Naltrexone in autism: A case
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Published
2005-03-01
How to Cite
Sanginés, M., Herreros, O., Rubio, B., & Sánchez, F. (2005). Naltrexone in autism: A case. Revista De Psiquiatría Infanto-Juvenil, 22(1), 22–26. Retrieved from https://aepnya.eu/index.php/revistaaepnya/article/view/61
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Section
Orginial article
Keywords:
Pervasive developmental disorders, autism, naltrexone, self-injuryAbstract
It is hypothesized that self-injurious behavior and other symptoms of autism may be due to overactivity in some opioid systems in the brain. The opioid hypothesis suggests that childhood autism may result from excessive brain opioid activity during neonatal period which may constitutionally inhibit social motivation, yielding autistic isolation and social withdrawal. This hypothesis is currently based on three types of arguments: (1) similarity between autistic symptomatology and abnormal behaviors induced in young animals by injections of exogenous opioids; (2) biochemical evidence of abnormalities of peripheral endogenous opioids being reported in autism and (3) therapeutic effects of the opioid receptor blocking agent naltrexone in autism. Naltrexone a pure opioid antagonist, well tolerated in children, has been found to be an interesting treatment in some other disorders in children and adolescents. In this report, naltrexone
efficacy in decreasing autistic self-injurious behaviour was explored in a 9-year-old autistic girl. Symp- 23 toms like self-injury behaviours, hyperactivity, stereotyped and ritualistic conducts appear to be improved in a subgroup of children with the opiate antagonist in some studies, but due to other contradictory results more controlled studies still need to be done before recommending naltrexone in autism.
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References
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studies. Arch Gen Psychiatry 1995, 52: 766-773.
34. Zingarelli G, Ellman G, Hom A, Wymore M, Heidorn S, Chicz DeMet A. Clinical effects of naltrexone on autistic behavior. Am J Ment Retard 1992, 97: 57-63.
2. Bouvard MP, Leboyer M, Launay JM et al. Low-dose naltrexone effects on plasma chemistries and clinical symptoms in autism: a double-blind, placebo-controlled study. Psychiatry Res 1995, 58: 191-201.
3. Buitelaar JK. Self-injurious behavior in retarded children, clinical phenomena and biological mechanisms. Acta Paedopsychiatr 1993, 56: 105-111.
4. Campbell M, Adams P, Small AM et al. Naltrexone in infantile autism. Psychopharmacol Bull 1988, 24: 135-139.
5. Campbell M, Anderson L, Small A et al. Naltrexone in autistic children: behavioral symptoms and attentional learning. J Am Acad Child Adolesc Psychiatry 1993, 32: 1283-1291.
6. Campbell M, Overall JE, Small AM et al. Naltrexone in autistic children: an acute open dose range tolerance trial. J Am Acad Child Adolesc Psychiatry 1989, 28: 200-206.
7. Chakrabarti S, Fombonne E. Pervasive developmental disorders in preschool children. JAMA 2001, 285: 3093-3099.
8. Chamberlain RS, Herman BH. A novel biochemical model linking dysfunctions in brain melatonin, proopiomelanocortin peptides, and serotonin in autism. Biol Psychiatry 1990, 28: 773-793.
9. Feldman HM, Kolmen BK, Gonzaga AM. Naltrexone and communication skills in young children with autism. J Am Acad Child Adolesc Psychiatry 1999, 38: 587-593.
10. Fombonne E. The epidemiology of autism: a review. Psychol Med 1999, 29: 769-786.
11. Gillberg C, Svennerholm L, Hamilton-Hellberg C. Childhood psychosis and monoamine metabolites in spinal fluid. J Autism Dev Disord 1983, 13: 383-396.
12. Gillberg C, Terenius L, Hagberg B, Witt-Engerstrom I, Eriksson I. CSF-endorphins in childhood neuropsychiatric disorders. Brain Dev 1990, 12: 88-92.
13. Gillberg C, Terenius L, Lonnerholm G. Endorphin activity in childhood psychosis. Arch Gen Psychiatry 1985, 42: 780-783.
