In reference to our Occupational Therapist (OT) discussion on a thread in the WC, I looked at the article you linked about naltrexone. This could be contributing to our problems. difficult child's violence appears to be impulsive and is definitely explosive and not in proportion to whatever made him mad. I'm wondering if maybe naltrexone could be triggering that - like AD's and stims can trigger mania in a person with BiPolar (BP). We could have missed it as a cause because the previous higher dose of depakote can/did also cause aggression. We took the depkote out of the mix, but it never occurred to me that the naltrexone that had just been added could be contributing, too. Thanks for bringing this up and posting that link!! Yes- it does block endorphins. I was told that difficult child was getting this medication added to block endorphins so he would quit cutting.