Selincro has reduced my drinking but ..................!

Thankyou Joanna, The Naltrexone option is worth looking into. My GP is not too Knowledable on the subject it was just that I am a retired health professional and I looked into it before discussing things with my GP. he knows me and my background well and so supported me. 

I do wonder though why NICE went with Selincro rather than Naltrexone if it works in a similar way and is much cheaper . I obviously need to do more reading on the subject.

I am writing this 20 minutes after taking a Selincro. Already I have that strange feeling within my head, a feeling from the roof of my mouth that is hard to explain and a cold clammy forehead and face. Off for a shower now to take my mind off it !

Oh, and there goes the tinitus lol

When NICE was taking advice on Selincro, a proposal was put forward by some of the parties involved to change the naltrexone guidelines at the same time.

The makers of Selincro opposed this, saying they were two different medications.  They won!

I understand they were trying to protect their investment and profitibility but it's a shame, isn't it?

So, naltrexone remains a medication only approved to help with cravings in those already abstinent.

I love that you are a retired health professional!  If there is any information I can provide you with to help you discuss naltrexone with your doctor, just let me know.

I am currently researching all the areas of the UK to see what instructions they have given their doctors with regards to prescribing.  Sadly, out of over 30 areas so far, only 2 areas have gone with the NICE recommendation to allow GP's to prescribe

All other areas are either specialist prescribing and monitoring only (alcohol services) or only to be initiated by specialists and then shared care with the GP.

Joanna, I would be happy to receive any information from you. Saves me searching the internet when you have it at hand. Yes , I was in Nursing for 38 years so that helped me to know what was going on and approach my GP.  He did not seem too aware of what was available but was supportive and suggested I approached a local charity support group.  It was several weeks before I eventually was prescribed the drug . I have no idea if he took advice from the local commissioners and so I don't know what the official line is locally.  Happy to answer  and questions for you privately about my area. My support worker was at the time ignorant of the NICE guidelines and the Sinclair Method but with my agreement she contacted Paul Turner on this forum who provided her with information. This is now being shared within that support group and I have agreed to write a piece on my experiences to date for a Newsletter that goes out to similar support groups and interested parties including the Local Authority.

I've pm'd you a link to a letter that you can print out and give to your doctor about prescribing naltrexone.

If you wanted me to check what the 'official' line is for your area on prescribing, I just need to know either which town you live in, or which local health authority you have then I will look it up for you

 

Hi Joanna,

You appear to be very knowlegeable on the issue of alcohol treatment.  May I ask what do you know about baclofen? I am Franco-British and I am astonished not to see anything on this medication here in the UK.

Hi Sophie,

I have no personal experience with Baclofen.  I know there is a lot of people who use it, or have used it.

Generally, all I have heard about is that a lot of people suffer terribly on it.  Two people I know had it prescribed prior to nalmefene but they had to stop because of blurred vision and other things that (unlike nalmefene) those side effects didn't pass.

 

Absolutely do NOT take the tablet every day if you are not drinking.

To do this would cause what is called 'up-regulation' plus you would be blocked from receiving any good endorphins too.  This method works so well because you 'target' the drinking endorphins only and leave yourself free to enjoy good endorphins and good feelings on days that you don't drink. This creates a push-pull effect away from the drink (which no longer provides the hit you need) and onto other things that you start enjoying more.

Have you read book explaining all this?  It's called The Cure For Alocholism by Dr Roy Eskapa.  It explaines the science behind what you are doing, but in a way that we can understand.

If you have not, please PM me your email address and I will forward you a PDF copy of it free (obviously I have Dr Eskapa's permission to do this).

In addition, do be sure that if you have alcohol free days and no alcohol when you want to drink you have a meal prior to taking the Selincro.  This will help you feel less side effects.  Drink lots of water too.

Thanks JoannaC3 for the advice and the reminder of the effects on endorphins.  I have read the book, but in my frustration, I forgot how the drug blocks out other pleasures. I actually ate a lot of chocolate yesterday, as well, and I wonder if that didn't compound the side-effects and the alcohol effects.  I will be sure to eat properly and drink lots of water before drinking alcohol.  Thanks again for your advice. 

I know nothing about this drug..but find the topic interesting and kinda feel like you guys are "test" subjects for the drug...no one seems to know too much about this.

But, what I do know about drugs....is that they are forumlated to have an effect on certain areas of our brains...so I believe that your lowered consumption was definetly from the use of this particular drug. 

And it sounds like....that like with any other drug...that if you were to try and switch to everyday (talk to your Dr. of course)....that your body would become more used to it and maybe you wouldn't have such terrible reactions to the drug as you take it infrequently now.

 

I took Nalmefene yesterday for the first time and I felt terrible, headaches, dizzy this morning anxiety like a hangover. I dont understand the benefits. Wont try it again. Any advise ?

Eat first, drink plenty of water.

Carefully break the pill into a half tablet (a quarter if you can) and then take after food. Stay at that small dose for a couple of days, then increase to a bit more.

Build up to the full tablet over the course of a week. That will make things much, much easier to handle. The leaflet that comes with the tablets doesn't mention titrating up, and it even says not to break the tablet, but most people who go from zero dose to full dose in one go will experience side effect issues, as you describe.

