Naltrexone is a medication used to treat alcohol dependence and opioid use disorder, helping reduce cravings and prevent relapse. Many individuals starting naltrexone report feeling “weird” or experiencing unusual sensations. This article explains why these feelings occur and how to manage them.
How Naltrexone Affects the Body
Naltrexone works as an opioid receptor antagonist, blocking these receptors in the brain. Endorphins, naturally produced chemicals, activate these receptors, contributing to pleasure and reward. Naltrexone prevents both natural endorphins and external opioids from exerting their effects.
This blockade disrupts the body’s natural reward system, diminishing pleasurable responses. When naltrexone occupies these receptors, it can lead to dysphoria because the brain’s typical pathways for experiencing pleasure are altered. The medication competes with endorphins for binding sites, effectively blocking them. This altered reward processing explains why some individuals feel “off” when starting treatment.
Common Sensations and Side Effects
The “weird” feelings associated with naltrexone often manifest as common side effects, especially during the initial adjustment period.
Gastrointestinal issues are common, including nausea, vomiting, stomach pain, cramping, diarrhea, or reduced appetite. These digestive symptoms typically occur early in treatment and often improve as the body adapts.
Neurological effects include headaches, dizziness, fatigue, drowsiness, or sleep disturbances. These effects can contribute to a general feeling of being unwell or “weird.”
Psychological effects can include anxiety, nervousness, irritability, or tearfulness. These mood changes are usually mild and temporary but can be unsettling. The disruption of endorphin signaling, which influences mood regulation, might contribute to these feelings as the brain adjusts. Most side effects are temporary, lasting from a few days to a few weeks.
Navigating Initial Discomfort
Managing the initial discomfort from naltrexone involves several practical strategies that can help the body adjust more smoothly.
Taking the medication with food or a snack can reduce nausea and stomach upset; avoiding an empty stomach is often recommended. Adjusting dose timing can also help; if fatigue or dizziness occur, taking naltrexone at bedtime may allow individuals to sleep through symptoms.
Staying well-hydrated can alleviate headaches and reduce gastrointestinal issues. Over-the-counter remedies, like ginger for nausea or pain relievers for headaches, can provide relief, but consult a healthcare provider first.
Starting with a lower dose and gradually increasing it can minimize side effects. Open communication with a healthcare provider is essential to discuss persistent side effects for personalized advice or dosage adjustments.
When to Seek Professional Guidance
While many initial side effects are temporary, certain symptoms warrant immediate medical attention.
Severe allergic reactions, such as hives, difficulty breathing, or swelling of the face, eyes, mouth, or tongue, require emergency care.
Persistent or worsening side effects that interfere with daily activities or do not subside after a few weeks should be reported to a doctor.
Concerns about liver damage are important, as naltrexone can affect liver function. Symptoms like severe stomach pain lasting more than a few days, dark urine, yellowing of the eyes or skin, or unusual tiredness should be reported immediately.
Significant mood changes, including severe depression or thoughts of self-harm, also necessitate urgent medical advice. Do not discontinue naltrexone without consulting a healthcare professional, as they can guide the safest course of action.