant vs. classical conditioning, and 2. the behavioral extinction is the result of removing a pleasure-stimulus at the neural level. I'm only a couple of days in to TSM, but have every impression that this is a complex and sophisticated neurobehavioral extinction-protocol that works very well.

I currently am using an experimental anti-depressant called NSI-189. I find it very effective for rapid amelioration of depression, but don't recommend anything that isn't psychiatrist-approved. As with SSRIs, NSI-189 promotes neurogenesis and synaptogenesis. If you've read the Eskapa book, you know that the neurological model is specific to long term potentiation in the opioid/mu-receptor system. Hypothetically, any neurogenic agent might increase activity in any number of neurological systems including the opioid/mu-system, thereby increasing cravings etc. However, since naltrexone demonstrates such high affinity for the opioid/mu-receptor sites, the basic TSM principle should still apply. Therefore, I don't sees any specific reason why SSRIs should impede the overall extinction process in TSM.

As many people observe, TSM takes time. I think mindfulness can shed some light on the complexity of the learning process in acquiring compulsive-alcohol behaviors. Hence, I assume this will take some time to really and truly work. Hang in there!

Great post, Orpheus! Very interesting info on the stimulus.

Are you dysthymic or more towards the bipolar end of the spectrum?