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The Effectiveness of Naltrexone in Treating Task Attending, Aggression, Self-Injury, and Stereotypic Mannerisms of Six Young Males with Autism or Pervasive Developmental Disorders

  • Steven Anderson
  • Ronald Hanson
  • Myron Malecha
  • Arla Oftelie
  • Cynthia Erickson
  • Jane Moore Clark
Article

Abstract

An 8-week trial of 2 mg/kg/day of naltrexone (Trexan, now called ReVia) was conducted with four males with autism and two males with pervasive developmental disorders. Two dependent measures were employed: (a) direct behavioral measurement conducted by blind observers using videotape recordings of periodic learning task sessions, and (b) performance measures of the learning activity. Direct behavior measures revealed one participant's attending-to-task improved while receiving naltrexone. However, two of the participants' rates of self-injury increased, as did one of those participant's rate of aggression. Significant improvement was observed on performance measures of the learning task; however, the improved performance continued during the non-drug return to baseline for the three participants who experienced this additional condition. Discussion is provided relating these findings to previously published results.

naltrexone autism pervasive developmental disorders aggression self-injury 

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REFERENCES

  1. Aman, M. G., Singh, N. N., Stewart, A. W., and Field, C. J. (1985a). The Aberrant Behavior Checklist: A behavior rating scale for the assessment of treatment effects. Am. J. Ment. Def. 89: 485–491.Google Scholar
  2. Aman, M. G., Singh, N. N., Stewart, A. W., and Field, C. J. (1985b). Psychometric characteristics of the Aberrant Behavior Checklist. Am. J. Ment. Def. 89: 492–502.Google Scholar
  3. American Psychiatric Association. (1987). Diagnostic and Statistical Manual of Mental Disorders DSM-III-R (3rd ed., revised), Washington, D.C.: Author.Google Scholar
  4. Benjamin, S., Seek, A., Tresise, L., Price, E. and Gagnon, M. (1995). Case study: Paradoxical response to naltrexone treatment of self-injurious behavior. J. Am. Acad. Child Adol. Psychiatry 34: 238–242.Google Scholar
  5. Campbell, M., Adams, P., Small, A. M., Tesch, L. M., and Curren, E. L. (1988). Naltrexone in infantile autism. Psychopharmacol. Bull. 24: 135–139.Google Scholar
  6. Campbell, M., Anderson, L., Small, A., Adams, P., Gonzalez, N., and Ernst, M. (1993). Naltrexone in autistic children: Behavioral symptoms and attentional learning. J. Am. Acad. Child Adol. Psychiatry 32: 1283–1291.Google Scholar
  7. Campbell, M., Anderson, L. T., Small, A. M., Locascio, J. J., Lynch, N. S., and Choroco, M. C. (1990). Naltrexone in autistic children: A double-blind and placebo-controlled study. Psychopharmacol. Bull. 26: 130–135.Google Scholar
  8. Campbell, M., Overall, J. E., Small, A. M., Sokol, M. S., Spencer, E. K., Adams, P., Foltz, R. L., Monti, K. M., Perry, R., Nobler, M., and Roberts, E. (1989). Naltrexone in autistic children: An acute open dose range tolerance trial. J. Am. Acad. Child Adol. Psychiatry 28: 200–206.Google Scholar
  9. Cataldo, M., and Harris, J. (1982). The biological basis for self-injury in the mentally retarded. Anal. Intervent. Devel. Dis. 2: 21–39.Google Scholar
  10. Deutsch, S. I. (1986). Rationale for the administration of opiate antagonists in treating infantile autism. Am. J. Ment. Retard. 90: 631–635.Google Scholar
  11. Duker, P. C., Welles, K., Seys, D., Rensen, H., Vis, A., and van den Berg, G. (1991). Brief report: Effects of fenfluramine on communicative, stereotypic, and inappropriate behaviors of autistic-type mentally handicapped individuals. J. Aut. Devel. Dis. 21: 355–363.Google Scholar
  12. Ernst, M., Devi, L., Silva, R. R., Gonzalez, N. M., Small, A. M., Malone, R. P., and Campbell, M. (1993). Plasma beta-endorphin levels, naltrexone, and Haloperidol in autistic children. Psychopharmacol. Bull. 29(2): 221–227.Google Scholar
  13. Gillberg, C., Terenius, L., and Lonnerholm, G. (1985). Endorphin activity in childhood psychosis. Arch. Gen. Psychiatry 42: 780–783.Google Scholar
  14. Gonzalez, N. M., Campbell, M., Small, A. M., Shay, J., Bluhm, L. D., Adams, P. B. and Frotz, R. L. (1994). Naltrexone plasma levels, clinical response and effect on weight in autistic children. Psychoparmacol. Bull. 30(2): 203–208.Google Scholar
  15. Herman, B. H. (1991). Effects of opioid receptor antagonists in the treatment of autism and self-injurious behavior. In Ratey, J. J. (ed.), Mental Retardation: Developing Pharmacotherapies. American Psychiatric Press, Washington, DC, pp. 107–137.Google Scholar
