title: Effects of naloxone and naltrexone on self-injury: a double-blind, placebo-controlled analysis.
abstract: The effects of naloxone hydrochloride (Narcan) and naltrexone hydrochloride (Trexan) on the pervasive self-injury of a 12-year-old autistic and mentally retarded girl were examined. Using separate multiple schedule (A1/B/B') and withdrawal (A-B-A1B-A1) single-subject experimental designs, we investigated the effects of both opiate antagonists in serial fashion under double-blind, placebo-controlled conditions. Results of the two studies showed that self-injury increased during the naloxone trial, whereas a decrease to near zero rates of self-injury was observed following treatment with naltrexone. The differential effect produced by the two drugs was discussed in terms of drug half-life and the operant conditioning theory of extinction. Follow-up data showing near zero rates of self-injury for 22 months following the conclusion of active treatment with naltrexone indicated that the intervention produced a durable result.
authors.affiliation: Brown University Program in Medicine, Emma Pendleton Bradley Hospital, Providence, RI.
authors.forename: R P
authors.initials: RP
authors.lastname: Barrett
authors.forename: C
authors.initials: C
authors.lastname: Feinstein
authors.forename: W T
authors.initials: WT
authors.lastname: Hole
mesh_terms: D001321:Autistic Disorder / Q000150:complications; D002648:Child; D002986:Clinical Trials as Topic; D003216:Conditioning, Operant; D004311:Double-Blind Method; D005108:Extinction, Psychological; D005260:Female; D006207:Half-Life; D006801:Humans; D009270:Naloxone / Q000493:pharmacokinetics / Q000494:pharmacology*; D009271:Naltrexone / Q000493:pharmacokinetics / Q000494:pharmacology*; D012055:Reinforcement Schedule; D012652:Self Mutilation / Q000150:complications / Q000188:drug therapy*
chemical_list: D009270:Naloxone; D009271:Naltrexone