Naltrexone reduces self-injury and improves learning.

Sandman, Curt A.; Hetrick, William P.; Taylor, D.; Barron, Jennifer L.; Touchette, Paul E.; Lott, Ira T.; Crinella, Francis M.; Martinazzi, Vernon

doi:10.1037/1064-1297.1.1-4.242

Cited by 39 publications

(53 citation statements)

References 67 publications

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“…elevated transitional probability for SIB). Based on procedures employed in our previous studies (Sandman et al, 1997; Sandman, Touchette, Lenjavi, Marion, & Chicz-DeMet, 2003; Sandman et al, 1993) each subject was administered one of three doses of naltrexone (NTX; 0.5, 1.0 or 2.0 mg/kg, QOD) on separate weeks. Each positive treatment week was separated by a week of placebo treatment.…”

Section: Methodsmentioning

confidence: 99%

The role of proopiomelanocortin (POMC) in sequentially dependent self‐injurious behavior

Sandman

Touchette

Marion

et al. 2008

Developmental Psychobiology

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Self-injuring behavior (SIB) is a life-threatening behavior exhibited by many species, including humans, and has no known cause and no agreed upon treatment. The role of the stress axis in the maintenance of this mysterious behavior was examined in subjects with life-long SIB. Over a sixyear period, forty hours of direct observations of behavior and the environment were recorded on palmtop computers while 36 residential subjects (28 target and 8 control subjects) conducted their daily activities. Blood samples were collected in morning and evening for all subjects and within minutes after a self-injuring act in 28 target subjects who exhibited SIB to determine levels of ACTH and B-endorphin (BE). Self-injuring events in the patient group were significantly sequentially dependent (i.e. the only predictor of a self-injuring act was an antecedent self-injuring act). Higher morning levels of BE relative to ACTH predicted [r df=27 =0.57, p<.001] the sequentially dependent pattern of SIB. This effect was validated in a subgroup re-tested several months later [r df=22 =0.60, p<.001]. A subgroup of seven subjects exhibiting sequentially dependent patterns were administered an opiate blocker (naltrexone) in a double-blind, crossover design with an additional 14 hours/week of observation for seven weeks. Naltrexone challenge interrupted the sequential pattern (improved behavior) in subjects with elevated BE immediately following SIB (r=0.85, p<0.01). The pattern of results supported the conclusion that the stress axis played a significant role in the maintenance of complex episodes of self-injury.

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Section: Methodsmentioning

confidence: 99%

The role of proopiomelanocortin (POMC) in sequentially dependent self‐injurious behavior

Sandman

Touchette

Marion

et al. 2008

Developmental Psychobiology

Self Cite

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“…Equivocal evidence also currently exists for opioid antagonists, some studies showing better results on large doses and others on small doses (Sandman et al, 1993;Willemsen-Swinkells et al, 1995;Casner et al, 1996;Sandman et al, 2000). There is currently no evidence available to support use of anti-anxiety medication (King & Davanzo, 1996), psychostimulants or vitamins.…”

Section: The Evidence Basementioning

confidence: 91%

The use of medication to manage behaviour problems in adults with an intellectual disability: a national guideline

Unwin

2010

Adv Mental Hlth Intell Disabil

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2008),"A qualitative study on the knowledge and views that people with learning disabilities and their carers have of psychotropic medication prescribed for behaviour problems"If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. AbstractThis article describes a national guideline for the use of medication in the management of problem behaviours in adults with an intellectual disability. As problem behaviours in this group are common and medication is often prescribed 'off licence', it is important that a framework is established to direct this practice. The article details a guideline development project that is of importance because it is the only national guideline in the area. It also highlights important issues in clinical practice in the field, and addresses the current evidence base on the effectiveness of psychotropic medications in the management of problem behaviours. There is a lack of good research evidence to support use of medication for problem behaviours. Where medication is used for this purpose, it should be used with a clear rationale, following a thorough assessment of the individual, and carefully monitored, and withdrawal should always be considered. People should always be given information in a way that they understand, and they should be given choices about their treatment.

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“…Several articles reviewed [Aman et al, 1989;Anderson et al, 1984;Handen et al, 1990;and Lewis et al, 1995] that fit the criteria for this section also included follow-up studies that will be reviewed consecutively. Sandman et al [1993] used a double-blind, placebo-control study to examine the effects of naltrexone on self-injury and learning in 24 persons diagnosed with developmental disabili-ties. The purpose of the study also was to address some of the inconsistencies the authors identified in previous studies.…”

Section: Medication Effects On Multiple Dependent Variablesmentioning

confidence: 99%

Drug-behavior interactions in persons with mental retardation and developmental disabilities

Jack

Sheldon

Williams

et al. 1999

Ment. Retard. Dev. Disabil. Res. Rev.

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Naltrexone reduces self-injury and improves learning.

Cited by 39 publications

References 67 publications

The role of proopiomelanocortin (POMC) in sequentially dependent self‐injurious behavior

The role of proopiomelanocortin (POMC) in sequentially dependent self‐injurious behavior

The use of medication to manage behaviour problems in adults with an intellectual disability: a national guideline

Drug-behavior interactions in persons with mental retardation and developmental disabilities

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