A quick disclaimer that I am not a medical professional, and please consult one if this info interests you or may help you.
I thought I'd do a quick check-in about taking Naltrexone or Revia. I did previously write about it here too. I take it off label - it's mostly used in aiding alcohol and drug addiction - for trichotillomania (which is the lovely word - ha! - for hairpulling). I've been taking it for so long now that I can't remember exactly when I started. I know it's been at least six-seven years and a good chunk of my 40's (I turn the big 5-0 next year - what?!?). For reference, I've had trich or TTM since I was eight; the pic above is me and was taken before it took over my little kid world - good times! :-)
Side note: where are my eyebrows in this pic? It's common with TTM to pull brows, but in my case, they are just super-pale. Anyway, this photo always makes me laugh, but oh, I would love to have that head full of hair again!
Throughout my life, I've been prescribed many different medications for anxiety and depression in the hopes that it would alleviate my trich. And while I believe they are effective for anxiety and depression, they've never really helped my TTM. In fact, some antidepressants have made it worse. Naltrexone is the only medication that has helped me stop pulling or at least helped me delay the urge to pull (if that makes sense). Instead of automatically pulling, I can slow down and really think about it and more often than not, I don't want to or the urge diminishes, and I forget all about it. It's been a game-changer for me, to say the least.
Naltrexone works by decreasing urges (again, usually for alcohol or opioids) by blocking the effect of opioid receptors or reducing the need/use for the things we are craving. It's also currently used as a weight-loss drug (Contrave) in conjunction with Welbutrin (an antidepressant).
Basically, Naltrexone tamps down the pleasure centers in your brain. This is a good and kinda weird thing all at the same time.
The good: I can keep my pulling at bay and give my scalp and hair follicles a chance to heal. It decreases my appetite, which I am OK with; it helps keep my weight in check because I have thyroid issues too.
The weird: It can be hard to get adequate calories, and sometimes food is just not appetizing. But I also have high cravings for sugar - it tastes the best (duh)! As we all know, sugar or empty calories are not ideal to nourish yourself, so I have to be mindful of that. I guess your brain/body gets its kicks wherever it can? I've heard that when people quit drinking/smoking/etc., they often turn to sugar, and I can totally relate!
Unfortunately, Naltrexone does not regrow hair. I wish! :-) Despite having so much success in not pulling, I still have a lot of permanent damage. It's OK as I just cover my head, get over myself, and get on with my days - I've made peace with it. How? Therapy, people! I also follow lots of women with hair loss (TTM, alopecia, or many other reasons) on social media, and it's made a world of difference to me. I have a supportive husband, friends, and family - no complaints! I am also lucky to have access to healthcare and a doctor that suggested trying a drug off label. It really does take a village!
I hope this helps anyone struggling with trich; it's such a complicated disorder to navigate.
I don't think Naltrexone is a miracle pill and may not be for everyone, but it might be worth exploring with your healthcare provider. It's given me a lot of relief, and I believe that's worth sharing. I still have to be intentional about the work I do in regards to my trich; taking medication does not give me a free pass - diet, exercise, sleep, and good mental health hygiene are all important, and I have to work on all of those aspects every day and often fail (but don't we all?).
Either way, if you have trich, please remember you are not alone, and there is lots of help in many different forms. I know it can be hard to ask for help when you feel alone and struggle, but it can also lead to wonderful, unexpected things.
PS/update: I did take a break from taking it for about six months this year to see how I would do. My urges definitely increased and food tasted better too/had a bigger appetite - crazy! I do notice a big difference with and without it. Thanks for reading!