Selincro (Nalmefene) vs. Naltrexone. Awful side effects with both...

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Dear All,

Whilst undergoing therapy for alcoholism, I was eventually recommened a course of Naltrexone. I thought this might be the miracle cure and gladly signed up, but suffered quite strong side effects - mainly severe drowsiness/sleepiness and irritability. After a few days this began to interfere with my life more than my drinking did, so I stopped taking it and was eventually recommended by my clinic that I try Nalmefene. I gladly agreed, thinking this might finally be the key. The side effects from Nalmefene, however, were unlike anything I could have imagined from any prescribed drug; absolute fatigue/drowsiness, absolute irritability, complete loss of apetite - so much so that I've only had a six inch subway sandwich in 3 days, itself eaten in bites over the course of a day, yet still don't feel in the slightest bit hungry (it also must be noted that I usually eat quite well and have never had any problems that may be associated with an eating disorder). I was unable to leave my bed - when I went to shower I could only go back to bed. When I eventually tested myself to go outside I was literally unable to be there as I found every single thing extremely irritating for no reason and couldn't wait to be back alone in the comfort of my own room (again, I live in a busy part of London and am normally a very congenial and outgoing person). I was in bed for a total of about 35 hours, yet still couldn't sleep properly - though I was 'asleep' it was more akin to the 'sleep' one may have when nodding off on a bus or train only to be jolted awake again, yet only to repeat the process.

Even still, Nalmefene's effect is obscured; through I didn't crave a drink I was so tortured by my solitude - and the racing thoughts induced by it and the drug - that I felt I simply must get out, and so at 11.30pm I went to my local pub. This, to be fair to the drug, was not for the want of alcohol but for a change of setting. Nonetheless, when I arrived and was greeted by friends, I found them all quite irritating and the whole ambience inconducive to my current demeanour (another odd occurrence since they are nice people and this is the same pub I've gone to 4 times a week for 6 years). I wound up leaving, wanting a quiet pint on my own and went to an old man pub down the road, where I sat alone and drank 6 lagers - which would seem to contradict what the drug claims to do.

It should also be noted that while I was on Naltrexone, this urge to keep drinking was quelled.

What I want to ask then, is if anyone else has had similar experiences on Nalmefene? These last few days were, without exaggeration, the single worst days of my life - complete, utter and constant despair, total fatigue, unfounded irritability and complete despondency from the outside world. Combined with zero appetite and recurring nausea, these were days of utter hell, so much so that I have stopped taking Nalmefene because I simply cannot put myself through it again, and reverted to taking Naltrexone again tonight. More worrying is the fact that Nalmefene didn't seem to work - the only reason I wasn't compelled to drink on itnis because I wasn't compelled to do anything at all - exercise, have sex etc, yet once I had a drink the insatiableness of my habit leaked through again. The Naltrexone side effects have so far not shown any symptoms that compares with its counterpart, but it was taken with alcohol, coming off Nalmefene and late at night.

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12 Replies

  • Posted

    Sorry you're having such strong side effects from the meds, Dave! Some do, but it usually passes within a few days to a couple of weeks. 

    How much Naltrexone are you taking? Do you take it with food and a good bit of water? 

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  • Posted

    Just as a bit more info, the side effects from Selincro are usually rather stronger than with Naltrexone, although there are some that don't get side effects at all. I use Naltrexone and was quite irritable the first few days. I still find it supresses my appetite, so perhaps you can get around that by eating first, as that tends to lessen the problem.
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  • Posted

    What a bad time you've had. I tried nalmefene and had bad side effects including vertigo which took months to subside (I'd had it on the past). As well as making me feel too I'll to consider drinking it also suppressed my appetite. I only took it once. However I have since found out that you should talk it with food and plenty of water. You can get lots of info about the right way to take it on this site. But for someone like me whose drinking is associated with eating, eating two hours before so I can take the tablet is strange.So I haven't tried it since.
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    • Posted

      h1954, it's my understanding that you only need to have have a bite before the Selincro (or Naltrexone) till the side effects pass, then you can take it with just a full glass of water.  
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  • Posted

    Dave,  your experiences with both medications are not uncommon - but much more severe than most.

    Forgetting the nalmefene (since if you can get used to naltrexone, you won't need the nalmefene), this below is the way to take it in order to gradually allow your body to adjust.  I am wondering if you have suffered so badly because you went from zero dose, to the full tablet in one.

    1.  Have a good meal about 30-60 minutes prior to beginning.  Drink a good-size glass of water.

    2.  Take HALF a tablet of naltrexone with another good-size glass of water.

    3.  In the next hour, be sure to drink more water.  You may feel a little strange, perhaps a feeling of being a little spaced out.  This is normal.

