Skip to main content

Advertisement

Log in

Opiate antagonists in children and adolescents

  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

Naltrexone a pure opioid anatagonist, well tolerated in young patients, has been found to be an interesting treatment in some disorders in children and adolescents. Naltrexone has been first tried in mental retardation and autism disorders in children and adolescents. Symptoms like self-injury behaviours, hyperactivity, stereotyped and ritualistic conducts appear to be improved in a subgroup of children with the opiate antagonist. But new controlled studies still need to be done before recommending naltrexone in autism. Preliminary results in the treatment of alcoholic adolescents seem to support the efficacy of naltrexone on abstinence when combined with a supportive psychotherapy. In adults, results found with the use of naltrexone in eating disorders are different, when considering the duration and the dosage of the treatment and the kind of eating disorder (bulimia, binge eating or anorexia nervosa). Studies in children and adolescents are needed before proposing naltrexone in eating disorders. We resumed here the results found with this treatment in these indications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Atkinson RL, Berke LK, Drake CR, Bibbs ML, Williams FL, Kaiser DL (1985) Effects of long term therapy with naltrexone on body weight in obesity. Clin Pharmacol Ther 9: 347–353

    Google Scholar 

  2. Barrett RP, Feinstein C, Hole WT (1989) Effects of naloxone and naltrexone on self-injury: a double-blind placebo controlled analysis. American Journal of Mental Retardation 93: 644–651

    CAS  PubMed  Google Scholar 

  3. Bouvard MP, Leboyer M, Launay JM, Kerdelhue B, Dugas M (1992) Opioid hypothesis in infantile autism. In: Naruse H, Ornitz EM (eds) Neurobiology of Infantile Autism. Excerpta Medica. Amsterdam, London, New-York, Tokyo

    Google Scholar 

  4. Bouvard MP, Leboyer M, Launay JM et al. (1995) Low dose naltrexone effects of on plasma chemistries and clinical symptoms in autism: a double-blind, placebo-controlled study. Psychiatry Research 58: 191–201

    Article  CAS  PubMed  Google Scholar 

  5. Campbell M, Anderson I, Small A, Locascio J (1990) Naltrexone in autistic children: a double blind and placebo-controlled study. Psychopharmacological bulletin 26: 130–135

    CAS  Google Scholar 

  6. Campbell M, Overall JE (1989) Naltrexone in autistic children: an acute open dose range tolerance trial. Journal of the American Academy of Child and Adolescent Psychiatry 28: 200–206

    Article  CAS  PubMed  Google Scholar 

  7. Carr KD, Papadouka V (1994) The role of multiple opiod receptors in the potentiation of reward by food restriction. Brain Research 639: 253–260

    Article  CAS  PubMed  Google Scholar 

  8. Croop R, Faulkner E, Labriola D (1997) The safety profile of naltrexone in the treatment of alcoholism. Archives of General Psychiatry 54: 1130–1135

    CAS  PubMed  Google Scholar 

  9. De Zwaan M, Mitchell JE (1992) Opiate antagonists and eating behavior in humans. A review. Journal of Clinical Pharmacology 32: 1060–1072

    PubMed  Google Scholar 

  10. Emanuele NV, Lapaglia N, Steiner J, Kirsteins L, Emanuele MA (1999) Reversal of chronic ethanol-induced testosterone suppression in peripubertal male rats by opiate blockade. Alcohol Clin Exp Res 23: 60–66

    CAS  PubMed  Google Scholar 

  11. Garbutt JC, West S, Carey TS, Lorh K, Fulton TC (1999) Pharmacological treatment of alcohol dependence, a review of evidence. JAMA 14: 1318–1325

    Article  Google Scholar 

  12. Gillberg C (1995) Endogenous opioids and opiate antagonists in autism: brief review of empirical findings and implications for clinicians. Developmental Medicine and Child Neurology 37: 239–245

