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Case study: paradoxical response to naltrexone treatment of self-injurious behavior.

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  • 1Department of Psychiatry, University of Massachusetts Medical Center, Worcester 01655.


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.

[PubMed - indexed for MEDLINE]
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