Naltrexon vs Selincro

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Happy New Year !

 I started Selincro in early December with very satisfying results, but rather nasty side effects. At the time, I attributed the severety of the side effects to the fact that I was stopping smoking with the help of Champix at the same time. I stopped both champix and selincro just before Christmas. Non smoking is going fine, but drinking went quickly back to previous levels (as was sort of expected during the hols). After 1/2bottle of bourbon and 1 1/2 bottles of red wine on Thursday, I started the Selincro again on Friday. Immediate results, but the big downer are the side effects. Same as the first time...if not worse.

My question is as follows: If Naltrexone and Selincro are more of less the same (?) and the side effects of Naltrexone are more bearable, would I get similar results? If not, is there any info about how long I can interrupt the course without encountering the initial side effects?

I hope this makes sense, unfortunately, confusion is one of the more disturbing side effects :-/

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12 Replies

  • Posted

    Some people report the side effects of Naltrexone to be less. If you are able to change to Naltrexone, it's worth trying. You should be aware that Naltrexone has more of an effect on the liver than Nalmefene (Selincro) but neither have as much effect as large amounts of alcohol. You may be required to have regular Liver Function Tests if you are on Naltrexone, depending on who prescribes it and it is certainly worth keeping an eye on your liver, although many people get no liver changes. You get a test done by ordering a test kit online, pricking a finger to collect a sample and sending it back to the company you bought it from for analysis.
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  • Posted

    HI DreamDancer. I salute Paul for his response since he is the expert and I am not. However, I do see how honest and clear you are about your drinking and your strong desire to reduce it. Well done and I think that 2016 is YOUR year!! Keep trying! Regards Robin
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  • Posted

    Naltrexone and Selincro re both opioid antagonist medications, so they are both suitable for taking prior to drinking in the way that you are, and they will provide the same results.

    In my experience, and as Paul says, naltrexone does seem to have less reported side effects than Selincro.  I have taken both and very easily tolerated naltrexone but like most others, Selincro seemed a 'harsher' and 'heavier' type of medication and it took the usual week or so for my body to adjust to it.

    If I only take naltrexone occasionally because I only drink occasionally (for example, every couple of months) the only sensation I get from naltrexone is a little tiredness.  Though it has to be said that the tiredness might not be coming from the naltrexone, but from the evening itself, as I usually only drink now if I am in a restuarant with a family.  For me, a warm restaurant, meal and a couple of glasses of wine would probably make me tired anyway!

    The issue for you is how to get the naltrexone.  It is usually only prescribed by alcohol services for those who have already stopped drinking and to help them manage their cravings.

    So, I think the first thing to do will be to go back to the person who prescribed you the medication and have a discussion with them about the severity of the side effects for you, but that the medication is working well otherwise.

    Hopefully, it will be viewed as the same as changing an anti-depressant to a slighty different one because the first one didn't agree with you!

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    • Posted

      Thanks Joanna. I am aware of the difficulies getting Naltrexone for reduction instead of cessation. I am seeing the doctor at OnTrack this week for a review of the Selincro this week...and I intend to give him hell for downplaying the side effects of Selincro. Once I got him in the defensive, I hope to be able to squeeze a prescription for Naltrexone out of him :-)

      The one question I can't seem to find an answer for is how long a gap between doses I can allow myself without suffering the "day1" experience. If at all possible, I'd rather avoid eperimenting personally for obvious reasons :-/

      Talking of which, thank you very much for your "personal trials" on Selincro on the C3 site.. I wish I had read it before starting!

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    • Posted

      Thank you!  I am glad it is helping people because it was not the nicest couple of weeks of my life as I am sure you can imagine!! 

      But that need to experience it for myself and therefore being able to honestly understand and empathise with those on Selincro, was what it was all for.  I always say to people that feeling confident enough to do what I did just shows the trust I have in the method - at no point either before or during did I feel that I was putting myself at risk by drinking to that level again in the name of an experiment.

      As Selincro is so new, I am not sure anyone can give you a definitive answer on how much of a gap you can have without feeling the side effects again.... at present a lot of people are still very new in their experience of it.  In those that I have personally spoken to, the safest answer is probably not too long at all.  Though of course everyone is different.

      I do wonder if this will have an effect on those who chose total abstinence over occasional drinking.  Information on naltrexone appears to show that 40% of those who achieve the pharmacological extinction chose to go completely abstinent.  I would suspect that as the years go by with Selincro being prescribed, that figure might be much higher due to these side effects.

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    • Posted

      Our finding, after using Nalmefene (Selincro) for just over a year with our clients is this:

      Some people get very few side effects initially and are able to have a break from drinking for weeks and then have no side effects if they then take a pill before drinking.

      Some people experience much more severe side effects initially but only mind ones after a break and these only last the first couple of times they take a pill after this break.

      Some people suffer severe side effects initially AND every time they take a pill after a break. Our experience with these people is that they are far more likely to become abstinent as a result of fearing these side effects. This is not necessarily a bad thing as they achieve this abstinence with no cravings at all because they have reached the point of pharmacological extinction (unlearned their addiction) by this point.

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    • Posted

      I clearly belong to the 3rd group :-) Abstinence still does not seem to be an option for me at this moment in time, although I can see why one would prefer not to drink rather than incur the side effects! 

      I will wait a couple more days before making a decision, as the side effects make any cognitive process a bit difficult, Perhaps a bit of self experimentation will help finding "safe gaps"..

       

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  • Posted

    Hi Dreamdancer, I don't know if you have read the other previous posts on the forum but there is a wealth of similar issues and advise provided within the discussions. 

    'One week today '   a recent discussion will also be helpful to you.  

    I also had a successfull outcome on selincro and after several months found I was only having a drink once or twice a week. However, the side effects returned on those occassions. 

    I have stopped Selincro and so far so good and I am still only drinking small amounts and having most days alcohol free. I was never a massive drinker compared to many on this forum but I was consuming at the very least 70 units plus a week. Probably a lot more if we were to entertain or go out for a meal at weekends.  In the past I also drank spirits but I stopped regular spirit drinking about 3 years ago. I sought help for this because I realised that I could not continue like this at my age and realised that I was having difficulty having even one evening off drinking. 

    I know I am taking a risk drinking unprotected, yes I am doing well at the moment but I want to stay that way.  So I am going down the Naltrexone route. I have just ordered some online from a recommended sourse. That is until I can get things sorted through my GP and a specilaist. ( Full story in the other discussions )

    Best of luck with your journey.

    Ray

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    • Posted

      Your experiences seem very similar to mine. Stopping spirits was the greatest step for us. In a strange way, the 10-15 units/day on wine felt almost like temperance. No hangovers, no black-outs no memory holes and more importantly, no anxiety attacks at night. 

      Also, it meant that my "reason", "incentive" for a more serious reduction had sortof disappeared. Long term health considerations and a bit of fatty liver just doesn't pack the same punch as waking up at 3am in the morning, hyperventilating and your heart trying to get out of your chest!

      I will try to convince my doctor to change the prescription to Naltrexone this week. See how it goes. Please do keep us posted about your progress so we can compare notes :-)

      All the best,

      Juergen

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