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If serious symptoms persist despite a few months of treatment while using patient being abstinent from substances of abuse or alcohol, you can be sure they've a dual diagnosis, but only if you're sure they've got really been abstinent. Remember, once your pt comes for help, it is about them, and never you. Six trials that have been more neutral and better-designed-- which proved that phenylephrine doesn't work-- were completely dismissed by the FDA. Naltrexone is quite expensive, averaging $200 per month. This is simply because alcohol alters the results of these drugs; sometimes, the consequences of the alcohol-drug interactions are serious. No, you'll most definitely get equally as drunk of course when drinking on naltrexone. 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