/r/Alcoholism_Medication

Photograph via snooOG

A safe place for investigation and discussion of scientific and medical treatments for the neural glitch of Alcohol Use Disorder (AUD) such as The Sinclair Method (TSM), Baclofen, Campral, Topamax, Antabuse, etc.

We foster an open environment geared towards the exploration of medical and scientific approaches to the treatment of Alcoholism more modernly referred to as Alcohol Use Disorder (AUD). Kindly abide by our modest set of rules:

 

  • Be kind, respectful and constructive in your participation here. Free thought and discussion is encouraged. As such you may disagree with some perspectives; however, treat individuals with the same courtesy as you wish to receive. There is no single treatment suited to all persons.
  • Topics of discussion should at their core have supporting elements grounded in modern science and secularism. As such we discourage discussion of non-secular (faith-based) methods, as substantial resources elsewhere are at an arm's reach./r/alcoholicsanonymous
  • Note that none of the moderators, or participants, are medically qualified, and that any information or resources provided as part of this subreddit are not meant as, or intended to be taken as, medical advice. *Please see your doctor for a balanced and informed discussion about Medically Assisted Treatment for Alcohol Use Disorder.
  • If you suspect your communication and thinking skills may be compromised, we encourage you to participate in the sub at a later time.
  • No sourcing, no marketing, no advertising, and no solicitation permitted. NO SURVEYS/PHISHING!
  • Once subscribed, moderators can be engaged privately through PMs.

Medical Treatments:

 

The Sinclair Method ~78% success rate

   Naltrexone & Nalmefene (Selincro-EU)

by Dr. Roy Eskapa2012

  • Documentary:'One Little Pill'2015

  • TSM in the Atlantic Monthly

  • Find a Physician

  • Hints & Tips

  • Mindful Drinking

  • Clinical Trials (120)

  •  

    Baclofen~42-62% success rate*

    • Text: 'The End of my Addiction'

    by Dr. Oliver Ameisen2009

  • Interview with Dr. Ameisen2009

  • Prescribing Guide

  •  

    Acomprosate~33% success rate*

    • Text: 'Acamprosate in Relapse Prevention of Alcoholism'

    by Michael Soyka1996

  • Prescribing Guide

  •  

    Topamax ~20% success rate*

    • Text: 'My Way Out'

    by Roberta Jewell2005

  • Severe interaction with cannabis

  •  

    Disulfiram (Antabuse)~n/a

    Questionable Effectiveness

  • Controversy

  •  

    *limited studies available and/or other variables

    Metaphysical Treatments:

    Ayahuasca

    Ibogaine

    Ketamine

    *There are a lot of hack-administrators in these modalities so do your due diligence vetting providers. Peculiarly, though of the same vein, 'Healthcare' backed Ketamine trials rarely reach theraputic levels instead pussy-footing around and wasting everyones time.(MassGeneralHospital). In such a case a private administrator is advantageous.


    Alcohol Use Disorder (AUD) / Alcoholism Test:

    DSM 5 (AUD)


    Additional Tools:

    Drink Log

    C3 Android Drink App


    Additional Resources:

    Sinclair Method Resources:

     

    Baclofen Resources:

     

    Leaving AA by Jon Sleeper


    General Literature of note:

    Other Subreddits:


    /r/Alcoholism_Medication

    22,941 Subscribers

    5

    Using Carnotol

    Hello! I’ve decided to make to the change and have a prescription for Carnotol. After reading the warnings- it dawned on me that as an automotive technician, a lot of chemicals that I breathe in and touch with cut fingers have some form of alcohol in it.

    Any other techs out with any experience regarding this?

    Thank you very much for your help!

    14 Comments
    2024/11/04
    00:16 UTC

    4

    Antabuse and energy drinks?

    I am wondering if anyone has any experience using the two at the same time. I know there are many things you absolutely can't have on Antabuse and I am starting it this week. I can't seem to find info online about any danger in having them together but would like to be sure.

