Mode of action

Some patients who drink while taking naltrexone report that they feel less of the ethanol 'high'. This could lead to less impulse to carry on drinking. (586°) However, O'sMalley et al.'(5,6) found that more patients reported total abstinence as well as a reduction of drinking overall. It is possible that the reduced craving for alcohol and the reduced likelihood of picking up the first drink occur because the strength of the previous triggers—emotional, cognitive, or environmental—is attenuated.

Reports in the 1970s that naltrexone might cause dysphoria seemed to be supported by statements from heroin addicts given naltrexone to help them abstain from opiates. However, laboratory studies and randomized controlled trials have not found evidence of dysphoria or loss of feelings of pleasure. (6D

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