Better to build up gradually.

Hello Paul, I was going to message you but for some reason our previous private correspondance on here has disappeared . From what you have read of my present situation you would support that I approach my GP to suggest changing to Naltrexone. It is just the side effects that is getting me down and spoiling what has been otherwise a very successful past few months.  I was having 6 -12 monthly Liver Function tests anyway as part of general health screening. 

Yes, Rayboy and I'm sure that your GP will be delighted to since Naltrexone is about a quarter of the price

Based on this bit of advice...I would stick with the Selincro vs. switching if I were on this medication....we have affected our livers quite enough...who needs a drug that you need to have your liver tested for at intervals?  That just sounds WRONG to me...Antabuse is the same way..it messed me up so bad...and I didn't go for the liver function tests because I thought (I'm fine)..and didn't have time for that......boy was I sorry.

Neither Naltrexone or Nalmefene (Selincro) are as bad for the liver as heavy drinking The liver testing with Naltrexone is precautionary.

Obviously I am just "spooked" from my reaction to Antabuse....another drug they do precautionary testing for...which became very toxic to my body.

To me any drug...including a simple asprin has to go thru my liver and since I don't want to drink....I'm not going to take anything that has warnings directed toward the liver.

As we get older they put us on more and more medication...

I tend to only be willing to take the pills that give me immediate gratification...like my tranqualizer and antidepressent....and an occassional headache pill if I get a headache.  Other than that...my belief and individual thought process happens to be....when they tell me I need liver testing (occassionaly) for any drug....my next words are "I don't want that drug"...LOL.

 

For me, personally, I've been taking naltrexone for the last two years whenever I need to (when I drink) and had my full liver tests done a month or so ago.  My results showed that my liver is now healthier than it was 10 years ago, and therefore obviously much healtier than I would be if I had continued drinking as I was.  My results are now comfortably within the 'normal' range in all aspects.

For me, the risk of taking naltrexone on the liver was so small in comparison to continued long term drinking - not to mention all of the paracetamol etc I was taking to try get rid of the hangovers!

Though I agree that liver testing is valuable, I spoke to the makers of Selincro recently, Lundbeck, and even they told me that despite Selincro not even being processed through the liver AT ALL, due to the compensation culture we live in, even they decided to put on the Patient Information Leaflet that Selincro should not be taken by those with liver issues!  They, and I suspect most other drug manufacturers, prefer to cover themselves for every eventuality.

 

Antabuse is a seriously dangerous drug which can kill if you drink with it and I can't understand why it is still legally available.

Naltrexone and Nalmefene are nothing like Antabuse. They are both processed by the liver but Nalmefene is considered to be more gentle on the liver. However, neither have as big an effect on the liver as alcohol and we do LFTs before we will recommend a client starting on The Sinclair Method because we can't advise a person with serious liver damage that it is ok to drink ANY alcohol.

Stealing this sentence from another website which I will send you a link to in a private message, Joanna. I hope the moderators will allow me the theft of one sentence :

'Nalmefene is extensively metabolized in the liver, but largely by glucuronidation rather than transformation to a different metabolite.'

Whoever you spoke to at Lundbeck didn't check their facts

That is why it is deemed better for the liver than Naltrexone, however, as you said, excessive alcohol is far worse than either drug for the liver.

What? I'm confused...all medications go thru our livers...kidneys...heart..."blood". 

Anyway...I'm curious...really? People can take these drugs and end up still being able to drink without getting carried away?  Do you still enjoy the drinking?  Do you still get a buzz?  I WOULD LOVE To drink without carrying on for days and days.  I put one in my mouth and I'm done for DAYS.

 

Thanks Paul!  I've read the link and will send it to Lundbeck to see what they say.

I was under the impression that it is so safe that it can be given to those with serious liver issues, too.

It takes some additional work too, Misssy - it isn't a magic pill.

And it takes time, too.  Sometimes many months.

To me, drink tastes nice but I no longer have that compulsion to continue.

I agree with that with the exeption that Selincro (the less I need it but on days I take it ) affects me in a way that makes me feel slightly unwell. Which is why I am looking for another option. I don't need to totally stop drinking as I was just someone who drank too much everday but never became a problem where I couldn't hold down a responsible job ( when I was working ) or affect my relationships or the way I functioned. I want to be able to any joy a drink 2 -3 times a week without then having a craving to continue. That is something I now can do but as I say the side effects interfere with the pleasure .

So it tastes nice.....but no compulsion to continue...what about the buzz?

Do you have side effects from the pill when you drink?

Side effects from drinking alone is enough for me.'

LOL

It can, to an extent, Joanna. The way it is processed is much more gentle on the liver.

When we treat people with Naltrexone, we have to ask them to do regular Liver Function Tests because it can have an impact on the liver, although much less of one than large amounts of alcohol.

When we use Nalmefene, we ask for ONE LFT test only, because, although we are not concerned about the impact of the Nalmefene on the liver, we need to ensure that it is appropriate for us to advise a person to carry on drinking. If their liver was in a serious state, we would be being negligent in our duty telling them it was ok to drink.