    5 Comments
    2024/11/03
    23:42 UTC

    6

    Scared of Delirium Tremens

    So I've decided to finally quit drinking for good. Started with 1 bottle of wine every other night (about 3 years ago). Escalated to about 2 bottles every other night, sometimes more. I asked my psychiatrist for Antabuse a month or so ago to help me have an added layer of protection and expressed how worried I was about withdrawals. The psychiatrist said I could cut the amount I drink in half for a week and then start the Antabuse, but I found that I didn't have the self control for tapering. I got tired of trying and failing to wean off and decided a little over 24 hours after my last drink to take my first dose of Antabuse. I'm not experiencing any withdrawal symptoms so far (approaching 48 hours since my last drink now) but I know that DTs can take a few days to set in. It was impulsive of me to take the dose without tapering and now I'm worried. I do have 5mg diazepam, 10 pills. I've researched what to look out for and have a plan in case things go awry. If anyone has any tips, encouragement, first-hand experiences, etc I would really appreciate it, I'm just a bit anxious at the moment because now there is no going back - I want and need to quit the booze, but I'm afraid of what could happen over the next few days as my body adjusts.

    9 Comments
    2024/11/03
    13:47 UTC

    2

    Lyrica + Vyvanse. Thoughts?

    Naltrexone is a no go for me.

    In 2020 Lyrica helped me quit booze. 10 social drinks all year; mostly unfinished. Then the first pandemic winter changed all that. I've been off lyrica for a few years now. 

    I'm finally getting treated for my ADHD. That will be with a stimulant. I figure that I'll also ask for Lyrica to balance out the overstimulation from the stimulant, and help the drinking, at least to start. 

    If I need more help with AUD then Tirtzapeptide + up the lyrica to balance out the additional overstimulation.

    Any thoughts?

    4 Comments
    2024/11/03
    12:57 UTC

    2

    Saturday check in! :)

    Welcome to another lovely Saturday check in! Whatever it is you've got going on lately, feel free to leave it in the comments! As always, to you lovely lurkers: we see you, we love you, come out when you're ready! :)

    0 Comments
    2024/11/02
    20:56 UTC

    26

    Coming up on 3 years of TSM - Added Ketamine - just WOW

    I can't believe I'm about one month shy of my 3rd anniversary of starting TSM. You can feel free to peep my profile if you want a more detailed story, but the 50,000 view is that I was knocking back roughly 70 drinks a week - I was a daily drunk, a power drinker. I was also a super responder to TSM and saw an immediate and dramatic reduction in my alcohol intake from Day 1. To this day, I still only take 25 mg. All in-all, a great success.

    Of course, life has a way to keeping things interesting. This summer, my 22 year old son decided to pick up a meth habit and a full-blown sex addiction. Unfortunately, when we tried to sit him down to discuss our concerns around that, the discussion went really poorly. He's a big dude, 6'3", 320lbs, he went into a full blown rage, and came within an inch of smashing my face in. Thankfully I'm small and nimble and literally could run away from him while he was chasing me in a full on rage.

    As a result of all of this, I entered into a pretty deep depression and also was experiencing all the classic PTSD symptoms. Gunshots on TV would scare the living shit out of me, even. Life got really hard. I was still compliant with TSM, but there was definitely a general uptick in my drinking. In the back of my mind, I knew none of this was good, my depression, my PSTD symptoms, my overall increase in drinking. I don't really track my drinks, but I was probably drinking 3 drinks, most days of the week.

    Historically, I have had some other severe depressions. One was just before COVID, and I ended up doing ketamine-assisted therapy. I only got in a handful of sessions, but I experienced significant relief. After suffering for a while, I figured I needed to do something. I found a place that does at-home ketamine (happy to share the details, if anyone wants - just don't want to break any rules or seem like I am promoting any particular provider).

    The results have been astounding. I've been doing the ketamine sessions every 3 days for about 2 months now and my mood, anxiety, and PTSD symptoms all have dramatically improved. As part of the protocol of doing at home, the provider doesn't allow their patients to have alcohol on days when they take ketamine. First thing first, and props to TSM and staying compliant, I had zero issues not drinking on my ketamine days. I was a little worried that I would actually have an issue there, but TSM was still doing what it's supposed to be doing, protecting my brain from re-establishing those neurological pathways of physical dependency.

