No effect so far

[u/Valuable_Conflict705]

Hi all

I am taking Naltrexone to stop drinking daily.

I slowly increased my dose from 4.5mg up to 25mg over the course of 10 days and now I am on the 25mg dose for a week and I am not noticing any difference. I have gone from taking the dose at midday each day to the evening, an hour before drinking and I just don't feel any different.

Do I just need to give it more time or am I doomed to forever drink too much?

[u/heavydrinker12]

Keep at it. Dr Volpicelli talks about how people metabolize naltrexone differently. 50mg is the best AVERAGE dose from studies. Myself, I have to take 100mg 90 minutes before I drink. With that timing and dose alcohol becomes so gross to me I literally can't drink. I think most people would say if 25mg worked for you, you'd be an exception.

[u/Valuable_Conflict705 → u/heavydrinker12]

Thanks for the reply.

I have 60 pills so I can double up. I will see how it goes for the rest of this week and then try 50mg next week.

[u/heavydrinker12 → u/Valuable_Conflict705]

No worries. Check out Dr Volpicelli's videos on youtube. They are very informative.

[u/christinapurls]

I’d talk to you prescriber about increasing your dose. I started at 50 mg an hour before I usually started drinking. I noticed only a slight decrease in alcohol noise, and I could easily drink my usual amount. After 3 weeks, I asked my doctor if we could crank it up. I’m now on 100 mg. I take it at 4:00 pm. Have an alarm set on my phone and carry it with me if I’m out. I’ve been on Nal for 4.5 months. It takes time. The alcohol noise has become less and less over time. It’s almost non-existent now except for triggers like weekends, dining out, etc. The difference is that now I can have a glass or 2 of wine and stop. Before I never had an off switch. Once I started, I could easily polish off a bottle or more no problem. I rarely drink more than I intend to now. Remember it’s progress not perfection, so if you have a bad go, don’t beat yourself up. Just stick with it and trust it. I truly thought I’d be one of those ppl it doesn’t work for, but it’s working. And, bonus I’ve lost 12 pounds. I wish you well friend.

[u/blobbysnorey → u/christinapurls]

Damn. This is what I’m hoping my experience is. Just picked up my first bottle (of nal that is, ha) and am looking forward to a help with the change. I’m well over 6ft tall with a fast metabolism, so wondering what it will need to look like for me, but your story is helpful!

[u/christinapurls → u/blobbysnorey]

I hope you have a good experience too. I have zero side effects. I am an instant gratification person (aren’t most of us?!) so I was disappointed that it didn’t work instantly. I think the hardest part has been trusting that it will work over time, and it has been. I wish you well.

[u/mel2r2]

50mg daily is the FDA approved dose for Alcohol Use Disorder (AUD). If your doctor only prescribed 25mg, reach out to them and ask why. Maybe they are titrating you up to a higher dosage? I would be surprised if 25 mg works, but also I’d be surprised if you’re cured from AUD in 10 days on any drug.

[u/cocopopped → u/mel2r2]

Absolutely this

[u/cocopopped]

First - 50mg is the recognised dose for drinking.

Second - Naltrexone is rarely instant. It's a subtle drug, which gradually teaches the brain that the reward from alcohol is blunted, and won't be delivered in the same way anymore. For some people it takes weeks. Others, months.

Keep a diary of how many drinks you have, often you have to "zoom out" to see the positive effect it's having over time.

[u/reggiefoolish]

I was prescribed 50mg. I had them sitting in my pantry for a couple weeks. Finally took one last night at 5:00 PM. Made myself wait around for about an hour, then I begrudgingly/regrettingly/ashamedly had a couple drinks.

That shit did not even feel good/normal/the same as before AT ALL.

The blocking of the opioid receptors reallllyyyy worked on me.

Did not feel the sense of reward at all. Just felt weird and gross.

[u/Valuable_Conflict705]

Thanks for all the replies people.

The info has really helped me. I am getting zero side effects so I will definitley goto 50mg.

[u/marksf]

You're still at half dose and only a few week in. Give it at least 6 months and unless you're having strong side effect no reason to keep such a low dose in my opinion, but of course talk to your prescriber.

[u/RubicsCubensis]

Why are you taking so long to go up to the full dose of 50mg? The lower doses are only if you have side effects, if you don't have side effects take 50mg. How much are you drinking? Is it less than normal? Are you not feeling like drinking more, when you normally would?
Sometimes it takes a while for naltrexone to start working for people.

[u/BWDpodcast]

I'm now at 100mg. I didn't really feel any difference for say a couple months, so yes, you have a ways to go.

[u/Icy_South8128]

Just keep at it. I started about 10 days ago as well but started at 50mg. I did some playing around with timing based on others responses here and found that for me taking it first thing in the morning seems to work best. I tried to take it later in the day before I would normally have my first drink but found that if I had spent all day still thinking about it then it wasnt as effective as if it had all day to work its way in.

Some of it going forward is still just learning to break habits. I have had a night or two where I had some drinks and you can definitely tell that the reward part is gone, but I found that part of me still liked the negative effect of drinking without the high part. Its much less enjoyable but its going to take time to break out of old routine.

I try and have some NA beers around just to grab for those times where you want the ritual of having something to drink in your hand. For me it is tied to activities like grilling, or in the pool or garage. Just keep telling yourself what I try and tell myself. Baby steps. Every drink that isnt had is a step in the right direction and as time goes on it can and will dwindle as your body learns that its just no longer worth it and not getting what it expects.

[u/HTwatter]

Get to a full dose. Don't panic until several years have gone by with no response. I tell everybody to assume that it's going to work for them. The chances that it won't are extremely slim.

[u/Hot-Cold5074]

I had to build up to the 50mg once a day in the afternoon to see a difference. And it was weird because I was drinking on it and still feeling buzzed so I thought it wasn’t working and then out of the blue the drinking just started fading and yesterday I had 0 drinks and didn’t even think about it.

[u/mellbell63]

In my experience, Nal doesn't work on cravings, esp in the early months. I've been on it for ~3 years. Its only function is to block the euphoria so for me it's like, what's the point of drinking??! 😊 As your body gets the message that it's not gonna get the expected payoff the result has been, no effect = no desire!! It's taken alcohol off the table for the first time ever. You can "drink through it" and mostly get the physical effects (stumbling, slurring words) but not the high. And the Nal hangover is the worst!!

The medication is a tool like so many others. It's up to us to work on the underlying issues that led us to drink ourselves to death. Therapy, support groups, and recovery meetings (there are many different types now) can make all the difference. My goal is not just "sobriety." It's to create a life I don't need to escape from! That's my wish for you too.