Back to what should truly be my "weekly progress" on the TSM...

I am not going to go into a whole lot of detail right now as I got in late and have been catching up elsewhere...see my post on "So is it working" or something like that under General Discussion...BUT:

I went to my DR today with the article I pulled from somewhere on this site (from Virgil) about the McCaul study re:fine-tuning/adjusting doseages. After some discussion, he suggested upping my dose to 100mgs. I was a little shocked at the immediate double dose - thought he'd say 75...but he said he had had good success w/ gambling addicts at 100mgs! I was wondering why I had to be the one to suggest it...but oh well! It was probably the best visit I've had w/ the guy.

He was asking good questions about my progress, my life, etc. He was researching upper doseages of NAL as we were talking...said liver damage was only seen in patients taking in excess of 300 mgs daily...we laughed that the drinking would be more of a concern than NAL...he seemed to have quite a lot of data and knowledge about this medicine. Also suggested I start taking Camprall again to help w/ cravings (he prescribed it on my 1st visit but I only took a couple of doses. Several ppl on here said it would be moot while I was drinking). I dunno -

We agreed that altho my levels were down, it was slow going. I talked again about this site, what other members were experiencing as far as successes, AL free days & weeks, what normalcy means to them & me and the support I was getting here bigtime...etcetcetc. I really stressed the hope I had for this method to work, the fact that I hadn't felt any real changes & wanted to try the upped doseage. I told him my desire of simply being "normal"...going days/weeks AL free & then being able to drink a couple if so desired (after an hour of taking NAL) without feeling like I was breaking the ancient Code of Hammerabi or some such...that I could NEVER drink again!!! Also that if alcoholism is a "disease" then surely there should be a medicine to cure it & I believed Naltrexone was it..until Nalfemene is available in this country. blahblahblah


I was really relieved and impressed he did not offer an AA program again, like he has in the past. He actually seemed to be knowledgeable about TSM & what I was doing, even tho I haven't seen the guy in 3 months. So I'm excited!!

AGAIN!! I am going to start @ 75 mgs for a week. Even tho I upped my dose to this a month or so ago for a couple of weeks, it did not last long. I'm not going to mess around with it this time. Dr. assumes I am going to 100 mgs immediately, but I think I will do 75 for a week and then 100 after Labor Day. Thkgvg/Christmas will be my benchmark/checkpoint. Hopefully will see change before then. I will be the guinea pig - unless Virgil is in this with me.

So bottom line: I think after 6 months w/ no changes, it's time to reassess. Especially if you are older and have been drinking longer. I agree with the "it will just take longer" thought...but who has that kind of time when you're 50something??!! I started Feb 6th @ 50 mgs. & no changes since. I probably need to do something else at night. This is a habit I need to break. I work out, go to the driving range, etc, but by 7 or 8 I am pouring wine and on this box and then force myself to bed at 11 after having had about 4-5. UGH - so ready to change that to the tune of having glasses of green tea or something! LOL A dose of a GUY would be nice too LOL!!!

So Boom! He wrote me a Rx for 60 tabs of 50 mg NAL to be taken 2 at a time (w/ 1 refill). "Come see me in a couple of months and see how it goes". He said as he ushered me out. 30 minutes. A whole new beginning. Wondering where G4M has been & her experiences at 75 mgs...and Virgil?? and anyone else??

Ultimately, looking forward to this working for me "again"!! :-)

What wonderful news!!! Good luck!
eta... I've been at 75 mg for a month, and that's worked really well for me. Never more than two glasses of wine in an evening, and I had several, easy AL free days last week--I'm very happy!

Houtx,

I'm so glad your Dr. is supporting you on increasing Nal to 100mg, and I agree with you completely that 6 months is long enough to wait before trying something different. Like you said, this is new territory. Future members will surely benefit from seeing the whole picture, not just the "typcial or average" results. We'll give them the truth, the whole truth, and nothing but the truth... I really hope this change to 100mg will do the trick, and I admire your tenacity for sticking with this for so long. It's great to hear you're excited again - me too! My fingers are crossed (but it's hard to drink that way). Oh, that must be what straws are for! I wish you all the best.

Hi houtx,

Yes, I'm very much in there with you. I increased my dose of naltrexone from 50mg to 75mg exactly one week ago and ran with that dose until two days ago (Sunday 30 August) at which point I bumped it up to 100mg (one hour before drinking). There have not been any obvious side-effects of which I have been aware, either at 75mg or 100mg.

One thing I find extremely surprising (and upsetting) is that the original article about Dr McCaul's work was published in September 2000 - nine years ago! I'm speechless! I would really like to have a blood test to determine the level of 6-beta-naltrexol in my body and I'm going to discuss this with my doctor; it's obviously very important.

All the best.

V.

houtx
Glad you sound so much more positive again - i really hope it does the trick- you surely deserve it for sheer bloody minded determination!

You are to be commended for being so credible to your doctor!! You came in cold, totally unknown to this stranger who seemed pretty set in his ways, and sold TSM to him, even though it is not working as fast as it was "supposed to" for you. Now he is learning and changing it up and RESPECTING you in your effort to continue. That says a lot about your doc, but I think it says even more about you.

