Naltrexone/Nalmefene (Selincro)/The Sinclair Method Hints and Tips

Each local NHS area has a slightly different guideline in terms of who they feel is the best physician to assess and prescribe for this method.  In rare cases, it is a GP responsibility.  In most cases though, it is the responsibility of the prescribing physician at alcohol recovery services.

If you PM me the town and county where you live, I will look up the specific guideline for your area.  Please include an email address in your message as it is easier to email you the information back.

Joanna.

Prepare yourself by eating a good, solid meal about 30-60 minutes prior to the tablet. 

And drink water.  With the meal, with the tablet, during the wait and between alcohol drinks.  Then have one last glass before going to bed.

Hopefully, these will keep any issues to a minimum, but remember that this would be the worst if will be, and from after the first time, any side effects lessen.

The short term discomfort (if you experience it! you may not) is usually worth the long term gain that this medication can give you.

Good luck!

Can you clarify the following please, gerimaus?

1.  Did you have alcohol in your system before taking the Selincro or were you sober at the time?

2.  Did you eat a meal to line your stomach before taking the Selincro?

3.  How much had you been drinking and for how long?

4.  Had you taken any type of medication in the week prior to taking the Selincro?

Louise, I can tell you that side effects like that aren't uncommon with Selinco, but they usually pass. Give us a bit more background on yourself and your drinking, it'll help Joanna give you some more helpful suggestions and feedback.

Best wishes to you!

Hi I am a 40 year old who is taking Nalmefene with a view to moderating my drinking. I drink half a bottle of wine per night, increasing to a bottle a night a couple of times a week. My problem is that I have to drink every day...not until the evening though, and don't enjoy daytime drinking at all.

I was drinking nearly 80 units per week a few years ago and then managed to go alcohol free for 9 months, but this wasn't sustainable for me and it gradually started to increase again.  I am receiving CBT counselling, but haven't been on anti depressants for over a year, and don't plan on takin them again!

Hopefully this gives you more of an insight...

Thanks, Louise! 

I'll qualify my comments about the side effects being fairly common, that relates more to the detachment, I haven't really hear about anyone bingeing as a side effect. 

I understand that it's recommended that the Selincro be taken on top of a meal, with plenty of water throughout the evening. Many have reported that this helps with the side effects. 

The bingeing kind of throws me though, hopefully Joanna will have some more info on that.

Hi there

Its strange as I experience the detachment the following day as opposed to soon after taking the tablet.

The bingeing is concerning me as it seems I am swapping alcohol for food, and am beginning to feel fat and miserable....which isn't much different to how I feel when I drink! Btw there isn't a chance of me being pregnant! Hopefully Joanna can help me 😔. 

I know her scedule can be a bit volatile, so if you don't hear anything you might try the contact info on the CThree Europe website. Do keep a close eye on your junk mail folder just in case you go that route. 

It sounds like it would be a good idea to get ahold of your GP as well, as they may have some more in depth information for you. While Joanna is very smart indeed, she isn't a medical professional and I would think that alerting your GP to this would be a prudent move. 

Yes, I have a follow up appointment on Monday with my GP so will raise it with her then. I just wondered if anyone else has experienced the over eating problem, but it appears not!

Thanks for holding the fort for me, ADE! 

Everything you mention is very normal indeed, Louise.  Some form of detachment is even mentioned on the Selincro Patient Information Leaflet as a possible side effect.

In my experience, though, bingeing on food has never been mentioned to me as a possible side effect.  If anything, not feeling so well tends to make people eat less - even if just in the early stages of getting used to this medicaiton.  So, yes, please, speak to your doctor about this. 

For most, the side effects can be quite uncomfortale but do settle (or at least start improving considerably) over the first 8-10 tablets.

The only other thing that I can think of as a possibility is that our bodies tend to crave sugary foods to replace the sugar in the alcohol that we are drinking less of.  Do you think that may possibily be it?

Really??   A moderator looked at this and approved it?????? 

I am sure the MHRA will love to hear about a UK-based website advertising prescription-only medications via an online website abroad......

This is absolutely 100% against the MHRA Blue Guide with reguates the 'advertising and promotion of medicines in the UK' as well as the 'legal requirements for medicines advertising in the UK'.

Still, I guess it only highlights how low this websit has fell since the changes.  Apparently, legal requirements no longer applies to them.

Sadly, Alan isn't a moderator one here any more, he does site testing or similar nowadays.

I must test post a web link and see how quickly it gets through moderation.

Yes, I heard that.

Funnily enough, I've been in touch with Alan a number of times with reporting posts that moderators have approved as they have clearly been approved against the forum terms and rules, and he has had to go on the site and moderate it properly (ie delete them), and he has said that they are looking at ways to prevent this happening, with better training of the new mods etc

Last time, I told him that unless Patient want to start paying me to report posts and basically moderate their forum, it was the last time I was going to report any posts and if their forum loses all credibily as a result of loads of links to unproven websites etc, then that is their fault!

For me, it's the fact that they have had new moderators since Aug, and they must have a list of things that they should not be approving - such as online pharmacy websites abroad - and yet, these type of posts are being looked at by a moderator and considered as okay to publish.

Hence why I have not reported this one :-)

PS.  I should point out that I am not looking to be paid to moderate the forum..... my point was that they have rules for the forum and if they are not willing to enforce those rules correctly, then they shouldn't expect the people who use the forum to do their job for them!

(What I wrote makes it sound like I was after a job with them, ha ha.  Definitely not, have far too much of my own stuff to do!)

Being a moderator is a thankless task and one I have turned down many a time. You can never please everyone and you are always accused of being biased and being reported to admin - generally admin stand by moderators 100%, because otherwise they find they have a high turnover of mods.

I did do a stint for a year as a global moderator on a forum that was very, very busy. It was certainly interesting, it was close to being political and we had journalists and even radio station presenters joining to try and cause mischief. It was that bad, that we even had to have ex-pat moderators to cover the night shift.

I imagine this forum just uses company admin staff to do moderation shifts, staff that have no real understanding of forum dynamics. They look for cuss words but have no understanding of an advert for Antabuse and how dangerous the stuff is, even when given by a medical professional, let alone self medicated.

Oh yeah, but as a company they make their bed and so have to lie in it.  If they can't even train their moderators to understand the extremely basic concept of 'no links to online pharmacies', and if they fall foul of the MHRA or other regulators then they deserve all they get (eventually) when they get found out.

I've moderated a forum, too.  Still do.  So I know what it is like.  This isn't a case of taking sides, it's a case of a very straightforward, basic rule that they set in place and is not being followed.  How difficult is it to see that this included a link to an overseas online pharmacy and should therefore should not have been approved?

If they are not going to follow their own rules (baring in mind many links have already been removed over the past months but only because I have reported them to Alan) then I am not interested in taking part in a forum that is run that way.  Without me reporting them, so many of these threads would have some very uninformed and maybe downright dangerous links included.

If they are not interested in running a properly moderated forum, then I am not going to be interested in being a member of that forum.  I have standards, but it appears that Patient don't.