Dreaming On Naltrexone: Does Naltrexone Cause Weird Dreams?

Naltrexone is a medication that helps people recover from alcohol and opioid addiction by blocking the pleasurable effects these substances create in the brain. It comes in two forms: a daily pill taken by mouth or a monthly injection called Vivitrol. Many people find naltrexone extremely helpful in their recovery journey, as it reduces cravings and makes it easier to stay sober. However, like most medications, naltrexone can cause side effects. One side effect that some people experience is having unusually vivid, strange, or intense dreams.

While not everyone who takes naltrexone will have this issue, it’s common enough that it’s worth understanding why it happens, how long it might last, and what you can do about it if these dreams are disrupting your sleep or making you uncomfortable.

Learn more about the side effects of Naltrexone

How Does Naltrexone Affect Sleep?

Naltrexone is an opioid antagonist that binds to and blocks opioid receptors. Through this action, naltrexone modulates natural endorphins in the body. The modulation of natural endorphins, known as endogenous opioids, in the body can affect the levels of dopamine and serotonin, two neurotransmitters, in the brain. According to some research, increases in serotonin and dopamine that are caused by medications like naltrexone or certain antidepressants, may cause more intense dreams.

Common sleep-related effects of naltrexone include:

• increased vividness of dreams
• nightmares
• insomnia (difficulty falling or staying asleep)
• sleepiness

Sleep-related effects of naltrexone, such as vivid dreams, may not last for the duration of a person’s treatment. For some people, this effect may last only for a few days. If this issue persists, however, and becomes a deterrent to continued treatment, consider talking to your doctor about suggestions for managing sleep-related concerns.

Factors That Can Affect Naltrexone Effects On Sleep

Not everyone who takes naltrexone will experience sleep problems or weird dreams. Whether you have these side effects depends on several factors. People taking higher doses of naltrexone are more likely to report vivid or disturbing dreams than those on lower doses. If you are already facing insomnia or have a history of poor sleep quality, you may be more vulnerable to sleep-related side effects when starting this medication. Your brain’s existing sleep patterns can make you more sensitive to how naltrexone affects your rest.

Other personal factors also play a role in whether naltrexone disrupts your sleep. High stress levels, mental health conditions like anxiety or depression, and other medications you’re taking can all contribute to unusual dreams or sleep disturbances. The amount of time you spend in REM sleep, the stage where most vivid dreaming occurs, also matters. Some people naturally spend more time in REM sleep, which may make them more likely to remember intense dreams while on naltrexone.

What Can Help With Weird Dreams While Taking Naltrexone?

Quality of sleep, and the types of dreams people have, can be influenced by a range of factors, some of which may be out of one’s immediate control. Feelings of nervousness, anxiety, or major changes in a person’s life, such as seeking help for drug or alcohol abuse, may affect a person’s sleep.

What may help address sleep disturbances while taking naltrexone:

• meditation or relaxation techniques
• cognitive behavioral therapy
• regular physical activity
• biofeedback
• muscle relaxation
• stress reduction
• maintaining a regular sleep schedule

Sleep disturbances may often occur as a result of other stressors in a person’s life or poor sleep hygiene. Addressing these co-occurring issues may help improve sleep in addiction recovery.

When To Talk To Your Doctor About Naltrexone And Sleep

Vivid dreams and mild sleep disturbances are generally considered manageable side effects of naltrexone, and for most people they improve on their own within the first few weeks of starting the medication. There are, however, situations where it’s worth bringing the issue up with your prescribing doctor.

Reach out to your doctor if you experience:

• nightmares intense enough to cause significant distress, especially for people with PTSD or a history of trauma
• regularly waking up throughout the night or struggling to fall back asleep after vivid dreams
• sleep issues that are making you consider stopping naltrexone
• symptoms that aren’t improving after a few weeks

Never stop taking naltrexone or adjust your dose on your own without medical guidance, as doing so can affect your recovery and, in the case of opioid use disorder, increase the risk of relapse.

For more information about naltrexone, drug side effects, or how to find naltrexone treatment for addiction near you,  browse our directory or reach out to the Substance Abuse and Mental Health Services Administration (SAMHSA) for more information.

Written by the Addiction Resource Editorial Staff