One week today

Thank you 😁

Thank you, I just feel bloody amazing no cloudy head feeling or dehydrated I honestly didn't think I would feel this good and yep ur right proper sleep 😊

Thank you 😁

Well done you. After having a few drinks over Xmas, I've also gone back to not drinking. So like you, I've not drunk this year!

cant say I sleep better without booze, but then I've had sleep issues for years, one of the reasons I used to drink. Always slept better after a few drinks, although I know it's not classed as proper sleep. Let's hope we keep on track and manage dry January.

Fingers crossed 😊

Thank you 😁

Hi Paul. Can you help. I have been on Selincro for nearly a year now. With a prety good result. However I am getting dizzyness and feel like I want to stop taking this medication. I am worried about what will happen when I do. I am thinking of cutting down gradually, while still drinking moderately. i.e. perhaps trake one every other day for a week or so and then 3 times a week etc. Also if I felt I needed to go back onto it in the future woyuld the awful side effects be the same /

​There is alot of talk about Selincro but no-one seems to cover what happens when it's time to stop the pills. Worried and confused. No point in talking to G.P as they don't seem to know much about it apart from what's in their book.

Ho Boo, I stopped taking Selincro nearly four weeks ago now. However, the fact is that if following The Sinclair Method you should really take the drug for life at the times you have a drink. It is a risk to drink withuot it. The NHS ( NICE ) guidelines  though don't seem to cater for this and the impression from them is that this is a short term fix. ( i.e. 6 - 12 months taking Selincro )

I have written on this forum why I stopped taking the tablets but to cut a long story short the less I took the drug the bad side effects I had at the beginning returned.  I wanted to change over to Naltrexone ( said to have less side effects and does the same job )  but have had some issues making that happen to date.   I did not stop taking selincro gradually as by this time I was not drinking much and so therefore I was not taking the tablet nuch at all anyway.

I have drank since coming off Selincro but it is a risk and I know that. So far all is going well with me I am drinking probably less than the new government guidelines . ( and that includes over the Christmas and New Year period ) I am pursuing the Naltrexone option though either via prescription or buying them privately.

One thing I would say is that it sounds like you are still taking Selincro daily. Is that because you are still drinking everyday ? If you are not drinking everyday you don't need to take the tablet on those days.

You can't drink without protecting yourself with a pill, Boo, because you will be back to square one very quickly. There are people who simply stop drinking within the first few months because they no longer feel the need, but those who continue (usually drinking only occasionally) carry a pill with them just in case. Cutting down and using Nalmefene to help you is fine.

It appears that Nalmefene (Selincro) is worse for side effects returning if a person stops taking them for a few weeks. It may be worth looking at changing to Naltrexone if you can.

Hello Paul,

I have been taking Selincro since Sept, and am also finding the side effects hard to handle, especially if I take a break from drinking and the pill, and then start up again.  I have gone as long as two weeks without either, and then back to pill before a drink, and each time it is like starting over.  I have recently had a few mid-week glasses of wine without the pill because I knew I would only have a glass with my meal, and not have more.  Psychologically I feel I only need to take the pill on occassions when I would otherwise drink heavily (parties, weekends, etc), but this means dealing with the side-effects.  I have discussed this with my doctor , as well as the feeling that the dose seems to be too high for me (if I take a pill on Friday, I feel it stays with me the whole weekend; I don't feel out of control at all regarding drink if I don't take a second pill on Saturday or Sunday, but my head hurts, I don't sleep and I don't feel well).  The worst thing with Selincro is the heavy, foggy head, and the inability to sleep.  My doctor has suggested trying half a pill, which I have done this weekend (half Friday and half today) .  I still have the side-effects and have not had more than four drinks all weekend. What is your opinion regarding half a pill?  One last thing, sometimes the whole rollercoaster thing with side-effects makes me feel like Selincro is having as much, if not more effect on my brain than the alcohol, even if it isn't addictive.  What is your take on this?  Thanks for all your help, 

Selincro is coated for a reason. I is not supposed to break down until in the stomach and side effects could be worse if it started to break down higher up the digestive tract. I wouldn't advise breaking pills.

It appears increasingly like this is a problem with Selincro. People seem much more able to take Naltrexone after a period of not taking it, without experiencing side effects again. I would have a chat to the person prescribing it and ask if you can be prescribed Naltrexone instead.

HI Jacqueline. It seems that there are lot of side effects which is a shame. Paul is a good advisor for certain but at least you are on the right track with much less drinking. Good for you! Keep us posted Regards Robin

Paul, as you know this is an avenue I am exploring  ( messaged you BTW ) It is not just a case though of asking your GP to prescribe Naltrexone instead of Selincro.

