Autism naltrexone

Additionally, an opioid antagonist, naltrexone, has been used to treat children with autism. The results from these studies have been mixed, with some studies showing a mild decrease in hyperactivity and self-injurious behavior, and improved attention (Gillberg, 1995). The children who respond best to this medication appear to have more severe abnormalities in their beta endorphin levels (Bouvard et al., 1995). Overall, the research suggests that the endogenous opioid system, which is important in the reward aspects of affiliation, may also play a role in the neurobiology of autism. 

Bouvard, M.P., Leboyer, M., Launay, J.M., Recasens, C., Plumet, M.H., Waller-Perotte, D., Tabuteau, F., Bondoux, D., Dugas, M., Lensing, P., et al. (1995) Low-dose naltrexone effects on plasma chemistries and clinical symptoms in autism a douhle-hlind, placebo-controlled study. Psychiatry Res 58 191-201. 

Willemsen-Swinkels et al., 1996a). This further seems to detract from the clinical utility in prescribing naltrexone to treat hyperactivity in subjects with autism. Although an expert has advocated that all autistic children should have a trial with naltrexone, this opinion has not met consensus within the professional community (Campbell and Harris, 1996). 

Feldman, H.M., Kolmen, B.K., and Gonzaga, A.M. (1999) Naltrexone and communication skills in young children with autism. / Am Acad Child Adolesc Psychiatry 38 587-593. 

Herman, B.H., Asleson, G.S., Borghese, I.F., Chatoor, I., Powell, A., Papero, P., Allen, R.P., and McNulty, G. (1991) Acute naltrexone in autism selective decreases in hyperactivity. In Proceedings of the 38th Annual Meeting of the American Academy of Child and Adolescent Psychiatry. San Francisco AACAP. 

Herman, B.H., Hammock, M.K., Arthur-Smith, A., Egan, J., Chatoor, I., Zelnik, N., Corradine, M., Appelgate, K., Boecks, R., and Sharp, S.D. (1986) Role of opioid peptides in autism effects of acute administration of naltrexone [abstract]. Soc Neurosci Abstr 12 320. 

Leboyer, M., Bouvard, M.P., and Dugas, M. (1988) Effects of naltrexone on infantile autism [letter]. Lancet 1 715. 

Panksepp, J. and Lensing, P. (1991) Brief report a synopsis of an open trial of naltrexone treatment of autism with four children. / Autism Dev Disord 21 243-249. 

Scifo, R., Batticane, N., Quattropani, M.C., Spoto, G., and Marchetti, B. (1991) A double-blind trial with naltrexone in autism. In Proceedings of OASI Conference (unpublished paper). 

Willemsen-Swinkels, S.H.N., Buitelaar, J.K., Van Berckelaer-Onnes, LA., and Van Engeland, H. (1999) Six-month continuation treatment of naltrexone-responsive children with autism an open-label case-control design. / Autism Dev Disord 29 167—169. 

To test the hypothesis that elevated endogenous opiate levels contribute to autism and/or to self-injurious behavior, 33 adult subjects with autism and/or self-injurious behavior were treated for 4 weeks with 50 or 150 mg/day naltrexone in a double-blind, placebo-controlled crossover trial. Naltrexone was not superior to placebo with respect to either frequency of self-injurious behavior or CGI and ABC measures of autistic symptoms (Zingarelli et al., 1992). 

Overall, the results indicate that naltrexone has little if any therapeutic efficacy with respect to learning or core symptoms of autism and argue against the hypothesis that overproduction of endogenous opioids plays a major role in autism. Nevertheless, the results indicate that naltrexone is generally well tolerated and may offer modest benefits primarily for treatment of hyperactivity associated with autistic disorder. 

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