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Author Credentials

Rebecca Katlyn Hicks BA; Iram Kingson BA, MS; Jordan Gaal DO; Suzanne Holroyd MD

Author ORCID Identifier

https://orcid.org/0009-0006-9913-1917

Keywords

case report, naltrexone, food addiction (FA), impulse-control disorder, autism spectrum disorder (ASD), compulsive eating behavior, binge eating, food obsession, trauma, impulse control, intellectual disability, schizoaffective disorder, post-traumatic stress disorder, opioid antagonists, compulsive behaviors, impulsivity, trauma-related eating disorders, pharmacotherapy, impulse-driven conditions, reward pathway, psychiatric treatment, eating disorders, obsessive behaviors, food hoarding

Disciplines

Medicine and Health Sciences | Mental Disorders | Other Mental and Social Health | Other Pharmacy and Pharmaceutical Sciences | Other Psychiatry and Psychology | Psychiatric and Mental Health | Psychiatry

Abstract

Impulse-control disorders, including those related to eating behaviors, are complex conditions with limited pharmacologic treatment options. While naltrexone is primarily used for opioid and alcohol dependence, emerging research suggests it may also be effective in managing a variety of impulse-driven conditions. As a pure opioid antagonist, naltrexone’s mechanism of action involves the inhibition of opioid receptors on dopaminergic neurons involved in the reward pathway of the brain, thereby reducing the reinforcing effects of substances such as alcohol and opioids. Research suggests that through this mechanism of action, naltrexone shows promise in treating impulsive behaviors also driven by the reward pathway, such as binge eating, purging, gambling, kleptomania, and self-injurious behavior, as well as autism spectrum disorder (ASD) and intellectual disability. This case presents a 28-year-old female with a history of intellectual disability, ASD, schizoaffective disorder, bipolar disorder, and posttraumatic stress disorder (PTSD) who displayed binge eating, hoarding, and aggression related to food following years of food restriction and trauma. After the failure of other medications, naltrexone was prescribed and showed a marked reduction in these behaviors. This case highlights naltrexone’s efficacy in treating trauma-associated binge eating and its broader potential in managing impulsivity-related disorders. Ultimately, further research is still needed to determine the proper dosages and duration of treatment and what conditions best indicate the use of naltrexone instead of alternative forms of treatment.

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