Cessation of long-term Naltrexone administration: Longitudinal follow-ups

Longitudinal follow-ups of the cessation of long-term Naltrexone administra tion (1 year of drug therapy) were conducted with a young woman (in her ear ly 30s) with profound mental retardation who had previously displayed drama tic decreases in her self-injurious behaviors (SIB) both during, and for a period of at least 6 months following termination of drug treatment. After 2 and 4 years, post-Naltrexone therapy, the subject continued to exhibit ne ar-zero rates of SIE episodes despite significant turnovers in her direct c are staff by the a-year follow-up, and changes in her physical/living envir onment and fellow residents by 4-year follow-up. These findings provide fur ther support to the idea that long-term Naltrexone administration may resul t in highly durable reductions in SIE long after treatment ends and argue a gainst certain aspects of the subject's environment affecting her rates of SIB significantly. These results are discussed in light of the endogenous o piate system theories of SIB. A functional analysis and discussion of the e ffectiveness of behavioral treatments for her few remaining SIE episodes ar e also provided. (C) 1999 Elsevier Science Ltd.