As many of you are aware, I began The Sinclair Method in October 2013, using naltrexone. At the time, nalmefene (brand name Selincro) was not available.
During 2014, the makers of Selincro (Lundbeck) have been rolling out the release of this medication across the majority of the European Union states.
Both medications are opioid blockers and are suitable for use with the TSM protocol. Unlike naltrexone, nalmefene has the advantage of not being processed through the liver, so the release of this medication was a major breakthrough for those drinkers suffering from poor liver function, in addition to those concerned about their drinking levels. Indeed, Selincro is the first medication of its kind to be indicated for the reduction of alcohol consumption in adult patients.
Over the past months of coaching many people taking Selincro, however, it has become apparent to me that nalmefene may well come with an increased risk of side effects that appear to be quite strong in comparison to naltrexone. In the UK, the medication is subject to the “yellow card scheme” which allows patients to report adverse side effects. This information is then compared against existing, known side effects for the medication and, if any new issues are raised, the safety profile of the medication may be re-examined, ensuring that all medications are used in a way that minimises risk. I understand this to be a fairly common procedure for newly-approved medications so, in itself, this is not a cause for concern, and should not be taken as such.
I am not medically qualified, but was naturally quite concerned about the reports I was hearing. Any side effect issues could potentially mean that someone would stop taking their Selincro (or skip doses) prior to the full course of treatment being completed. In a worst case scenario, this may lead to the patient reverting back to drinking at dangerous levels. Another area of concern for me was that the medical industry, and especially those doctors prescribing Selincro and hearing directly back from their patients, may make the decision that pharmacological extinction (the medical term for The Sinclair Method) simply does not work, when in fact all that was happening was that compliance was the issue preventing successful completion of the treatment. The knock-on effect of this could be that they may stop prescribing – and no one would want that to happen.
Though the Patient Information Leaflet for Selincro does not state The Sinclair Method by name, the instructions to take one tablet 1-2 hours prior to drinking only is TSM in all but name.
The reports I have been hearing from those already taking Selincro include some quite worrying comments about the severity of any side effects. Below are some quotes taken directly from emails, conversations, or our C3 Options Save Lives community forum;
- I felt icky, had sleep issues, and generally felt toxic for the whole week.
- On Selincro I felt anxious, depressed, foggy, nauseaus and irritable.
- It encourages alcohol-free days just to avoid the Selincro (note: this action will NOT result in pharmacological extinction. For that to happen, one must repeatedly drink one hour after taking the medication.)
- The side effects are so bad that I would not be surprised if some people end up not taking it and drinking anyway!
- I didn’t have one wink of sleep last night due to the nalmefene. I think I’d rather go teetotal than face all this.
- After taking my first Selincro tablet, I thought I was going to die, I felt so ill.
This doesn’t make for comfortable reading, does it? It makes me think that although I have subsequently been told that the side effects have lessened and disappeared, this does seem to be taking much longer to happen than with naltrexone. Side effects on naltrexone seem to be much milder and lesson much quicker, often within the first 4-6 tablets at most.
It is correct, and fair, to say that some people will experience no side effects whatsoever from Selincro, and others will experience worse side effects using naltrexone – everyone is different. Believe me, I do not wish to scare anyone or prevent them from considering Selincro as an option.
Only today, I received an email from a lady who began using Selincro a few days ago. She reported that although she felt a little spaced out, she had no real issues with it. The next day she felt “flushed out” and experienced some lower back ache, but that was all. Based on everything I’ve been hearing, however, she is very much in the minority when it comes to experiences of Selincro.
It is certainly not my intention to create alarm. Everyone should be very glad that Selincro is available because it is a very valuable tool for those suffering from Alcohol Use Disorder.
My intention is only to support those people through TSM, if they wish me to. If someone is prescribed Selincro, how can I best support them through any side effects and provide them with some gentle support to ensure they get “across the bridge” with any issues they may experience? I don’t want them to stop taking their tablets – and everything I am being told so far indicates that some may well stop simply because the effects could be so strong.
I’ve always been a believer that our own personal experiences using naltrexone are of great benefit to those who ask for help from either myself here at C3 Foundation Europe, or from Claudia at C Three Foundation in America. It made sense to me that in order to fully understand what people are going through, and to be in a position to help them as effectively as possible, I needed to experience Selincro for myself – from the first tablet through to whenever any side effects may dissipate.
I sincerely hope that doing this will enable me to help even more people through the early days of The Sinclair Method.
NOTE: This article, along with the my documented Selincro experience that follows in part two of this article, is my own personal experience. It is NOT intended as medical advice, not should it be taken as such. Please consult your physician, or other suitably qualified medical professional, before beginning any course of medical treatment.
This article is part 1 of a 2-part series.
Both parts should be read in their entirety, and in conjunction with each other.