Long-term effects of naltrexone on self-injurious behavior

A subgroup of self-injuring patients responds positively to the opiate-bloc king agent naltrexone in acute, double-blind studies. In this study we exam ined the effects of naltrexone after acute treatment and the long-term effe cts of naltrexone on SIE. Rates of SIE were collected from pretreatment bas eline; a second baseline a year after the acute trial; and a subsequent 12- month double-blind, placebo-controlled treatment. A subgroup of patients de creased SIE for a year without treatment after acute exposure to naltrexone . Five participants who decreased SIE by 70% after acute treatment increase d SIE to the long-term treatment with naltrexone. In contrast, those for wh om SIE increased over the one-year treatment hiatus decreased their SIE aft er the first long-term treatment. Discussion of these complex effects consi dered the role of background opioid levels, dosing, and treatment regimen o f naltrexone and other factors limiting receptor adaptation among patients who exhibit SIE.