    CAS  PubMed  Google Scholar 

  13. Gonzalez NM, Campbell M, Smalla AM, Bluhm LD, Adams PB, Foltz RL (1994) Naltrexone plasma levels, clinical response and effect on weight in autistic children. Psychopharmacology Bulletin 30: 203–208

    CAS  PubMed  Google Scholar 

  14. Guillemin R, Ling N, Vargo T (1977) Radioimmunoassays for alpha-endorphin and beta-endorphin. Biochem Biophys Res Commun 77: 361

    Article  CAS  PubMed  Google Scholar 

  15. Herman BH, Hammock, MK, Arthur Smith A, Egan J, Chatoor I, Werner A, Zelneck N (1987) Naltrexone decreases self-injurious behavior. Annals of Neurology 22: 550–552

    Article  CAS  PubMed  Google Scholar 

  16. Kars H, Broekema W, Glaudemans-van Gelderen I, Verhoeven WM, van Ree JM (1990) Naltrexone attenuates self-injurious behavior in mentally retarded subjects. Biol Psychiatry 27 (7): 741–746

    Article  CAS  PubMed  Google Scholar 

  17. Kolmen BK, Feldman HM, Handen BL, Janosky JE (1995) Naltrexone in young autistic children, a double blind placebo-controlled crossover study. Journal of the American Academy of Child and Adolescent Psychiatry 34: 223–231

    Article  CAS  PubMed  Google Scholar 

  18. Kolmen BK, Feldman HM, Handen BL, Janosky JE (1997) Naltrexone in young autistic children: replication study and learning measures. Journal of the American Academy of Child and Adolescent Psychiatry 36: 1570–1578

    Article  CAS  PubMed  Google Scholar 

  19. Leboyer M, Bouvard MP, Launay JM, Tabuteau F, Waller D, Dugas M, Kerdelhue B, Lensing P, Panksepp J (1992) A double blind study of naltrexone in infantile autism. Journal of Autism Developmental Disorders 22: 309–319

    Article  CAS  Google Scholar 

  20. Leboyer M, Bouvard MP, Lensing P, Launay JM, Tabuteau F, Arnaud P, Waller D, Plumet MH, Recasens C, Kerdelhue B, Dugas M, Panksepp J (1990) Opioid excess hypothesis of autism: a double-blind study of naltrexone. Brain Dysfunction 3: 285–298

    Google Scholar 

  21. Leboyer M, Bouvard MP, Recassens C, Philippe A, Guilloud-Bataille M, Bondoux D, Tabuteau F, Dugas M, Panksepp J, Launay JM (1994) Dissociation between N and C terminal β-endorphines in autistic, Rett syndrome and controls children. American Journal of Psychiatry 151: 1797–1801

    CAS  PubMed  Google Scholar 

  22. Lifrak E, Alterman A, O’Brien C, Volpicell J (1997) Naltrexone for alcoholic adolescents. American Journal of Psychiatry 154: 439–440

    CAS  PubMed  Google Scholar 

  23. Margules DL, Moisset B, Lewis MJ, Shibuya H (1978) Beta-endorphine is associated with overeating in genetically obese mice (ob/ob) and rats (fa-fa). Science 202: 988–991

    Article  CAS  PubMed  Google Scholar 

  24. Marrazzi MA, Bacon JP, Kinzie J, Luby ED (1995) Naltrexone use in the treatment of anorexia and bulimia nervosa. International Clinical Psychopharmacology 10: 163–172

    Article  CAS  PubMed  Google Scholar 

  25. Marrazzi MA, Wroblewski JM, Kinzie J, Luby ED (1997) High dose naltrexone and liver function. American Journal of Addiction 6: 21–29

    Article  CAS  Google Scholar 

  26. Melchior JC, Rigaud D, Colas-Linhart N, Rozen R, Fantino M, Apfelbaum M (1990) Negative allesthesia and decreased endogenous opiate system activity in anorexia nervosa. Pharmacology, Biochemistry and Behaviour 35: 885–888

