Selincro (nalmefene) Side Effects – A Personal Experience – Joanna’s Journey

NOTE: Please read Part One

This is my own personal experience and is not intended as, not should be taken as, medical advice.  Please consult a physician, or other suitably qualified medical professional before undertaking any medical treatment.

For the purpose of this research, I took all necessary steps to ensure that my situation was as close as I could get to that of someone beginning The Sinclair Method (TSM) for the very first time, in terms of both the frequency and amount of alcohol drunk, i.e. drinking more often and in larger quantities than I have done for quite some time.  It was my hope that this would enable me to be as close to experiencing how a person new to TSM may feel.

However, taking Selincro in this way is not something that I decided to do on a whim.  In fact, I have been considering the pros and cons for the last couple of months, discussing it with those I trust.  I will admit that it has not been an enjoyable 9 days, and it has cost me a high price in terms of both physical and mental discomfort.  Though the reasoning behind this personal research was sound, I would caution others against it unless it is absolutely necessary.  Enduring what I have endured has been for the valid reason of wanting to support others, but it is not something I would wish to go through again.  There has been a necessary period of recovery for me, which is something that I had originally not anticipated.

As part of this personal research, it is also worth noting that it was my plan to test different parameters, allowing me to get a “feel” for what Selincro is like under different drinking circumstances.  One such example was to purposely drink through the tablets.  I am sure that had I really been undertaking TSM for real, I would have put the drink down far earlier in the day, but we also realise that drinking through the medication does happen, especially in the early days of TSM.

As the days passed, it became difficult for me to assess whether what I was experiencing might be the result of the Selincro tablet, or rather the result of heavy drinking which is something that I am no longer used to.  This may mean that some of what I felt could be slightly exaggerated by the excess alcohol in my system.

Now I am on the other side of my research, there is no doubt in my mind that Selincro works.  From the very first tablet, as with my experience of TSM using naltrexone, there was no “kick” from the alcohol.  I’ve come to the conclusion that although the prospect of making it through these much talked about potential side effects is no doubt uncomfortable and quite distressing (to say the least!), it is also necessary and is simply something that needs to be done.  If you are unlucky enough to experience them, there is no way to proceed other than to knuckle down, be kind to yourself, and know that they will pass eventually.

However, I feel that it is also true to say that it feels a “heavier” medication than naltrexone.   The example given by someone in part one of this article – “I felt toxic on Selincro” – also felt true for me.  I have not felt in good health at all during this time, though the side effects did eventually lessen.

At the end of this article there are a few suggestions that, based on my own experience, may help you to be best prepared for beginning The Sinclair Method using Selincro (nalemefene).

Day One/Tablet One

At 1:45pm,  I have a meal consisting of beans on toast and a large glass of water.  This is something that should always be done regardless of whether one has been prescribed naltrexone or Selincro as it helps to line the stomach and lessen any potential nausea.

At 2:20pm, I open the packaging and find that Selincro is a much smaller tablet than the naltrexone I am used to.  It looks more “modern” and more in line with what we are used to, in terms of medication.  Following the instructions for Selincro, I take the tablet with a large glass of water.

Within 20 minutes, there is a sensation of dizziness beginning.  I feel very woozy and have another large glass of water.  My head feels tight and I start to get very hot and clammy.  It feels overwhelming.

By 3:00pm, I am feeling foggy, dull and confused.  I’m unsteady and it feels difficult to concentrate on the simplest task, such as working out when one hour has passed from taking the tablet.

To be on the safe side, it was after 3:30pm when I took the first drink.  Happy to report there was nothing from it – no kick, no satisfaction.  For safety reasons, I am chatting to a friend on the phone whilst taking the first drink, but I was vaguely aware that I was distracted and struggling to keep my mind on the conversation.

I make a note that I do not remember feeling this way when taking naltrexone for the first time.

Less than an hour later, I begin to experience a tingling sensation in my left hand.  It is similar to pins and needles but not quite as severe – just a constant tingling that is irritating to say the least.  I begin to feel tired and at 4:50pm, I begin drink number two.  It is not appealing at all and at 5:45pm, I am still on drink number two.

I feel extremely tired and my head feels like a goldfish bowl.  Noise is echoing.   In my note pad, I have scribbled the words “feel out of it”.

Both calf muscles were relentlessly aching at this point, feeling about to cramp up.  I remember thinking how strange that my left hand only would tingle, and the bottom of both my legs was hurting.  I’m almost afraid to move in case it brings on full-blown cramp.

By 8:00pm that night, however, things have changed.  I started to feel like I was lighter and floating, very chilled out indeed.  I felt high.  It felt good, especially after the disorientation of earlier.  I vaguely remember having a conversation on Facebook with a friend, but everything was a blur.