    But holy shit, Ketamine has completely tanked my desire for alcohol. I honestly don't understand why it has had such an impact, but it is just nuts. This was also a hard week: my other brother has developmental disabilities, lives out of state, and needed major surgery. I flew out to be with him (alone - it's just me and him), and it's just a lot emotionally. Usually, even with TSM, I would plan on taking a NAL and drinking if something like this was going on. I'd probably be good for 3-4 drinks a night for the duration of the trip and his time in the hospital. Not this trip, though. I've actually been super productive, churning through a bunch of work projects with the help of ChatGPT (thanks AI, love ya), while also spending 12-14 hours a day at the hospital.

    I will say Ketamine is not without its own quirks. The sessions are long, and I do them every 3 days at home. Between journaling, taking the meds, and then coming back to reality, it's 3 hours per session, so roughly 6-9 hours a week. I also personally had some really intense somatic sessions at the beginning. One was incredibly distressing, I experienced my own death and was basically stuck. Interestingly enough, I saw the biggest shift in my mood and PTSD symptoms after that really hard sessions. That only happened once, and I've had the opposite happen where I've had some amazingly blissful sessions.

    I do regularly think about the success I've had with TSM and am thankful that at the time I started TSM, I didn't have any major underlying mental health issues or other big shit happening in my life.

    TL;DR - If you're doing TSM, and not seeing the progress you hoped or wanted, or feel like other emotional/mental health issues are holding you back, consider adding in Ketamine.

    35 Comments
    2024/11/02
    14:41 UTC

    4

    Got an axe to grind? Grind it here!

    Heyo all! Here's a thread whose sole purpose is to give those who have a grievance against the Sinclair Method a place to air it all out. I and several others have noticed an influx of comments detracting from the Sinclair Method, and or touting the (statistically speaking) miserably ineffective recovery/abstinence modality. In an effort to give those would would discuss in good faith a chance to do so, I'm making this post every Friday. Please take this opportunity to engage with people for whom the Sinclair Method has literally be life saving.

    Having said that, I will take this opportunity to say I'm gonna start straight up deleting comments that say anything like "IWNDWYT" or something to that effect. For those repeat offenders who never take the opportunity to post here, I'm just gonna have to hand you a ban. There are very few places on the internet where the Sinclair Method can be discussed safely, and that's something worth protecting. Until I figure out a better way to mitigate the bad faith folks who come here to detract from the life-saving Sinclair Method, this is just how it has to be.

    So with that unpleasantness out of the way, feel free to leave your grievances in the comments! I will drink with you today if I'm properly protected!

    0 Comments
    2024/11/02
    01:45 UTC

    9

    TGIF! Let's celebrate some TSM success

    Hey y'all! This is a place for you to post your successes, great and small, with the Sinclair Method! Whatever it is that the Sinclair Method has done for you lately, feel free to leave it here!

    I'll give a brief snapshot of my own story: I was a binge drinker for 20 years that started at weekend keg parties in high school and progressed to drinking 15 units nightly of spirits and beer near the start of the pandemic. This is the same time period that my first child was born.

    I have now taken control of my drinking with the help of The Sinclair Method and this community and enjoy a majority of AF days most weeks. I get to enjoy being clear headed around my children and enthusiastic about experiencing the world as it unfolds to them without the dread of searching for the next drink.

    If you've got any similarly positive stories, feel free to share them here! :)

    6 Comments
    2024/11/01
    21:00 UTC

    1

    Latinx Drinking and Anxiety Online Study

    Hello,

    The University of Houston is recruiting participants for a new online study. This study involves a computer-delivered intervention that addresses drinking and anxiety. You may be eligible to participate if you (1) are between 21 and 75 years of age, (2) self-identify as Latinx or Hispanic, (3) are fluent in Spanish, (4) report regular alcohol consumption, and (5) experience anxiety.

    Participation involves completion of a pre-screener questionnaire, five additional online surveys, and a brief online intervention that should take about 3 hours of your time across 6-months conducted completely remotely via Zoom. Eligible participants for the current study that complete the entirety of the study will have the opportunity to receive up to $220 in electronic gift cards. Electronic gift cards can be redeemed through the platform Tango which allows you to pick a gift card based on your purchasing preferences from over 100 different businesses. If you are a University of Houston student, you can earn 0.5 SONA credits for completing the pre-screener questionnaire.

    If this seems of interest to you, please use the link below to complete a brief online pre-screener questionnaire. If you are deemed eligible for the study, we will then schedule your next online study appointment.