    Article  CAS  Google Scholar 

  27. O’Malley SS, Jaffe AJ, Chang G et al. (1996) Follow-up of naltrexone and psychotherapy for alcohol dependenc. Archives of General Psychiatry 53: 217–224

    PubMed  Google Scholar 

  28. Panksepp J (1979). A neurochemical theory of autism. Trends Neurosci 2: 174–177

    Article  Google Scholar 

  29. Panksepp J, Siviy S (1985) Brain opioid and social emotions. In: Reite M, Field R (eds) The psychobiology of social attachements and separation. Academic Press, Orlando, pp 39–49

    Google Scholar 

  30. Panksepp J, Lensing P (1990) Naltrexone therapy of autistic children. In: Van Ree JM, Mulder AW, Wiegant VM, Van Wimersma Greidanus TB (eds) Elsevier, Amsterdam, pp 181–182

    Google Scholar 

  31. Panksepp J, Lensing P (1991) Naltrexone treatment of autism: a synopsis of an opentrial with four children. Journal of Autism and Development Disorders 21: 135–141

    Article  Google Scholar 

  32. Sahley TL, Panksepp J (1987) Brain opioids in autism: an uptade analysis of possible linkage. Journal of Autism and Developmental Disorders 17: 201–216

    Article  CAS  PubMed  Google Scholar 

  33. Sandman CA, Barron JL (1987) Influence of naloxone on brain and behavior of a self-injurious woman. Biological Psychiatry 22: 899–906

    Article  CAS  PubMed  Google Scholar 

  34. Sandyk R (1985) Naloxone abolishes self-injuring in a mentally retarded child. Annals of Neurology 17: 520

    Article  CAS  PubMed  Google Scholar 

  35. Scifo R, Cioni M, Nicolosi A, Batticane N, Tirolo C, Testa N, Quattropani MC et al. (1996) Opioid-immune interactions in autism: behavioral and immuological assesment during a double blind treatment with naltrexone. Ann Ist Super Sanita 32: 351–359

    CAS  PubMed  Google Scholar 

  36. Szymansky L, Kedesky J, Sulkes S, Cutler A, Stevens-Ours P (1987) Naltrexone in treatment of self-injury behavior: a clinical study. Research in Developmental Disabilities 2: 179–190

    Article  Google Scholar 

  37. Volpicelli JR, Alterman AI, Hayashida M, O’Brien CP (1992) Naltrexone in the treatment of alcohol dependence. Archives of General Psychiatry 49: 881–887

    Google Scholar 

  38. Walters AS, Rowland P (1990) A case report of naltrexone treatment of self-injury and social withdrawal in autism. Journal of Autism and Development Disorders 20: 169–176

    Article  CAS  Google Scholar 

  39. Willemsen-Swinkels SH, Buitelaar JK, Nijhof GF, Van Engeland H (1995) Failure of naltrexone hypochloride to reduce self-injurious and autistic behavior in mentally retarded adults. Double blind placebo-controlled study. Archives of General Psychiatry 52: 766–773

    CAS  PubMed  Google Scholar 

  40. Willemsen-Swinkels SH, Buitelaar JK, Van Engeland H (1996) The effects of chronic naltrexone treatment in young autistic children: a double blind placebo-controlled crossover study. Biological Psychiatry 39: 1023–1031

    Article  CAS  PubMed  Google Scholar 

  41. Wold M, Kaminer Y (1997) Naltrexone for alcohol abuse. Journal of the American Academy of Child and Adolescent Psychiatry 36: 6–7

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chabane, N., Leboyer, M. & Mouren-Simeoni, M.C. Opiate antagonists in children and adolescents. European Child & Adolescent Psychiatry 9 (Suppl 1), S44–S50 (2000). https://doi.org/10.1007/s007870070018

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s007870070018

Key words

Navigation