Case study: paradoxical response to naltrexone treatment of self-injurious behavior
Department of Psychiatry
Medical Subject Headings
Adult; Autistic Disorder; Dose-Response Relationship, Drug; Drug Administration Schedule; Humans; Male; Mental Retardation; Naltrexone; Self-Injurious Behavior
Opioid receptor antagonists have been studied in the management of self-injurious behavior (SIB) in developmentally disabled individuals. The authors present a case of a severely retarded, autistic man whose SIB increased dramatically during a trial of naltrexone. A paradoxical increase in SIB, attributed to the extinction burst phenomenon during the initial period of nonreward, is known to occur during treatment with naloxone, a short-acting parenteral opioid antagonist. It has only once been reported during treatment with naltrexone, a long-acting orally administered agent. Opioid analgesic effects and learning theory can explain both increases and decreases in SIB after opioid blockade.
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Citation: J Am Acad Child Adolesc Psychiatry. 1995 Feb;34(2):238-42. Link to article on publisher's site
Benjamin, Sheldon; Seek, Andrea; Tresise, Lucy; Price, Ellen; and Gagnon, Maureen, "Case study: paradoxical response to naltrexone treatment of self-injurious behavior" (1995). Psychiatry Publications and Presentations. 454.