  16. Herman, B. H., Hammock, M. K., Arthur-Smith, A., Egan, J., Chatoor, I., Werner, A., and Zelnik, N. (1987). Naltrexone decreases self-injurious behavior. Ann. Neurol. 22: 550–552.Google Scholar
  17. Herman, B. H., Hammock, M. K., Arthur-Smith, A., Kuehl, K., and Applegate, K. (1989). Effects of acute administration of naltrexone on cardiovascular function, body temperature, body weight and serum concentrations of liver enzymes in autistic children. Devel. Pharmacol. Ther. 12: 118–127.Google Scholar
  18. Knabe, R., Schulz, P., and Richard, J. (1990). Initial aggravation of self-injurious behavior in autistic patients receiving naltrexone treatment. J. Aut. Devel. Dis. 20: 591–593.Google Scholar
  19. Kolmen, B. K., Feldman, H. M., Handen, B. L., and Janosky, J. E. (1995). Naltrexone in young autistic children: A double-blind, placebo-controlled crossover study. J. Am. Acad. Child Adol. Psychiatry 34: 223–231.Google Scholar
  20. Krug, D., Arick, J., and Almond P. (1980). Autism Screening Instrument for Educational Planning, ASIEP Education Company, Portland, Oregon.Google Scholar
  21. Leboyer, M., Bouvard, M. P., and Dugas, M. (1988). Effects of naltrexone on infantile autism. Lancet 1: 715.Google Scholar
  22. Leboyer, M., Bouvard, M. P., Launay, J. M., Tabuteau, F., Waller, D., Dugas, M., Kerdelhue, B., Lensing, P., and Panksepp, J. (1992). Brief report: A double-blind study of naltrexone in infantile autism. J. Aut. Devel. Dis. 22: 309–319.Google Scholar
  23. Lensing, P., Klingler, D., Lampl, C., Leboyer, M., Bouvard, M., Plumet, M. H., and Panksepp, J. (1992). Naltrexone open trial with a 5-year-old boy: A social rebound reaction. Acta Paedopsychiatr. 55: 169–173.Google Scholar
  24. Panksepp, J. (1979). A neurochemical theory of autism. Trends Neurosci. 2: 174–177.Google Scholar
  25. Panksepp, J., and Lensing, P. (1991). Brief report: A synopsis of an open-trial of naltrexone treatment of autism with four children. J. Aut. Devel. Dis. 21: 243–249.Google Scholar
  26. Ross, D. L., Klykylo, W. M., and Hitzemann, R. (1987). Reduction of elevated CSF beta-endorphin by fenfluramine in infantile autism. Pediatr. Neurol. 3: 83–86.Google Scholar
  27. Sandman, C. A. (1988). B-Endorphin disregulation in autistic and self-injurious behavior: A neurodevelopmental hypothesis. Synapse 2: 193–199.Google Scholar
  28. Sandman, C. A., Hetrick, W. P., Taylor, D. V., Barron, J. L., Touchette, P., Lott, I., Crinella, F., and Martinazzi, V. (1993). Naltrexone reduces self-injury and improves learning. Exp. Clin. Psychopharmacol. 1: 242–258.Google Scholar
  29. Sandman, C. A., Thompson, T., Barrett, R. P., Verhoeven, W. M. A., McCubbin, J. A., Schroeder, S. R., and Hetrick, W. P. Opiate blockers (In Press). In Reiss, S. and Aman, M. G. (eds.), Psychoactive Drugs and Developmental Disabilities: The International Consensus Handbook, The Nisonger Center, Columbus, OH.Google Scholar
  30. Siegel, S. (1956). Nonparametric Statictics for the Behavioral Sciences. McGraw-Hill, New York.Google Scholar
  31. Sulzer-Azaroff, B., and Mayer, G. R. (1977). Applying Behavior-Analysis Procedures with Children and Youth. Holt, Reinhart, and Winston, New York, NY.Google Scholar
  32. Taylor, D. V., Sandman, C. A., Touchette, P., Hetrick, W. P., and Barron, J. L. (1993). Naltrexone improves learning and attention in self-injurious individuals with developmental disabilities. J. Devel. Phys. Dis. 5: 29–42.Google Scholar
  33. Thompson, T., Hackenberg, T., Cerutti, D., Baker, D., and Axtell, S. (1994). Opioid antagonist effects on self-injury in adults with mental retardation: response form and location as determinants of medication effects. Am. J. Ment. Retard., 99: 85–102.Google Scholar
  34. Walters, A. S., Barrett, R. P., Feinstein, C., Mercurio, A., and Hole, W. T. (1990). A case report of naltrexone treatment of self-injury and social withdrawal in autism. J. Aut. Devel. Dis. 20: 169–176.Google Scholar
  35. Wheeler, D. L., Jacobson, J. W., Paglieri, R. A., and Schwartz, A. A. (1993). An experimental assessment of facilitated communication. Ment. Retard. 31: 49–60.Google Scholar
  36. Zingarelli, G., Ellman, G., Hom, A., Wymore, M., Heidorn, S., and Chicz-DeMet, A. (1992). Clinical effects of naltrexone on autistic behavior. Am. J. Ment. Retard., 97: 57–63.Google Scholar

Copyright information

© Plenum Publishing Corporation 1997

Authors and Affiliations

  • Steven Anderson
    • 1
  • Ronald Hanson
    • 1
  • Myron Malecha
    • 1
  • Arla Oftelie
    • 1
  • Cynthia Erickson
    • 1
  • Jane Moore Clark
    • 1
  1. 1.Mount Olivet Rolling AcresVictoria

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