    Link: https://uhpsychology.co1.qualtrics.com/jfe/form/SV_1YwVAkvFGqz0m3k

    Please contact the RESTORE via email (restorestudy80@gmail.com) or phone (713-743-8056; mention study 80 when you call) for more information. Thank you!

    1 Comment
    2024/11/01
    18:54 UTC

    3

    Crowdsourcing Help/Suggestions

    I am looking to make a list for myself of things to do to relax and unwind without alcohol and wanted to get input from you all in your successful journeys. It can be hobbies, activities etc. or I am looking for quick things that can be done while I engage in the busy evening routine of dinner, baths, bedtime etc. So far I have "make a cup of tea to enjoy slowly." Any suggestions are appreciated!!

    1 Comment
    2024/11/01
    14:34 UTC

    3

    Severe anxiety/panic

    I’ve been 6 months sober now after liver/alcohal related hospital visit…randomly one day my anxiety spiked through the roof. I cannot sit still or lay down for even short periods of time with very bad insomnia (1-2 hours a night)and have a hard time concentrating…I just started taking Xanax .05 mg. Syroquil, and quetiapine..i still feel panicy jurt grorggy onto of it Iam really struggling here and need help..any advice?

    4 Comments
    2024/11/01
    09:14 UTC

    5

    acamprosate calcium 666mg 3xday

    Hi, i started acamprosate yesterday morning and took them 8 hours apart. i noticed that after dinner i was almost dizzy and like passed out for a solid 2-3 hour nap, waking back up at about 10:30pm. i took my last dose at 1am because that's the time it was due. Now i'm feeling like cold sweats and almost like mild flu-like symptoms....

    edit* i also had an itchy point of the day. like my back and my torso but there were no hives

    i have taken acamprosate before and it worked like a miracle for me but is this anyone elses experience or similar to? and is it possible i had no side effects before (earlier this year) and now all of a sudden have them? or am i legitimately getting sick. i have basically every vax you can get but i know it doesn't cover everything.

    and i messaged my doctor so hopefully i will hear back today at somepoint from her...

    12 Comments
    2024/11/01
    07:58 UTC

    18

    [Baclofen] I turned down my first drink today after 1 week on it, cravings are almost completely gone, and I didn't feel like I was "missing out" by not accepting the drink. Very satisfied with how this medication is helping me.

    For the title, I mean the first drink offered to me. I have only had 3 beers at a halloween party last Saturday, other than that I haven't had a single drink since then.

    After a long time of putting it off, I was finally able to find a place to get baclofen without dealing with online programs that basically want me to pay $500 for virtual rehab. I could always quit, but the intense cravings and kind of bad mood was what always brought me back. I knew I didn't need actual rehab.

    I chose baclofen because Naltrexone won't work for me. I take kratom, and that would be a miserable experience taking it. Disulfiram was a no-go, because it seems like it just makes you have such a horrible reaction to alcohol, but doesn't help with withdrawal symptoms. Acamprosate was my second choice.

    I got my first order of baclofen exactly one week ago today, 70x10mg. Dosing at 20mg a day, and trying not to go any above that. 5mg in the morning, 5mg afternoon, and 10mg an hour or two before bed, since that's when most of my drinking was.

    Holy shit, it worked like a charm. In what seemed like no time at all, my cravings for alcohol when quitting went from a 10/10 to a 3/10. I didn't feel like shit. I didn't get into a bad mood or irritated. I just felt... kind of normal, maybe a little bit less of a social butterfly, but compared to going cold turkey with no help... night and day difference.

    My girlfriend came up to me last night and asked how the medication was working (she's been wanting to stop as well, but she just drinks fruity, 5% can drinks, maybe 4-6 per day). I told her it was going great, I hadn't had a drop of alcohol and was doing just fine. She said "wait WHAT? Are you for real?". I then told her she could try some of mine if she was serious about it, and we went into a discussion about it.

    Today, my girlfriend offered me the rest of her drink that got kind of warm. 2 weeks ago I would have chugged the shit out of it. Today I turned it down, and it felt amazing. I didn't get that sense that I was "missing out", you know?

    Anyway, I'm going to be strict with 20mg a day, and I'm going to keep up on this for another month and see how I am feeling. . I'm not in it to replace alcohol with a prescription medication. I'm in it because I want to be free from it. I want to save that extra $50/week, and save my fucking liver.

