Hi Folks,

I thought it appropriate to give this important topic its own thread. The starting point is an article that Kris kindly supplied. For convenience, it is repeated below:

http://www.scienceblog.com/community/ol ... 00159.html

I sent this article to my doctor and, in the process, copied it to Dr Eskapa. Today, I received from Dr Eskapa an e-mail reply via this forum and he had this to say:

"The Finns are now working on a blood test to predict if some people are
more opioid / endorphin responsive than others. At one end of the spectrum
are folks who respond rapidly to the treatment and at the distant end -
perhaps 12 % there are those who simply do not respond. That is why there
is no 100 % efficacy in humans - as opposed to selectively bred alcohol
predisposed lab animals.

What dose are you taking? I had a meeting with Sinclair tonight in LOndon -
there is some possibility that a minority of patients may respond to 100 mg
naltrexone an hour before drinking (for physiological reasons) ...."

Should there be any further developments with either my doctor or Dr Eskapa, I will keep people informed.

V.

Hi WTE,

I will reply to Dr Eskapa asking him to clarify what he meant by "physiological reasons".

Watch this space!

V.

Yes, I'm also int'd in this. I upped my dose to 75mgs for only 2-3 weeks, but still didn't feel much difference - then decided maybe I was jumping the gun, plus blowing thru my supply and went back to 50mgs...But going to 100 seems huge. I'm seing my Dr. Monday & am going to show him this article.

The other ah ha! moment I just had was realizing I have been feeling very blase' about working out the last few weeks. I continue to do it b/c I must, but thinking I am just bored with the routine. Then was reading the thread from AJ about trying to have more AF days, the pleasurable endorphins from other activities being extinguished. Someone mentioned their exercise habit...and I thought AH HA!!! the pleasure I get from exercise is being extinguished, yet I am doing it out of habit.

I have never felt blah or bored about AL, never really seriously came home and NOT felt like having my wine. But excercise...I do it, but am bored and feeling like I am swimming against the current...as in BLAH. I have NEVER felt like this before. Once again, reminded I am taking a drug that works on the brain...weird dreams, no motivation to exercise except out of habit...(I'd add "no sex drive", but the drive is there just haven't had the daily opportunities to extinguish THAT thank god!!!! LOLOL If only -)

Long story longer - I think upping the doseage may be the trick & will see! Fingers still crossed.

Hey houtx, I am going through the same thing with working out - I feel good when I do it but I'm not CRAVING it the way I used to or even miss it when I skip a day. Have gone from consistently working out 5 days a week to 3 or 4 with usually one half-assed session. Wasn't seeing anyone else mention this. Hopefully, when the Al cravings decrease and I get more AF days, my workouts will improve. Guess this is a short-term price to pay..

and sleep has become more appealing than sex... I am sleeping a lot..

Hi Folks,

I have just received a reply from Dr Eskapa explaining what he meant by "physiological reasons". Here is what he said:

"I mean non-specific perhaps unexplainable (potentially knowable) biological
reasons (may be individual metabolic differences - why for instance do beta
blockers works for some at low doses and yet others require high doses - or
why do they not work for everyone all the time - naltrexone as with almost
all medications will not be 100 % effective for 100 % pf people using it
even in the correct way to obtain extinction ---- we may come to know more
as the research proceeds - see this also from dictionary.com:

Medical Dictionary
physiological phys·i·o·log·i·cal (fĭz'ē-ə-lŏj'ĭ-kəl) or phys·i·o·log·ic
(-ĭk)
adj.
Abbr. phys.

Of or relating to physiology.
Being in accord with or characteristic of the normal functioning of a living
organism.
Relating to the action of a drug when given to a healthy person, as
distinguished from its therapeutic action".

Dr Eskapa has also discussed my naltrexone dosage with my doctor and, as a result, it has been suggested that I increase my dose from 50mg to 100mg (1 hr before drinking). Just in case I experience any side-effects, I have decided to do this in two stages. So, initially, I will increase the dose to 75mg for a few days and then increase the dose to 100mg. Here's hoping for success!

V.

We are all keeping our fingers crossed that the increased dosage will work for you! If it does, you owe 1-4 more than just a beer!

Yes, fingers very much crossed that the increase will make a difference V Interestingly, Lenore has just posted on her introduction thread that she's had greater success since moving to a higher dose.

Wow, Virg - I'm impressed Dr E discussed your doseage w/ your Dr. So you are going to 100mgs right away just to see? Then perhaps drop back to 75 like Lenore? I'm so on board with this - thinking I will order Xtras from Alldaychemist (as they are cheapest) and just do it myself if I can't get my Dr. to comply. But 100mgs?? Hmmmm - will be hanging on your (and Lenore's) every word.

I have only seen my Dr 2x and just not connecting. Hoping I can talk to him about upping my doseage & will show him the article. He purports to be knowledgable about TSM, but we really have very little to say on the subject other than I refer to it exclusively and he asks about this website. Then he asks me why I do not like AA...then he writes the Rx and I am outta there in about 20 minutes. KA-CHING to my insurance co. for the full hr., I'm sure.

Anyway - don't really care except it would be nice to have a flesh & blood confidant, by way of a professional, who should know what he loosely professed to know about this in the beginning to me. Bugs me...but I am thinking upping the dose is key.

Wondering where G4M is in this - she upped hers awhile back & we haven't heard from her in awhile. Anyway - keep us informed, Virgil. Really excited about this again via your contacts with Dr. E & Lenore!

I truly hope that increasing the dosage will be the answer for those of you who've seen little or no progress. I wish it had been an option for me, because I feel it might explain why it has taken SOoooo long for me. Virgil, I'm thrilled that you have such a great doctor, and that Dr. E was willing to personally get involved - how cool is that? And Houtx, after presenting the article, if you can get your doc to prescribe more Nal (for less than it would cost to get it on your own), then I think you should go for it.

For what it's worth, even though I found the article but failed to convince my psych to up my dosage, I really AM still seeing results at 50mg - just not nearly as quickly as I'd like. I'm not sure if this is due to the dose or my very long history of heavy drinking. But, for anyone else who gets frustrated with irregular and slow progress - please know that TSM does work. Personally, I think it's still best to follow the suggested procedure for at LEAST a few months before assuming you need a higher dosage. I certainly don't want to start a "trend" where those new to TSM start experimenting with the standard formula if they become impatient early in the process - TSM may just take longer to work for some (like me). However, when you've stuck it out and given the recommended approach a fair shake, and still see no results, then it makes perfect sense to consider looking at changing the dose.

Luckily, Nal is considered to be very safe, so it's not like we're playing with fire. My very best wishes that this will work for all of you who've hung on so long - I can't wait to hear the good news! I'm drinking to your success!!!

virgil ,
my fingers are firmly crossed too . Good news . All the best .

Kris ,
I'm very much with you , obviously it crosses my mind to up dose but
shall not do it , not yet at any rate . Last week was better but it has to stick !!