    4.  After one hour of taking the naltrexone tablet, take a drink of alcohol.  Drink it slowly and appreciate that the 'kick' from the alcohol is missing from the experience.

    5. Continue to drink slowly and listen to what your brain is telling you.  When you get the signal that you are satisfied and don't want anymore, then stop drinking.

    Repeat this the next time with half a tablet again and if you are feeling okay with any side effects, then on the third time repeat but with a full tablet this time.  Once you are feeling no side effects at all, then you no longer need to eat first. 

    Side effects with naltrexone can include everything you mention, but by allowing your body to gradually get used to the tablets any side effects should lessen over the first few tablets.

    You should not take naltrexone every day - only take it on days that you are going to drink, and then take it one hour to the first drink.

    https://patient.info/health/sinclair-method-for-alcohol-use-disorder

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    • Posted

      Dear Joanna,

      Thankk you so much for this advice - it has helped considerably. I felt little to no side effects with Naltrexone following your method of ingestion and my drinking has reduced by about eighty percent. I haven't felt this good in ten years - I feel like a new man! Thanks aso much again!

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    • Posted

      So very pleased to read this and I am glad that I could help biggrin

      Your situation is not uncommon and could be easily sorted if the prescribing physicians knew a little more about what this medication really does and the best way to take it.

      If you feel so inclined, you could relay this 'way to take it' back to the person who prescribed it for you - at least that way, they may take it on board and suggest it to the next people they prescribe for.  The routine for nalmefene is exactly the same, but someone cannot half the nalmefene tablet (can cause skin irritation) so their side effects are usually always a little more severe than those taking naltrexone, but they do still wear off eventually.

      Stay compliant to the one hour rule, drink mindfully, log your drinking so you can see how things are progressing/particular times that trigger you more than others and it will get better all the time.  Do be aware, though, that some people experience this drastic reduction like you for a few weeks, then their drinking creeps up again before eventually reducing on a continued basis.  This is normal.

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  • Posted

    Hi. All I can say is well done and good luck with staying on the right side of the tracks. I can't give you any information but I see that others have, so that's good.

    Just wanted you to know that I'm rooting for you. All the best, and sorry you're having such a horrible time.

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  • Posted

    Dear All,

    Thank you so much for your advice, support and encouragement. I have followed the advice given by Joanna in the thread and it has worked spectacularly - little to no side effects and my drinking has reduced considerably. It really is a useful drug in controling alcohol consumption if one iis prepared to take it and be prepared to dance with the side effects. I wish you all the best of luck with your similar struggles and hope you can also get the to the stage where you can see the light again at the end of the tunnel. Thanks again to Joanna, her advice may have profound positive impact on my lifestyle.

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    • Posted

      That's excellent news, Daveprest! Thanks for letting us know and please post an update whenever you have the time. Your story gives another the heart to get off the relapse-go-round and give TSM a try.

      Be aware that your drinking might increase after an initial drop, there often is a "honeymoon" period, but don't be taken aback. Stick to the One Hour rule without fail and your intake will roll off from there. Mindful drinking is your friend especially in this case.

      You can also poke at your drinking routine to see where you can find a soft spot that will yield, like delaying your start time by 15 minutes or maybe opening the beer, taking a sip then putting it back in the fridge and getting up to a short task before the next sip. Be creative with it, you may come up with your own way to change up the routine and give you an extra measure of control.

      One thing's for sure though, if you crave a beer, always answer the craving with the One Hour rule (aka the Golden Rule) and that one little thing will move you one step closer to your goal. 

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  • Posted

    I'm so pleased this has worked well for you, Dave.

    After my horrible experience with nalmefene I did consider naltrexone, but the side effects on the website seemed much the same. I'm scared to risk it, as I'm still having the vertigo from time to time that kicked in with the nalmefene a year ago, and still on medication for it. But, my drinking has increased over the last year. Nowhere near back to former levels, but I was doing well before I tried the nalmefene, I was just looking for something to make it easier as it was always such a struggle. Had a bad couple of days Thursday and Friday. Not too bad today. But I'm not having any alcohol free days at the moment and I must.

    I find myself drinking even when I don't particularly want to, just because it's drinking time or drinking situation. Mad!!!

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    • Posted

      I would like to say too, this is fantastic Dave. I'm so happy for you and hope that life continues to get better for you..bless x

      h..I'm glad that life isn't quite as bad as it was. I too suffer with balance, sickness, vertigo. I've had labrinthitis plus perforated ear drum  twice( as painful as having a baby without any pain relief, which I've done). My mum has Ménière's disease which is passed down by 50 percent on the female side. I think that is why I suffer with meds and horrendous withdrawels plus hangovers. I hope I'm wrong though. Lots of love to you xx

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