selincro/nalmefene and alcohol

You should not take opiates if you are taking Nalmefene/Selincro. Is this what you are taking ? Let me know

No camprel is acamprasate it's for alcohol cravings

A lot of people on this forum ,including me bought on line out of frustration.Though I dint take it as it made me too ill

You could, Vicki, but you need to bear in mind that the NICE guidelines say a few things which must be adhered to when prescribing this drug.

Firstly, the patient must be seen a second time, two weeks after the first assessment before being prescribed Nalmefene (Selincro). The reason for this appears to be related to a second guideline which says that it should be prescribed for women drinking 5 units a day or men drinking 7.5 units a day. While that may seem tiny amounts to a person with a serious alcohol problem, the danger is that if a person takes the drug after drinking, for example, 20 units a day and then doesn't feel like drinking, they are in danger of withdrawal symptoms.

The other issue within the guidelines is that the drug should only be prescribed for people along with 'psycho-social' support. This is not clearly defined and it is my view that, rather than delving into people's lives and finding out why they drank too much in the first place, it should be more about education about how the drug works. For example, other more healthy activities stimulate the same receptirs in the brain and, when Nalmefene is taken, the pleasure from these other activities could diminished as well. That is why people need to work towards having days off from drinking, and therefore days off from taking the pill, so that they can get as much pleasure as they would normally get from those activities, which include extreme sports, rollercoaster rides, certain sweet and spicy foods, exercise, sex, cuddling babies and stroking animals.

Therefore, going privately, you would have to consider that you couldn't just pay for someone to write you a prescription, you would need to pay for the 'support' as well.

It CAN be done though.

Hi Paul. Just wanted to say Thanks for all the comments on selincro, I find them very helpful.

i have been a Drinker for the past 40+ years, always in denial, not wanting to admit that I had a problem. I have no time for AA or 12 steps programmes, and always managed to get away with my level of drinking, by not allowing it to affect my work or home life too much. Recently, I could see that I am/was heading down a slippery slope, two bottles of wine in the evenings and at weekends, a bottle of spirits added to that.

i heard about selincro on a radio programme and decided to try it. That was a month ago, I have had all the side effects your other posters have experienced, the worst being insomnia and a feeling of utter pointlessness in everything. I now know why, which is good. I am now down to no spirits, sharing the two bottles of wine with my wife in the evenings and not feeling the slightest desire to drink any more than that!

I know that I am still drinking too much, but after forty years, I feel that I am getting back to 'normal drinking' (whatever that is) without having to give up completely and declare myself an alcoholic. 

How long did the side effects last

Good to see another positive story Your drinking should continue to reduce as your opioid receptors get used to the idea that they don't get that additional reward they used to get.

Well done, , Michael, I'm really pleased for you. Did the side effects allow you to function, cos they make me too ill to do much

Hi John. In my case about a week. I was never a sound sleeper, so that's another issue. The side effects are less than stopping drinking for a day!!

Thanks Paul. From tomorrow, I am going to replace my evening wine with a walk, or a visit to the gym. I now need to break the habit of drinking every day. I find that once I get past 9pm, I don't need a drink as badly.

The first few days were the hardest. I took my first tablet on a Friday , so that i had the weekend to cope. Don't give up!! It's better than the alternatives!! 😁

Hi Paul,

Enjoyed reading your entries over the whole thread, and all other people's inputs, very interesting and helpful!

Have just started on selincro, 6 hours ago, and so far, just a bit groggy, nothing in the way of sick or too unusual, was expecting to be feeling like have flu or major hangover, as some have said happens.

I guess it's different for everyone, with certain similarities. Actually, a bit like being mildly stoned as someone suggested.[ A pity the pages are so long to scroll, hard to find individual entries.., i suppose at least they're there to find.]

So far: it being my first tablet, still feel inclined to (&capable of) open more cans, am not sure it's slowing the tendency down much, perhaps too soon to say.

Would there be any problem with taking two tablets, if one tab doesn't happen to curtail urge enough (weigh over 90kg, 6'4", drink over 140g/p/day, drinking very heavy well over 30 years, supposedly strong constitution)?

Other thing wondered was whether, like someone on thread suggested, okay to skip taking selincro for a weekend, enable session with a friend rarely seen, and resume the following day?

Or would that prevent getting most benefit from it's uninterrupted use, or create a problem in continuing it's use after the intermission?

Thanks very much for your help, much appreciated, Flat9 (bren)

:-)

Error! Am not quite that excessive, i meant circa 140 p/week, but generally slightly more than that.. cheers!

Flat9. The recommended dose is one pill per day for ANYBODY regardless of their size, drinking history and health. As a qualified nurse, I can't advise you to take more than that. What I will say is that the effect lasts in the body for up to 11 hours. If you were to drink after that, you would be unprotected. For example, it you took a pill at 9am, and started drinking at 11am, you would only be protected until 8pm. I can't tell you to take a second pill. What I will say is that during the trials, more than one pill was given to people with no ill effects.

One pill is sufficient to do the job each time you drink though, as long as you give it time to work (90 minutes to 2 hours) and don't carry on drinking for too many hours (or drink a second time too much later in the day). The main time I would expect this to be a problem is when people are on holiday and have a lunch time drink and then a night time one.

There is absolutely no good reason to skip a pill so you can have a 'good session'. Nalmefene doesn't stop you enjoying the taste or getting drunk or enjoying a party atmosphere. All it does is block the ADDITIONAL reward that you get on top of what most other people get. It makes you like the majority of people in that you can stop drinking when you want to and not have serious cravings the next day. You will completely destroy any good the drug has done if you drink without protecting yourself with it.

