Disclaimer: This article is not intended as medical advice. The content found in this article is only my personal opinion and should not be a substitute for seeking medical advice from your physician.
As with any medication, some people on naltrexone can have side effects. In my experience meeting and working with people over the last few years who are taking naltrexone for alcohol use disorder – most people do not have side effects. If they do have side effects, they are often mild and do go away after the medication has been taken over the course of a week or two.
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), here’s what one study showed about naltrexone side effects:
“In a large open-label safety study on naltrexone, conducted by Dupont Pharma in 570 individuals with alcoholism, the most common side effects affected only a small minority of people; they included the following:
Nausea (10 percent of participants)
Headache (7 percent of participants)
Depression (5 to 7 percent of participants)
Dizziness (4 percent of participants)
Fatigue (4 percent of participants)
Insomnia (3 percent of participants)
Anxiety (2 percent of participants)
Sleepiness (2 percent of participants).”
Of the people who do experience side effects, there are a small number who have such intense side effects that they cannot tolerate the medication – even in smaller doses. From my experience, this is quite rare and most people can acclimate to the medication over time. This is done by starting at a smaller dose and up to the standard 50mg dose that is suggested on the Sinclair Method.
If you're new to the Sinclair Method, try not to have fear of the side effects. I see this often in the online TSM forums that people hear or read horror stories about the side effects and it scares them from starting the medication. Again, they are usually quite mild and if they do occur, they are likely go away. And this is why all TSM doctors I know will start their patients on a lower dose to help prevent any bad side effects to begin with.
Tips for Dealing with Naltrexone Side Effects
If you’re someone who is experiencing side effects on naltrexone, here are some tips that worked for me when I took naltrexone, as well as tips that I’ve seen work for others:
Start by taking a smaller dose than the standard 50mg. All the physicians I know who use TSM with their patients will advise that they start on a 25mg dose for the first few times that they take the medication. Some people have to stay at this dose longer if they are sensitive to the medication, or their doctor may have them go to an even lower dose. The standard dose of naltrexone for the Sinclair Method is 50mg.
Eat a full meal with the medication.
Drink plenty of water.
Take a daily probiotic. This was something that helped with some stomach issues I developed after I had been on naltrexone for a few months. I added in a daily probiotic supplement and the issues totally went away. Anecdotally I have known a few others this has worked for as well.
Adding in activated charcoal after drinking. Sometimes people can feel extra hungover when they drink on naltrexone. This is referred to as a “nal-over” (naltrexone hangover) in the TSM community. This hasn’t been researched yet so I don’t believe doctors understand why this happens. For me, the “nal-over” only started to happen after I had been on TSM for almost a year – when I was drinking about once a month. I figured it was a combination of me drinking so infrequently that I didn’t have a tolerance for alcohol, and also being less adjusted to taking naltrexone as I was only taking it once a month as well. What worked well for me was adding in an activated charcoal dose at the end of the night when I was done drinking. (I actually used to do this pre-TSM to help myself with alcohol hangovers and it worked pretty well). Activated charcoal is known for helping with stomach pains, and it also has been used to help people with drug overdose or accidental poisoning by helping to absorb toxins so the body does not absorb them. Please do some research into this and understand the benefits of activated charcoal, as well as the risks. For example, it’s important to be well hydrated if you are going to take activated charcoal, as well not having blockages in your digestive track.
Take an over the counter anti-nausea medication. One fellow TSM’er I know takes Nauzene and it has helped immensely with her nausea she experienced on naltrexone.
If you are being challenged by naltrexone side effects, I believe it's best to start at a smaller dose and take your time increasing the dose. You don't have to rush to a larger dose if it's making you feel ill – that could just deter you from taking the medication at all.
I've talked with many people whose doctor slowly increased their dose over many months to help them overcome side effects. In my personal experience, for most people – including myself, the benefits of the medication naltrexone and all that it can do to change your drinking habits – far outweigh the side effects of it.
If you have more tips that have helped you with naltrexone side effects, please send them to me and I will add them to this list!
All for now,