Naltrexone in adults with intellectual disability improves compulsive and dissocial disorders: A case report

Orihuela-Flores, Milton; Deriaz, Nicolas; Carminati, Giuliana Galli

doi:10.1016/j.pnpbp.2010.05.003

Cited by 3 publications

(1 citation statement)

References 11 publications

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“…Another less common potential pharmacodynamic drug–drug interaction is connected to naltrexone administration. Naltrexone may be indicated for the treatment of self‐injurious behaviour (Mafrica & Fodale, 2006; Rana, Gormez, & Varghese, 2013), as well as compulsive and dissocial disorders (Orihuela‐Flores, Deriaz, & Carminati, 2010) in adults with ID. As an opioid antagonist, naltrexone may decrease opioid efficacy.…”

Section: Discussionmentioning

confidence: 99%

Pain interventions in adults with intellectual disability: A scoping review and pharmacological considerations

Lonchampt

Gerber²,

Aubry³

et al. 2020

European Journal of Pain

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Background and Objective Having to deal on a daily routine with prescriptions in adults with intellectual disability (ID), we systematically reviewed the literature on the specificities of pain interventions in that population, focusing on medication and trying to gather practical information on appropriate pain treatments. Given the scarcity of the literature on the topic, we also discussed the pharmacological considerations to be taken into account when prescribing analgesic drugs in that vulnerable population. Databases and Data Treatment Articles on pain and ID were searched in the Medline and Google scholar electronic databases using the key words "Intellectual Disability," "Developmental Disability" and specific keywords for pharmacological and non‐pharmacological pain interventions. Preset outcomes about pharmacological treatment specificity, efficacy and safety were then collected. Results One hundred and fifty‐two articles were found and 16 were retained based on our inclusion and exclusion criteria. Of the 16 articles, five were topical reviews. Among the 11 remaining articles, five discussed pharmacological interventions, four considered non‐pharmacological interventions and two discussed both. As anticipated, the literature matching our specific outcomes about the pharmacological treatment of pain was scarce and for the most part not designed to answer the questions of specificity, efficacy and safety of pain treatment in adults with ID. Conclusion The specificity of analgesic treatments in adults with ID is a totally unexplored domain. In the absence of clinical guidelines, pharmacological facts—such as inter‐individual variability in drug response, pharmacokinetic and pharmacodynamic interactions, frequent co‐morbidities and ease of administration—must be systematically integrated, when prescribing in the population of adults with ID. Significance This review synthesizes the state of research on pain interventions in adults with ID and is one of the rare articles addressing the specificities of analgesic prescriptions in this population.

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Section: Discussionmentioning

confidence: 99%

Pain interventions in adults with intellectual disability: A scoping review and pharmacological considerations

Lonchampt

Gerber²,

Aubry³

et al. 2020

European Journal of Pain

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Possible role of a dysregulation of the endogenous opioid system in antisocial personality disorder

Bandelow

Wedekind

2015

Human Psychopharmacology

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Around half the inmates in prison institutions have antisocial personality disorder (ASPD). A recent theory has proposed that a dysfunction of the endogenous opioid system (EOS) underlies the neurobiology of borderline personality disorder (BPD). In the present theoretical paper, based on a comprehensive database and hand search of the relevant literature, this hypothesis is extended to ASPD, which may be the predominant expression of EOS dysfunction in men, while the same pathology underlies BPD in women. According to evidence from human and animal studies, the problematic behaviours of persons with antisocial, callous, or psychopathic traits may be seen as desperate, unconscious attempts to stimulate their deficient EOS, which plays a key role in brain reward circuits. If the needs of this system are not being met, the affected persons experience dysphoric mood, discomfort, or irritability, and strive to increase binding of endogenous opioids to receptors by using the rewarding effects of aggression by exertion of physical or manipulative power on others, by abusing alcohol or substances that have the reward system as target, by creating an "endorphin rush" by self-harm, by increasing the frequency of their sexual contacts, or by impulsive actions and sensation seeking. Symptoms associated with ASPD can be treated with opioid antagonists like naltrexone, naloxone, or nalmefene.

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Mise au point sur la prise en charge de la douleur chez les patients adultes atteints de déficience intellectuelle

Lonchampt¹,

Gerber²,

Aubry³

et al. 2020

Douleur analg

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Devant faire face quotidiennement aux problèmes de prescription chez les adultes présentant une déficience intellectuelle en contexte hospitalier et étant fréquemment confrontés à la question de la prescription d’un antalgique, nous avons mené une réflexion sur les spécificités à prendre en compte dans cette population sur la base des données de la littérature, de considérations pharmacologiques et de notre expérience clinique. Cette réflexion s’organise en trois étapes : sources de douleurs fréquentes dans cette population, méthodes d’évaluation de la douleur et spécificités pharmacologiques de cette population.

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Naltrexone in adults with intellectual disability improves compulsive and dissocial disorders: A case report

Cited by 3 publications

References 11 publications

Pain interventions in adults with intellectual disability: A scoping review and pharmacological considerations

Pain interventions in adults with intellectual disability: A scoping review and pharmacological considerations

Possible role of a dysregulation of the endogenous opioid system in antisocial personality disorder

Mise au point sur la prise en charge de la douleur chez les patients adultes atteints de déficience intellectuelle

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