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Naltrexone

I will start with naltrexone, which can help people who have difficulty regulating their drinking have a more natural and sustainable relationship with alcohol should they choose to not cut it out of their lives entirely.

    • Newtra
      2•1 year ago

      I think the big difference between people benefiting at small doses (~0.3mg) and large doses (2+mg) is that the 0.3mg group use it for sleep quality through the night, whereas the 3+mg people just need the sudden shock to get to sleep in the first place.

      The drawback with big doses is that your brain becomes less sensitive so your naturally-produced melatonin might not be enough to keep you asleep for the whole night after the pill wears off. It has a very short half-life in the body (under 1 hour), so there’s no way for a single dose before sleeping to last 8 hours. We naturally produce only 0.06-0.08mg per night, so it’s easy to see how supplementing melatonin could desensitize someone and cause them to wake up after just 4-6 hours of sleep.

      I have ADHD and am in the large-dose category and use 2-3mg of melatonin to help me fall asleep. Without it, I can’t sleep reliably because my brain often won’t shut up. Sleep reliably is so much more important to me than sleep quality.

      Using it only 5 nights a week, I’m not significantly dependent. I can still sleep without melatonin, just less reliably. I’ve tried 0.3mg, but it felt the same as taking nothing.

      For me, 10mg would be excessive and probably harmful in a desensitizing way. The most I’ve taken is 6mg, but it only helped in 2 out of 6 times. The other 4 times my brain just wouldn’t stop. If doubling my usual dose didn’t help, I don’t think doubling it again would be any different.

      There are however studies with higher doses, e.g. this one about kids with ADHD that says:

      two-third of the patients responded to relatively medium doses (2.5–6 mg/d), whereas doses above 6 mg added further benefit only in a small percentage of children.

      so I guess it’s different for everyone.