BTW the studies do not show much in the way of efficacy for Campral and the COMBINE study was the worst for it.

You deserve this. We all want this for you. We are blessed by your presence here.

UGH - once again, I had a nice post, hit the wrong key and LOST it!!! WAAAAAAAAAAAAAA!!!!!! Will have to try again tomorrow. ACK - and am not drunk, at least not too much! LOLOL

Suffice to say, I appreciate all your support!! Am looking forward to what may happen w/ my upped doseage...again, late so will post again tomorrow!

XXXOOO

Hi Guys,

Sorry for the long absence - this is just a quick check in to see how you all are doing. I'm actually going to have my book ms. package (was responsible for all 100+ illlustrations besides the research/writing) complete in just another day or two. Well - submitted, anyway. Then comes the copy-editing and fine tuning, which will take another month or so. THEN comes a much deserved vacation. YES!!!

I wanted to chime in here to say that I've been on the 75 mg. for several weeks now. I'm still drinking more than I prefer. My daily average is down to about 7 units. Last night I had six glasses of wine, and absolutely could NOT drink any more. One night at a party I doubled that - but that was an extremely hard drinking night, whereas it would have only average for me six months ago. So, there's progress.

I'm glad to see houtx is going to 100 mg. with her doctor's blessing. I've been thinking of doing the same, to be honest. Having a gastric bypass means there's less absorption of everything, not just food. I have no thyroid, and had trouble adjusting the dosage to get me even into the 'low normal' range. I'm now taking twice the usual dose, and a brand that has both T3 and T4. It seems to be doing the trick. If I need twice the thyroid meds as most people, why wouldn't that hold true for naltrexone?

Once I get this deadline beat, I'll be back more often to post progress.

Miss you all!

Goin4More

Y'all - I have no clue what I'm doing. It's been a month next week that I have been taking 100 mgs. I don't really feel much difference and it worries me.

Those of us who are upping our doseage are going blind here. We have no clue, no studies before us. I, quite frankly, am dissappointed with the lack of response and interese from the good DRs. They rarely check in and their responses are vague, lackluster, and basically non-existent. Surely, you all agree to the extent that there have been successes, but I am not impressed with the statistics of those of us in, to those of us cured....what 10??

I dunno - let's get real. There are no studies, no hard facts, no doctors or former patients coming forward...we are all just giving each other pats on the back and cheery messages when we don't know if it's going to work for us. Ok, it's great Nick is feeling success, but HELLOOOO....

Who else is REALLY feeling the urge to cut back?? I have been on 100 mgs 3 wks and wondering what is the time frame. It frustrates me we have no clinical trials or studies before us as to the success rate w/ people doing TSM @ 100 mgs...I feel no changes.

Is this normal?? Am I in essence starting over?? Will I not expect to feel significant change until 4-6 months again...or WHAT???? I am really frustrated with the lack of information/history/study before me...

...and while I am happy to hear of the "success' of others (Nick not wanting to drink: Period. The end.)...I am worried, frustrated, depressed, pissed off and everything else. Where are the goddamn doctors who wrote this stuff and why do they not respond in a timely manner?!

I find their attitude cavalier and off-putting. I want to believe but at the same time, 10 people being "cured" doesn't move me much beyond wondering where everone else is. There are many of us who are using NAL @ 100 mgs/day and I want to know about that. I want to know if there are any studies of others who found success or not at that dose/how long the study lasted, etc;

I want to know about my dose!!!!!! I want to hear from the Drs. more often - it makes me crazy we are experimenting. I am taking the book and my strength from this board to my doc every month or so, but really - we are experimenting & have no clue. That's bogus, people. It's false hope. I hate to burst the bubbles, but this site is so froo-froo hearts and flowers when most of us are struggling!!!!

I just want to know about taking 100 mgs, if I am starting all over?! How long out should I set the bar this time?? Does anyone know?? We read about these people whose cravings are so extinguished...mine are not. I want wine the same as I ever did...so should I expect extinction in 4-6 months again??

Bottom line: what am I to expect as far as my success at 100 mgs?? I am still @ a 10 as far as cravings: I look forward to my wine at the end of the day. And I drink it...

Just wish I had some guidelines..obviously no answers are to be had - this is really bugging me and hope to get some intelligent, civil responses soon.

Hi Houtx
I am truly sorry you are seeing no effects after a month on 100mg. You have been so incredibly positive and such a cheerleader for others here. I am not going to respond with platitudes i know i would be feeling pretty fed up. I have been lucky in that i am feeling effects but i know i have been sceptical and impatient at a much earlier stage than you.
I am not clear did you send a Q to Dr Escapa? I saw Jim in a recent post actually quote his direct email address and he said he had gotten responses pretty quickly. But the reality is I imagine they cannot give you certainties as they haven't done the research on dosage greater than 50 mg and are definitely not going to make definite statements not backed by research on such a public forum for fear of litigation. So you are a guinea pig along with the others on the board who have increased their dosage.
I notice that Christy reported this week that she has started taking Baclofen as well and appears to be reporting significant changes.
I hope you find your sparkle and enthusiasm again in the meantime mind yourself.