This changed again, and by 9:07pm, I wanted to go to bed because I was starting to feel very sick.  I looked at what I had drank so far and it was, perhaps 9 or 10 UK units (5 or 6 US units).  I could see this, but seemed incapable of understanding it.  I was simply not able to meaningfully process any sort of information.

That night, I could not sleep at all.  I couldn’t rid myself of either the calf pain or the tingling.  After much tossing and turning, I opted to try sleep on my stomach with heat laying on my lower legs.  This soothed the cramping sensation but I could not rest enough to sleep.

Simply put, this first day was nothing like the first time I took naltrexone.  On that day I experienced some mild disorientation, and tiredness which resolved itself when I took myself off to bed early and slept, having only drank two drinks.

Day Two

After no sleep whatsoever and a feeling of general exhaustion and unsteadiness, I decided that I was not physically or mentally able to subject myself to this for a second day.  I tolerate medication very well generally, but I felt tired and ill.

I did not take a tablet or drink on day two.

Day Three/Tablet Two

Really dreading the next tablet, as I did not feel fully recovered yet, but I realised that if I wanted to be able to understand how those on Selincro feel, it was important that I stay the course.  I would be lying if I said that there wasn’t a part of me that was trying to think of a way to get out of taking another tablet.  After all, I’ve done TSM – there was no valid reason to subject myself to more discomfort except for my desire to want to be able to help others.

At 2:20pm, following a meal and plenty of water at 1:30pm, I took tablet number two.  Interestingly enough, only seven minutes passed before I felt the tingling sensation in my left hand begin again.  Starting to wonder why my left hand?  I am right-handed and if this had been in my right hand, I wouldn’t have been able to hold a pen or a drink.

At 2:50pm, I was overcome with sleepiness and the same foggy sensation that I felt on day one.  Twenty minutes later, I was feeling very nauseas.  Everything was affecting me much quicker this time.  Even before the hour had passed in it’s entirety, I had all the same side effects that took a few hours to appear on day one, except for the leg pain.  What a relief to not feel that cramping, but this feels like an assault on my body and my brain!

I took the first drink of the day at 3:40pm.  Again, there was no elation or kick from the alcohol.

At 6.40pm, the leg pain arrived with a vengeance.  In all honesty, it hurt so much and I was so ill that the tears flowed.  No matter how much I rubbed my calf muscles it would not relent.  Overcome with a deep dread of what the night might hold in terms of sleep, I drank about the same number of units as day one and went to bed at 8:30pm with a very thick and heavy head.  It felt very difficult to drink like this.  I actually didn’t want to drink, but the fear of another night of hell gave me the urge I needed to drink as much as I did.

On the good side, I never got to find out what the night may hold as the drink put me nicely to sleep quite quickly.  Woke almost every hour during the night but some sleep was better than none.  Interestingly, I could not remember if I was dreaming or not.  Several people have informed me about nightmares but I am not experiencing them.

Day Four/Tablet Three

I’m feeling down and irritable.  Unable to concentrate, preoccupied with drinking and am not finding any desire to do anything.  Putting the television on and then switching it off after ten minutes because either I can’t concentrate or I don’t want to concentrate – not sure which.  I haven’t been able to watch tv since the day I took the first Selincro tablet.

Nothing seems important, nothing seems to matter.  I think the earth could be about to end and I’d not care one bit…

Perhaps through a lack of proper, good quality sleep, I notice I am wanting to drink earlier in the day.  I want to feel “better”.  It is alarming that I am starting to want to drink to get rid of the hangover.  I just don’t feel well at all but it’s difficult to pinpoint what the problem is.  I feel like I am falling from a happy, outgoing person to someone with nothing to smile about.  I have a couple of drinks first thing, then feel a little better and try muster some willpower to go about my day today.

I manage to wait until 1:00pm before I take the tablet, but then the first effect I feel is overwhelming tiredness.  I cannot stay awake and fall asleep on the sofa.  I wake at just after 4:00pm and immediately feel the thick head and tingling.  However, no leg pain and the dizziness and nausea don’t seem quite so strong.

As I sink that first drink down, I close my eyes and hope this is over soon…..

Day Five/Tablet Four

I am struggling.

For the first time, I no longer feel in control of what I am feeling.  This is overpowering to the point of making me afraid.  I did not sleep well and I’m afraid to take the tablet.  How much more of this can I take?  It occurs to me that if I was new to TSM, this could well have been the line in the sand that I wouldn’t cross – I think I’d stop taking the tablets.  Even with all my experience of TSM and the knowledge that I know it will pass eventually, I was ready to give up.

I don’t understand how the very thing that is supposed to be helping me, is in reality making me feel rotten.  I am being driven to drink earlier and earlier in the day.

