Case study: paradoxical response to naltrexone treatment of 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.
Benjamin
S
S
Department of Psychiatry, University of Massachusetts Medical Center, Worcester 01655.
Seek
A
A
Tresise
L
L
Price
E
E
Gagnon
M
M
D000328:Adult; D001321:Autistic Disorder / Q000188:drug therapy* / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D006801:Humans; D008607:Intellectual Disability / Q000188:drug therapy* / Q000523:psychology; D008297:Male; D009271:Naltrexone / Q000009:adverse effects* / Q000627:therapeutic use; D016728:Self-Injurious Behavior / Q000139:chemically induced* / Q000523:psychology
D009271:Naltrexone