14. Herman B, Asleson G, Papero P. Acute and chronic naltrexone decreases the hyperactivity of autism. Soc Neurosci Abstr Abstract 1993, 732.3.
15. Herman BH, Hammock MK, Arthur-Smith A et al. Effects of naltrexone in autism: correlation with plasma opioid concentrations. In: Scientific Proceedings of the Annual Meeting of the American Academy of Child
and Adolescent Psychiatry 1986, 2: 11.
16. Kanner L. Autistic disturbances of affective contact. Nervous Child 1943, 2: 217-250.
17. Kehoe P, Blass EM. Behaviorally functional opioid systems in infant rats: II. Evidence for pharmacological, physiological, and psychological mediation of pain and stress. Behav Neurosci 1986, 100: 624-30.
18. Kolmen B, Feldman H, Handen B, Janosky J. Naltrexone in young autistic children: replication study and learning measures. J Am Acad Child Adolesc Psychiatry 1997, 36: 1570-1578.
19. Leboyer M, Bouvard MP, Dugas M. Effects of naltrexone on infantile autism. Lancet 1988, 1 (8587): 715.
20. Leboyer M, Bouvard MP, Recasens C et al. Difference between plasma N- and C-terminally directed-endorphin immunoreactivity in infantile autism. Am J Psychiatry 1994, 151:1797-1801.
21. OMS (2000), Guía de Bolsillo de la Clasificación CIE-10. Madrid: Editorial Médica Panamericana, 2000.
22. Panksepp J. Aneurochemical theory of autism. Trends Neurosci 1979, 2: 174-177.
23. Panksepp J, Sahley TL. Possible brain opioid involvement in disrupted social intent and language development of autism. En: Schopler E, Mesibov GB (eds), Neurobiological issues in autism. New York: Plenum
Press; 1987. pp:357-372.
24. Percy AK, Glaze DG, Schultz RJ et al. Rett syndrome: controlled study of an oral opiate antagonist, naltrexone. Ann Neurol 1994, 35: 464-470.
25. Ross DL, Klykylo WM, Hitzemann R. Reduction of elevated CSF _-endorphin by fenfluramine in infantile autism. Pediatr Neurol 1987, 3: 83-86.
26. Sandman CA, Barron JL, Chicz-DeMet A, DeMet EM. Plasma_-endorphin and cortisol levels in autistic patients. J Autism Dev Disord 1991, 21: 83-87.
27. Sandman CA, Hetrick WP, Taylor DV. Naltrexone reduces self-injury and improves learning. Exp Clin Psychopharmacol 1993, 1: 1-17.
28. Symons FJ, Thompson A, Rodriguez MC. Self-injurious behavior and the efficacy of naltrexone treatment: a quantitative synthesis. Ment Retard Dev Disabil Res Rev 2004, 10: 193-200.
29. Thompson T, Hackenberg T, Cerutti D, Baker D, Axtell S. Opioid antagonist effects on self-injury in adults with mental retardation: response form and location as determinants of medication effects. Am J Ment Retard 1994, 99: 85-102.
30. Vaccarino AL, Kastin AJ (2000), Endogenous opiates: 1999. Peptides 21: 1975-2034.
31. Volkmar FR, Szatmari P, Sparrow SS. Sex differences in pervasive developmental disorders. J Autism Dev Disord 1993, 23: 579-591.
32. Weizman R, Gil-ad I, Dick J, Tyano S, Szekely GA, Laron Z. Low plasma immunoreactive _-endorphin levels in autism. J Am Acad Child Adolesc Psychiatry 1988, 27: 430-433.
33. Willemsen-Swinkels SHN, Buitelaar JK, Nijhof GJ, Van Engeland H. Failure of naltrexone hydrochloride to reduce self-injurious and autistic behavior in mentally retarded adults: double-blind placebo-controlled
studies. Arch Gen Psychiatry 1995, 52: 766-773.
34. Zingarelli G, Ellman G, Hom A, Wymore M, Heidorn S, Chicz DeMet A. Clinical effects of naltrexone on autistic behavior. Am J Ment Retard 1992, 97: 57-63.
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