Naltrexone and sex drive: has anyone tried it?

[VicistiGalilaee (imported)]

I've read that naltrexone has been used successfully to treat sex addiction. Has anyone tried it in an attempt to lower their sex drive?

[Jorge2008 (imported)]

I used this drug for alcohol addiction. It didn't help for that purpose and did nothing to reduce my sex drive.

[zeebster (imported)]

I've never seen anything to suggest that Naltrexone would be effective in treating "sex addiction", it's for treating opioid abuse. The information on it's actions would suggest that Antabuse would be the drug of choice for alcohol addiction, not the Naltrexone.

[TopManFL (imported)]

Naltrexone and Antabuse work in two different ways.

Naltrexone replaces hydrocodone or heroin in the system and reduces cravings. Naltrexone is itself in the same class of drugs as hydrocodone or oxycodone.

Antabuse is basically half of a poison. The other half is alcohol. If a person who is attempting to stop alcohol is taking antabuse and they drink they become violently ill. There have been cases where family members who didn't understand how antabuse worked where slipping it into a loved ones beverages to get them to stop drinking. Also with antabuse, no perfume or any chemicals that contain alcohol on the skin and as well no mouthwash with alcohol.

Is is important to know the different ways the two medications work. In Europe Naltrexone is approved for alcohol withdrawal, but not in the United States.

[industry7]

I also use Naltrexone for alcohol addiction. There is research on this. It helps with reducing cravings and binge drinking behavior. I don't know what research there is for sex addiction. It definitely won't reduce your sex drive. But I know that for some people sex doesn't feel good when on Naltrexone, and orgasms in particular can basically feel like nothing. Basically what the drug does is crank down your dopamine reaction so you don't get that intense rush of good feelings that create an addictive feedback loop. That's why it works well for opioids, since those interact directly with dopamine.

[Swim_1650]

I have never used naltrexone personally so can't comment on my experience, but I do know it's pharmacology. In short, the most comprehensive clinical trails suggest most people experience no change in libido. A small percentage of people experience decreased sex drive, which makes some sense as naltrexone is an opioid blocker and endorphins (natural "feel good chemicals") are involved with arousal, pleasure, reward, etc. That said, yet another small percentage of men report having an increased libido- if there is a pharmacological explanation for this, it probably has to do with the blocking of opioid receptors changing the balance of other neurotransmitters.

The confounder here is that these drugs are used to in the treatment opioid and alcohol use disorder. Both these conditions can have short or prolonged sexual effects after discontinuation that can take months for the body to recover, some may not recover. So some patients reporting libido reduction may just be experiencing prolonged effects from the drugs they were using. And the ones reporting an increased libido may have had their libido suppressed, it bounced back quickly, and are now experiencing normal libido or potentially some sort of rebound effect.

Naltrexone has been used off label for sex addiction-- which I suppose in some sense is related to libido, but sex addiction is also not the same as high libido. I'm not aware of any larger trials to determine its efficacy for sex addiction, but I can check into that.

I suppose if nothing else you can always try it and see how it goes. It's generally a well tolerated medication just be aware if you're for example in a grievous car crash and need emergency pain management, it can make emergency pain control tricky as naltrexone will block opioid type pain killers from working. Naltrexone is effective for 3 days after your last dose (there is also a monthly injection option).

Naltrexone and Antabuse work in two different ways.

Naltrexone replaces hydrocodone or heroin in the system and reduces cravings. Naltrexone is itself in the same class of ww as hydrocodone or oxycodone.

Antabuse is basically half of a poison. The other half is alcohol. If a person who is attempting to stop alcohol is taking antabuse and they drink they become violently ill. There have been cases where family members who didn't understand how antabuse worked where slipping it into a loved ones beverages to get them to stop drinking. Also with antabuse, no perfume or any chemicals that contain alcohol on the skin and as well no mouthwash with alcohol.

Is is important to know the different ways the two medications work. In Europe Naltrexone is approved for alcohol withdrawal, but not in the United States.

A few corrections:
- Naltrexone blocks the opioid receptors... so if you're taking nalrexone and try to take an opioid, the opioid cannot bind to the body's opioid receptors, therefore the opioid cannot have an effect. But if you're actively taking opioids, especially if your dependent on opioids (withdrawal symptoms occur if you stop taking them) and then start naltrexone, overlapping the two drugs, naltrexone will rapidly force the opioids out of the receptors. That's called precipitated withdrawal. Basically rapid onset, severe opioid withdrawal because you kicked all the opioids out of the receptors at once. Because of this, naltrexone users must be opiate free for about a week before starting naltrexone.

- Antibuse is a very clever idea. When you drink alcohol your liver converts the alcohol to acetaldehyde, which is toxic to the body (and largely the cause of hangovers). An enzyme called alcohol dehydrogenase converts the toxic acetaldehyde into a non-toxic byproduct. Antabuse binds to the enzyme and prevents it from processing the acetaldehyde into a harmless byproduct. Therefore, acetaldehyde starts building up in high levels and that induces the vomiting, nausea (I'll skip the specifics of how that happens, it's complicated).

- "Naltrexone for alcohol withdrawal" may be a semantic misunderstanding. I've never heard of Naltrexone being used in the active withdrawal period for treatment of withdrawal symptoms. I believe I once read a study on using Naltrexone during active opioid withdrawal treatment to reduce cravings, but it was totally flawed in that the patients were being treated with either methadone or buprenorphine tapers- and when they said the patients had lower cravings at the same time you'd expect the opioid taper to be at a sufficient dose to reduce withdrawal symptoms and cravings.

Naltrexone is often marketed as an "anti-craving drug"... here's what we know happens for sure
1) In Opioid users it blocks opiates from working.
2) in Alcohol users it makes drinking less enjoyable- they do not experience the same "high" when not taking it.

I suspect most of the "anti-craving" effects reported have a lot less to do with a chemical effect in the brain involving opioid pathways involved with "craving" and more of a psychological effect. This is especially true in the opioid users. If the opioid patient knows at all they can't get high while taking naltrexone, they may not crave it as much. If an alcohol drinker knows they won't get the same high drinking, they might not be as inclined to drink. In both cases each will think if I wanted to get high I'll have to wait a few days (or a month if the injectable form).

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In conclusion, I would not have super high hopes for Naltrexone, at least for most people. There are better options out there that have strong evidence behind them. Then again, everybody reacts differently and has different factors that need be considered.