CASE-STUDY - PARADOXICAL RESPONSE TO NALTREXONE TREATMENT OF SELF-INJURIOUS-BEHAVIOR

Opioid receptor antagonists have been studied in the management of sel f-injurious behavior (SIB) in developmentally disabled individuals. Th e authors present a case of a severly retarded, autistic man whose SIB increased dramatically during a trial of naltrexone. A paradoxical in crease in SIB, attributed to the extinction burst phenomenon during th e initial period of nonreward, is known to occur during treatment with naloxone, a short-acting parenteral opioid antagonist. It has only on ce been reported during treatment with naltrexone, a long-acting orall y administered agent. Opioid analgesic effects and learning theory can explain both increases and decreases in SIB after opioid blockade.