After being asked to be abstinent for a month my GP was going to prescribe it and then realised that it needed to be prescribed , iitially , by a specialist.

So in my area it must come under the 'Amber' categorisation.

I am presently looking for someone to prescribe Naltrexone rather than just buying online. I have found a retired NHS chap who still does private work who after explaining my circumstances said he would be willing to prescribe it. However, to make it cost effective for me ( private consultation £260 ) I need to know that after the initial prescription from the specialist my GP will be able to prescribe the drug long term. 

I am presently researching the Traffic Light Classifications in my region and have found that they vary between trusts even within the same region. For example one trust classifies Naltrexone as an 'Amber' and a neighbouring trust classifies it as a 'Green Plus' basiscally that means it can be prescribed by a GP.  

The other thing I am discovering is that the traffic light classifications colours are different between trusts and authorities.  I.e. some have introduced a 'Blue ' category and others a 'green ' and ' green plus'. 

My next step is to write to my GP asking him to confirm what the local classifiaction is and then to liaise with the ' specialist' I have identified to see if they can work together on this.

Hi Paul,  Thank you for your advice.  I will talk to my doctor about the Naltrexone.

Did you read my post Jacueline. The one in response to Paul. Worth you reading and reserching before you speak to your GP. I wish I had done before first approaching my GP.

Think I understand what you mean. A GP will happily prescribe selincro, which works in the same way as naltrexone, but won't prescribe naltrexone. My GP claims he'd never heard of it, and even if he did know, it was practice policy not to prescribe 'those weird tablets' he was not very happy when I asked him "how can it be practice policy as you've just said you'd never heard of either of the drugs" lol!

It meets the NICE criteria and its in the BNF book. He did offer me the name of a private physciatrist who would issue a private prescription. It's a postcode lottery.

good luck with your gp

Vicky, I can understand GPs not knowing about Selincro as it only became available this year in England and Wales. My GP and my pharmacist had not heard of it.  If a GP wil not consider it well, find a GP who will.

The Naltrexone is a different issue in that in most cases GPs are not allowed to presribe it . At least initially. It is not licenced in our country for use as Nalmefene (selincro ) even if it is more or less the same drug with the same effect. It is licenced here for individuals who are abstinent from alcohol and it is supposed to reduce gravings.  Not sure how it works that way as it is an opioid receptor antagonist. So would you not think it works in the same way as Selincro and you need to have a drink for it to be effective. 

The prescribing instructions for naltrexone were agreed way back in the mid-1990's.  This was before it became apparent (via Dr Sinclair's 20 years worth of research) that it works better and produces much, much better results when used in conjuction with alcohol, in the same way that nalemfene is.

However, because naltrexone is generic meaning that any company can make it, there is no exclusivity on the profits anymore, hence no pharma company will spend the millions of £s it would take to have the prescibing instructions changed.

During the approval procedure for nalmefene, it was put forward that at the same time naltrexone should be accepting for treatment in the same way, but the company who make nalmefene successfully opposed this and the matter was dropped.

I can understand why, because they were protecting their investment in bringing nalmefene to the market, but it is a shame.

Also, I feel that it is NOT acceptable that GP's don't know about nalmefene.  The approval for European Marketing was granted back in March 2013 and since then it has gradually be rolled out across Europe. 

Officially approved on the NHS in England and Wales since November 2014, it was all over the news, the press, mentioned in the GP's magazines and if you search the internet, you will find many Local Health Authorty memos that have gone our to doctors since prior to the NHS approval.  The number of memos increased after November 2014, too.

Part of a doctors job is to keep up to date with the latest updates in the medical industry and most especially, in new drugs that are approved by NICE for use on the NHS.

It seems to me that a lot of GPs must live under a rock that they apparently know nothing, and never saw a news, or read a newspaper, and this seems to me as acknowledging that they don't read their official NHS memos, too!

Sorry if this appears a little harsh to GP's and I am sure there are some good ones out there, but my experience is that for every GP that I hear has heard of nalmefene, there seems to be another 30 that haven't!  I don't know about anyone else here, but in every job I have ever had, it's been expected that I keep up to date with anything that might affect my job.

This can be as important as a life or death situation for a lot of people.  Imagine if a cancer drug with amazing results was approved over a year ago and your GP didn't know about it.... there would rightly be questions to answer!  In this case, it seems to me to be another example of the negativity that is held with regards to AUD and other addictions

Show himthis NHS link.

http://www.nhs.uk/Conditions/Alcohol-misuse/Pages/Treatment.aspx

Interesting. You have me wondering now what I should do if I drive up to a traffic light which is on blue

 

Hahaha Paul, I like it!