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DrRussMD
DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 65651
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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Ok how does naltrexone work, does it block cocaine? And alcohol

Resolved Question:

Ok how does naltrexone work, does it block cocaine? And alcohol ?
Submitted: 2 years ago.
Category: Medical
Expert:  DrRussMD replied 2 years ago.
Hello
It helps decrease the craving for alcohol AFTER one has stopped drinking.
It does not have enough evidence to use in relation to cocaine.
OK, so that is an initial answer….
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Customer: replied 2 years ago.

ok but antabuse blocks cocaine feel good right? And why is there not enough evidence? WHAT happens if cocaine is taken while in antabuse. I got ill and very dizzy+ hives yesterday

Expert:  DrRussMD replied 2 years ago.
Antabuse does not effectively block cocaine.
The interaction between antabuse and cocaine is not well established.
You clearly had a reaction, and you should not be using cocaine anyway..it is dangerous and illegal.
You asked about nalrexone and I gave you an answer.
You now are really asking a new question. So, I thought I would answer that as well.
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Customer: replied 2 years ago.

ok but I read that is does to an extent. I would prefer more specific description about cocaine and antabuse please and their way of working( interaction.

Expert:  DrRussMD replied 2 years ago.
Preliminary indications are that naltrexone can block the craving to some extent.
Again, this must be used when one has stopped using cocaine.
It is also not an effective treatment by itself.
It has to be part of a comprehensive medical plan, supervised by your doctor.
Counseling
12 steps
Other medications for withdrawal if needed....then and only then , after any withdrawal, is naltresone likely to help.
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Customer: replied 2 years ago.

i asked ok but I read that is does to an extent. I would prefer more specific description about cocaine and antabuse please and their way of working( interaction.

NOT naltrexone

Expert:  DrRussMD replied 2 years ago.
antabuse currently has no indication for cocaine prevention.
I don't know what you read, but it is incorrect.
I would be glad to review any link.
That is a different question that we started with.
Please click a positive rating, and I will be glad to review what you read.
Customer: replied 2 years ago.

Abstract

Disulfiram has been studied as a treatment for cocaine dependence. We report results of a randomized, double-blind, placebo-controlled, within-subject study to examine the interaction of disulfiram with intravenous cocaine.

Methods

Non-treatment-seeking, cocaine-dependent, volunteers participated in serial experiments in which they received disulfiram placebo, 62.5 or 250 mg/day on days 1–6. On days 4–6, participants received a morning disulfiram dose 2 h prior to a scheduled session in which they were administered intravenous cocaine placebo, 0.25 mg/kg (n = 9) or 0.5 mg/kg (n = 3) over 1 min. Blood, cardiovascular and subjective measures were collected. Seven days of washout occurred between disulfiram conditions.

Results

Following active disulfiram treatments and cocaine 0.25 mg/kg administration, plasma cocaine AUC (0–480min) was increased (p = 0.003 and 0.001) and cocaine clearance decreased (p < 0.001). Disulfiram treatments also decreased cocaine clearance for the 0.5 mg/kg cocaine dose (p = 0.002 and < 0.001). Neither disulfiram dose with cocaine altered cardiovascular responses relative to cocaine alone. Following cocaine 0.25 mg/kg, ‘any high’ (p = 0.021 and 0.019), ‘cocaine high’ (p = 0.017 and 0.018) and ‘rush’ (p = 0.013 and 0.047) significantly decreased with either disulfiram dose.

Conclusions

Disulfiram decreased cocaine clearance without toxicity. Cocaine ‘high’ and ‘rush’ were diminished. Disulfiram may be a promising pharmacotherapy in selected cocaine dependent individuals.

Disulfiram (sold under the trade names Antabuse and Antabus) is a drug discovered in the 1920s[1] that is used to support the treatment of chronic alcoholism by producing an acute sensitivity to ethanol (alcohol). Disulfiram works by inhibiting the enzyme acetaldehyde dehydrogenase, which means many of the effects of a "hangover" are felt immediately after alcohol is consumed.

In the body, alcohol is converted to acetaldehyde, which is then broken down by acetaldehyde dehydrogenase. If the dehydrogenase enzyme is inhibited, acetaldehyde builds up and causes unpleasant effects. Disulfiram should be used in conjunction with counseling and support.

Disulfiram is also being studied as a treatment for cocaine dependence, as it prevents the breakdown of dopamine (a neurotransmitter whose release is stimulated by cocaine); the excess dopamine results in increased anxiety, higher blood pressure, restlessness, and other unpleasant symptoms.[citation needed] Several studies have reported that it has antiprotozoal activity, as well.[2][3] Disulfiram is the subject of research for treatment of cancer and HIV (to activate the reservoir of HIV-infected resting CD4 cells).[

Expert:  DrRussMD replied 2 years ago.
This study does not show any use for antabuse.
It only shows that more study is needed.
This is not a clinical trial, but only a preliminary study.
In your case, it made you sick.
Dont use it.
Customer: replied 2 years ago.

but does antabuse just work on the liver and not affect the brain/ like dopamine etc? the feel good after taking drugs etc?

Expert:  DrRussMD replied 2 years ago.
I think this question has been answered.
It made you sick when you tried it.
The study you saw actually simply demonstrated that it slowed down withdrawal...not that it helps in any way.
So, you need a comprehensive program, you should not be using cocaine, and you should be talking to your doctor about your drug issues.
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