I am also beginning to experience severe headaches if I try to abstain from drinking for more than a couple of hours.  As soon as I get some alcohol into my system, the headache disappears quickly.  This is worrying to me.  My judgement seems to be off-kilter and I am not sure if I can make a rational decision about anything.  An alarm is ringing in my brain that I should ring someone, get some support.  I ignore it.

It’s only 10:30am.  I’m stood in my kitchen being tortured by the idea that I have to take the tablet.  I’m tired, I’m hungover and I’m in some discomfort, mentally and physically.

If I can’t get past this point, how can I help others to do so?  How can I honestly tell them it’s going to be worth it in the end?

I pop the tablet with the knowledge that yesterday, the effects seemed to be getting a little better.  Thankfully, again the nausea is reducing and the disorientation is reducing.  The tingling sensation still remains and is still limited to only my left hand.  I no longer experience leg pain.

Day Six/Tablet 5

Woke very early with a jolt.  Very bad headache.  Drank some water and tried to go back to sleep.  Eventually give up.  I’m too uptight and unsteady to sleep.

I notice that I have a slight tremor in both hands.  This used to be a common experience for me first thing in the morning.  Is it exhaustion or do I need to drink?  I haven’t eaten much since starting Selincro, possibly due to the lack of interest in anything at all.  I think I would like some breakfast, but when I have it prepared I have lost any appetite and push it away.

I burst into tears.  Looking at my notepad for this day, I wrote “what is this doing to me?”

Confusion reigns, but almost all physical side effects are practically gone now.  Only the left hand tingling remains.  This now appears to be a mental battle.

Day Seven/Tablet 6

Very relieved that I am experiencing no physical effects at all from the medication, except for the tingling in my hand that just will not relent.

Mentally, the general feeling of being out of sorts persists.  I cannot seem to shake the “down” sensation – nothing seems to raise my mood.

Day Eight/Tablet 7

I am now almost clear of side effects and can see light at the end of the tunnel.

Feeling extremely tired, but I suspect that is most likely the effects of continued drinking rather than the medication.

In my notepad I write “Is this nearly over now? Hope so.”

Day Nine/Tablet 8

Today is the last of my Selincro tablets.  I’m relieved that although the tingling in my hand still has not completely disappeared, it doesn’t seem quite so intense as it has done for the last nine days.  I’d be interested to hear if those who experience the tingling also have it persistently in the same hand, and whether it is somehow connected to being right- or left-handed.

Am positive that although I feel some nausea today, it is not a side effect of the Selincro but the effect of the alcohol.  It is apparent that I am going to need some time to get healthy again.



Based on my experience, it appears to me that the reports about increased side effects from Selincro tablets are not exaggerated.  Both my body and mind feel like they’ve been beaten up this past nine days.  I never felt anything at all like this when beginning The Sinclair Method using naltrexone.

As I mentioned during part one of this article, the reason for my doing this personal research was not to scare anyone about the potential side effects, but to put myself in a position to be able to empathise with, and fully understand those people who are prescribed Selincro and reach out to C3 for help.

Any side effects WILL pass, but for those who experience them, I believe it is a case of being prepared for a rough first couple of weeks.  This seems in stark contrast to those prescribed naltrexone, of which most side effects are milder and generally completely pass within 3 to 4 tablets.

I’ve often said to people that whatever they may experience, it is never going to be as bad as the hangovers they typically suffered.  In the case of Selincro, I felt the side effects were probably on a par with an extremely severe hangover, repeated day after day after day, for many days.  There is a very big temptation to get some alcohol down you as quickly as possible in the belief that it will make you feel better – believe me when I tell you, it won’t.

If at all possible, I would suggest the following may be useful when beginning TSM using Selincro;

  • Take some time away from work, perhaps a weeks holiday if you can.  I found it almost impossible to concentrate on work, most especially during the first three or four days.
  • Eat and drink as much non-alcoholic liquid that you can.  I noticed that I was really having to force myself to eat, and what I did eat didn’t taste at all good.
  • If you take the first Selincro tablet and suffer quite severe side effects, take the next day off from the medication.  Your body will thank you!
  • Make a note of the time you take the tablet.  It seems quite unbelievable that I struggled to remember what time I took it, but it really does fog up the brain that much as to make you find it almost impossible to remember the simplest things.
  • DO NOT try and drink through the medication.  As part of this research, I did exactly that to see what would happen.  My advice would be to try and stop drinking the minute you feel like doing so.  Drinking through it will NOT help either your physical or mental condition during the first couple of weeks.
  • DO NOT isolate yourself.  If you can, discuss what you are feeling with family or friends.
  • Do believe that it is worth this discomfort.  Any side effects do lessen over time.
  • Even though it may feel that you cannot deal with this, you can.  Yes, I found it distressing to not be my “normal” self, but I am now beginning to recover from the experience.  If I can do this, then YOU can too!