    Anyway, thank you for reading. I am honestly fascinated with how well this is working so far, and after another week or two it's only going to get easier. If anyone is on the fence about baclofen, I strongly recommend it.

    9 Comments
    2024/11/01
    02:32 UTC

    17

    Need some support

    I, 36M am trying to support my partner 35F as she does TSM. It’s been a hard struggle, she’s a VERY slow responder but since it’s been over a year she’s losing faith and I think is being inconsistent with her dosing. She’s depressed that I insisted we postpone our wedding which should have been next week because I wasn’t confident she would be able to be sober and we could have a nice day to remember for the rest of our lives. Anyway she’s been drinking for a week. It’s so hard to watch and it’s also hard to hold our lives together. Can someone please give us some encouragement or advice? Do you think it’s possible she just isn’t trying because she doesn’t want to be sober? Sometimes it seems like it’s working wonders other times it seems hopeless. I’m so exhausted and currently discouraged. I don’t know what to do. Is there any support groups for spouses? Sorry for being such a crybaby but I just need someone to talk to. My family thinks it’s just a matter of deciding to quit. Her family wants her to go rehab. I believe in the science of TSM but I’m just so discouraged lately.

    64 Comments
    2024/10/31
    22:40 UTC

    3

    Headaches on Campral

    I’ve been taking Campral for 2 and a half weeks and I’ve been experiencing terrible headaches. I’m seeing my doctor this afternoon as I’ve missed 2 days of work due to these headaches. Has anyone else gone through this?

    0 Comments
    2024/10/31
    22:09 UTC

    20

    ADHD, medication & alcohol

    So last night my partner and I went out for Halloween (dressed as Kath & Kel for all my Aussie fam out there 😋)

    I got diagnosed with ADHD about a month ago and was given Vyvanse. At first I was still drinking and god I felt awful. Then I did a 7 day inpatient detox and haven't touched a drink until last night.

    We decided to have just one beer. I couldn't even finish it. It made me feel sick and it wasn't enjoyable at all.

    And then I realised, since getting sober and taking the vyvanse my panic attacks have stopped, my tachycardia had improved (I'm wearing a Holter in this pic), social anxiety is non-existent AND I no longer feel the desire to drink!

    I mean, it's even better tban any benzo that's been chucked at me.

    Has anyone else noticed this with ADHD and medication?

    16 Comments
    2024/10/31
    19:24 UTC

    1

    Day 10 on Naltrexone. PTSD flashbacks/nightmares every night and have started moving aggressively in my sleep. Anyone else experience this and could it stop over time? (TW: child abuse)

    I am on day 10 of taking 50mg of naltrexone once daily, trying to heal from my four-year abusive relationship with ketamine that is starting to have some serious health ramifications (sorry if other forms of substance use are not welcome here, I am having a tough time finding resources and info about nal for ket recovery and I don't know where else to ask).

    I suffer from bipolar 1 (symptoms managed well by medication, has been years since my last episode) as well as complex PTSD, so I take a ton of meds as is:

    • 40 mg viibryd
    • 200 mg lamictal
    • 600 mg gabapentin once in the morning and once at night
    • 0.5 mg xanax, as needed (usually once or twice a week)

    I spent basically the first 20 years of my life getting my ass both physically and emotionally kicked by the people in my life who were supposed to love me. My mother was the worst perpetrator of the violence and I lived with her until I was removed by CPS at 15.

    For the past week, it feels like I have been dreaming about her every time I fall asleep. It doesn't help that the naltrexone makes me extra tired so I have been sleeping even more and I know these nightmares are probably fucking with my sleep quality. The distressing part though is I have started acting out (I can't think of a better way to put this) my dreams while I am sleeping. I had a dream last week where I was kicking someone and kicked my end table across the room at like 3 am. Scared the shit out of me and probably my downstairs neighbor too. Then last night I had a dream where I spit in someone's face and I woke up half sat up, spitting on my pillow. There have been other small moments like this too where I know I've done similar things but I haven't been awake enough to remember clearly.

    I have NEVER been someone who moved in their sleep. At most, I will roll over but that's it. I'm scared to have my boyfriend sleep over because what if I hit him or do something to him while he sleeps?

