Naltrexone is currently not approved by the United States Food and Drug Administration for the management of symptoms and behaviors associated with autism. This article reviews 22 available studies (published between 1987 and 2001) and finds that naltrexone may help to stop self-injurious behavior as well as hyperactivity, agitation, aggression, irritability, temper tantrums, social withdrawal, attention, eye contact, and stereotyped behaviors.
The authors begin by outlining the theory that children with autism may have high levels of the protein by-products casomorphine and gluteomorphine in their systems. These by-products are created as a result of digesting milk and grain proteins. Naltrexone blocks some of the action of casomorphine and gluteomorphine in the brain. Some of the studies included in this review showed that daily naltrexone treatment (doses ranging from 0.5 to 2 mg/kg/day, or 10-35 mg a day for a 40-pound child) resulted in improved behavior. The authors suggest that most likely only a small percentage of children with autism can be helped by naltrexone, and they acknowledge that it is difficult at this point to identify these children. The authors conclude by suggesting that naltrexone therapy (beginning at 0.5 mg/kg) be tried in children with autism and self-injurious behavior, especially if all other therapies have failed. Finally, the authors note that the most commonly reported side effect of naltrexone was sleepiness.
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