Hi Paul, thanks for your reply. Am now on the third Selincro, having taken it about 5 hours ago (7.30pm), much the same time last night, and drinking around an hour and a half after tablet taken.

Have been surprised as to how little I’ve felt effects in the evenings, drinking a bit less than normal, not a lot of a difference from my usual level, and generally enjoying it much the same as usual. Very tired in the mornings and not sleeping very well at nights, as others seem to have found. Lower food appetite also.

Presumably, the desire for drink will progressively become less and less as time goes on, taking the medication as described?

‘Wondered whether, of the 22% in trials, not suited to the drug, would they include those for whom it does little for, maybe doesn’t quite prevent endorphins from meeting up with the reactors in their brains, or would they more-so be those for whom it has a chemical/allergic reaction with, making them sick?

Perhaps all kinds of unsuitability are included, the answer probably doesn’t matter anyway, maybe forget that one! J

Also wondered if of any great advantage to purchase the Roy Escapa's book, to perhaps help with psychophysical (or lack of) support-end-of-things (although, I’ve a lot of books to get around to reading, so unless essential) and on similar lines, whether the likes of CBT and Mindfulness, are advisable, to enhance effects of the drug experientially?

Have been wondering whether one needs to decide (regarding question that arises for most of us): will I have a drink?, with one’s will-power making the decision, or whether the Selincro automatically will determine if I should have another drink or not!?

I did find, yesterday afternoon, that ‘had a very relaxed feeling in body & mind and had no desire to have a drink later (although I later did) to take-care-of that ‘uneasiness’ in the gut, related to the craving. Very pleasant and was impressed very much with how the drug was working, but at night, ‘still seem to be sinking the few cans, wondering should I still be thinking of another can (or maybe a g&t to finish with) or to just say ‘right, enough for tonight!’? L

Others seem to have found that they automatically didn’t desire to have any more to drink, which is of course great for that to be the case.

Enough rambling...

Regards & many thanks,

Flat9 (b9)

Roy Eskapa's book is well worth a read but it focuses on alcohol addiction as a medical condition and not any psychological aspects. I would say that a great deal of the psychological issues associated with alcohol addiction are down to the fact that people have been told for years that it is ALL their fault, that they should feel shame and guilt for the awful person they are. It's all nonsense of course and I believe that, by focusing on the fact that you have a medical condition which has a physocal treatment will help you to raise your self-esteem.

Some of our patients have experienced a slow response to Selincro. Like you, their drinking has not decreased that quickly. As the drug is very new, those providing it as a treatment are still collecting data and studying its effectiveness. If I was YOUR treatment practitioner, I would suggest that maybe a drink or two is slipping through before you are fully protected by the Selincro. We have discovered this with a couple of our clients and have suggested that they increase the time period between taking the drug and drinking to 2 hours.

Try that first, Flat9, and see if it makes a difference. People's bodies vary and the absorption of the drug will occur at faster or slower rates in different people.

*physical treatment

 

You also need to consider that the drug is only effective for about 8-11 hours. It has not been made clear how that should be dealt with. The recommended daily dose is one pill per day. I can't advise you to take more than one in a day, but the trials showed a very low risk of overdose.

Thanks for that Paul, good to keep in mind and if necessary take another pill after the 11 hours, perhaps.

I often do drink for up to circa 10-12 hours at home, but it's not in the way of a drink-to-get-drunk marathon, it's much more relaxed and would generally be a can or less per hour, often while playing on an instrument, reading or tv..

I have the, perhaps unusual, situation that 'can go on meditation retreat for a week, generally once a year,and aside from a bit of difficulty getting to sleep first couple nights, no problems or particular cravings (first year i did it, kept some cans in boot of car, just so I'd know they were there, and didn't need them ).

Back home, after a while slip into regular (heavy) drinking, very little meditation, although i did last year for a few months, decide not to drink 3 days a week on average, and it worked well enough, kept track in diary

But, probably from lack of will-power (hence the question earlier as to will-power or selincro deciding!?) reverted back to the daily consumption, it having been the norm for quite a few previous years.

i had recently wondered, when things blew-up at home about excessive drinking, if Campral was the amswer, but then discovered Selincro in a related search and opted for it (with the great help of an open-minded very supportive GP) since I don't fancy complete abstinence, can control it, to an extent at least and don't fancy going to AA meetings. 

Hopefully also control it much more with the help of Nalmefene and the likes of this thread. Time to get another beverage, before bed, I shouldn't really!.

Regards and best wishes,

Flat9.

Selincro can help with minimal willpower. All you need to do is ensure that you are protected for EVERY SINGLE alcoholic drink you have and the reduction should happen naturally. The only motivation needed for most people is that of organising their medication taking and their drinking so that they are not risking the opioid receptors getting a hit of that additional reward that people with alcohol problems get.

Thanks for posting a positive experience with these pills.  All the "side effects are unbearable" posts almost turned me off this treatement.  

I took my first Selincro 2 days ago.  I did have 5.7 units (2 500ml ales), the start of my normal midweek "treat," but didn't run out for 2 more bottles of beer or a shot from the liquor cabinet like I would also do normally.  I don't think I had a single side effect.  I woke up several times through the night but that would be normal after some drinks anyway.  The next day was totally fine and had no problem going to work and the gym in the evening as always.  I would say I was in a better mood then I had been in weeks, probably related to not being smashed the night before.