Abstract
People with mental retardation, autism, and related developmental disabilities who self‐injure are treated with a wide array of behavioral techniques and psychotropic medications. Despite numerous reports documenting short‐term and some long‐term changes in self‐injury associated with the opiate antagonist naltrexone hydrochloride, no quantitative review of its efficacy has been reported. We conducted a quantitative synthesis of the peer‐reviewed published literature from 1983 to 2003 documenting the use of naltrexone for the treatment of self‐injurious behavior (SIB). Individual‐level results were analyzed given subject and study characteristics. A sample of 27 research articles involving 86 subjects with self‐injury was reviewed. Eighty percent of subjects were reported to improve relative to baseline (i.e., SIB reduced) during naltrexone administration and 47% of subjects SIB was reduced by 50% or greater. In studies reporting dose levels in milligrams, males were more likely than females to respond. No significant relations were found between treatment outcomes and autism status or form of self‐injury. Results are discussed with respect to future efficacy work related to study outcomes and the pharmacological treatment of self‐injury. © 2004 Wiley‐Liss, Inc. MRDD Research Reviews 2004;10:193–200.