Opiate antagonists have shown promise for treating a subset of self injurious patients. The authors report on the use of naltrexone with three mentally retarded adults who had long histories of self-injurious behavior and unsuccessful behavioral and drug treatments; for all three, the self- injurious behavior was substantially decreased. The authors have found a positive response for half the self-injurious patients for whom naltrexone has been tried. Before any drug therapy is initiated, environmental reinforcers of the behavior should be sought out and modified, and any reversible medical and psychiatric disorders should be treated.
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