    Has this happened to anyone else? I do feel like the naltrexone has started to help with my cravings and I can already feel my health improving with how much I have managed to cut back. This is just really freaking me out and it would be reassuring to know it could go away over time.

    1 Comment
    2024/10/30
    19:32 UTC

    147

    Be honest

    82 Comments
    2024/10/30
    02:12 UTC

    1

    Hard time falling asleep and tired all the time

    This could just be my depression manifesting itself more since I'm not self medicating as much, but I'm so tired and can't sleep at the same time. I have such a hard time sleeping and turning off my brain, once I'm out, I'm dead to the world. I'll sleep past multiple loud alarms. I'm so tired most of the time. Has anyone else experienced this too?

    5 Comments
    2024/10/29
    04:30 UTC

    5

    How long after I take Nal with a meal should I have one drink?

    I will be around alcohol tonight and instead of glugging like 4-6 beers, hopefully it’s at max 2. However that’s not until tonight and I just took 50mg of Nal after a light meal.

    For reference I’m also on Cymbalta (SNRI) , low estrogen BC, and occasionally Dexedrine (for ADHD)

    7 Comments
    2024/10/29
    02:26 UTC

    4

    When to go up a dose?

    I've been on nal using tsm for about 3 weeks. Drinking 4-5 days a week, it hasn't reduced the binge drinking. Luckily I don't black/brown out or find myself in unsafe situations for myself or others, I'm just perpetually hungover and can't seem to reduce my drinks per day week. I've seen people say you can go up to 100mg, but I'm not sure I want to risk more intense side effects if I'm still in a window where I can expect to see better results down the road. For those that have gone above 50mg, at what point did you realize 50 wasn't enough? Thanks yall!

    5 Comments
    2024/10/29
    00:11 UTC

    16

    Day 1 on Nal

    Just took my first dose. Went with a quarter of a pill as some people have suggested. Really excited to see what this drug can do for my AUD. Wish me luck!

    6 Comments
    2024/10/28
    18:32 UTC

    5

    Longer Term Drink Tracker

    Hey there!! This week marks 2 years for me on TSM. I am doing well but I really enjoy tracking and am motivated by seeing the chart drop. Does anyone have an excel chart tracker (like the CThree one) that is longer than one or two years? Obviously, 3 years would be ideal for me but I am sure I am not the only one who has passed 2 years. Any help is appreciated!

    2 Comments
    2024/10/28
    13:32 UTC

    6

    Special Guest at TSMMeetups

    Come here Dr. Perron share valuable tips as we head into the holiday season.

    0 Comments
    2024/10/28
    13:19 UTC

    7

    GLP-1 & alcoholism

    9 Comments
    2024/10/28
    03:08 UTC

    5

    Naltrexone experience?

    Thinking about asking my doctor tomorrow about it. Anyone have any advice?

    19 Comments
    2024/10/28
    02:25 UTC

    6

    Naltrexone and persistent nausea

    I've been on 50mg of naltrexone daily for four weeks and I STILL have nausea from it. I began at 25mg for one week with no nausea before upping to 50mg and take it at night with food. In most posts I've seen the nausea goes away within a week or two, but my body just isn't getting used to it.

    Alcohol-wise it's been amazing and virtually eliminated my cravings, so I really hope I can find something to help.

    Does anyone have experience with this? Should I try and split it into 25mg twice a day? My doctor's only suggestion was to drop by down to 25mg permanently.

    12 Comments
    2024/10/28
    00:38 UTC

    8

    ADHD, Vyvanse & Naltrexone

    Has anyone heard of someone

    • Failing out on Naltrexone from depression
    • trying Vyvance (which ups dopamine)
    • then successfully using Naktrexone

    ?

    Love this sub. Y'all are the best!

    Thanks!

    12 Comments
    2024/10/27
    14:09 UTC

    5

    So once I take a tablet of Librium 25mg, I cannot drink a single drop of liquor for the next 3 days?

    I know you shouldn’t mix them and I know you obviously don’t wanna drink within hours of taking it. But sometimes the cravings are too strong and I find it insane that drinking the night after taking a pill is dangerous.

    I’m sorry I sound weak.

    2 Comments
    2024/10/26
    23:01 UTC

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