A case report of naltrexone treatment of self-injury and social withdrawal in autism.
A single naltrexone cycle quickly slashed self-biting and boosted peer talk in one autistic teen, but pair it with behavioral teaching for lasting change.
01Research in Context
What this study did
Doctors gave one autistic teen naltrexone pills for self-biting and social withdrawal.
They used a double-blind test: sometimes the pill was real, sometimes it was a placebo.
No one knew which was which until the end.
What they found
During naltrexone weeks the student stopped biting himself and started talking to peers.
When placebo weeks returned the biting came back and he pulled away again.
The change was large and fast.
How this fits with other research
Corrigan et al. (1998) tried a different body-based fix, TENS patches, for self-hitting in Down syndrome.
TENS also cut SIB fast, yet the benefit vanished when patches stopped.
Both studies show quick relief, but relief may not last without extra teaching.
Ingersoll et al. (2013) took the teaching route: reciprocal imitation training lifted social play in four autistic teens.
Their gains stayed without drugs, hinting that pairing naltrexone with social skills work could give longer-lasting change.
Why it matters
If you face severe SIB that blocks learning, a short naltrexone trial can calm the storm and open a window for teaching.
Use that quiet window to run solid behavioral programs so the gains stick when medicine stops.
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02At a glance
03Original abstract
The endogenous opiate release theory of self-injurious behavior (SIB) was investigated through double-blind placebo-controlled administration of naltrexone hydrochloride (Trexan) to a 14-year-old autistic and mentally retarded male for treatment of severe SIB. Results yielded a marked decrease in SIB during two phases of active drug treatment, though SIB did not revert to originally observed placebo levels during a second placebo phase. An increase in social relatedness also was observed during phases of active drug treatment. Opiate theories of self-injury and the possible interrelationship of self-injury with pituitary-adrenal arousal and with social relatedness are discussed.
Journal of autism and developmental disorders, 1990 · doi:10.1007/BF02284716