# Off-Label Use of Naltrexone in Pica and Other Compulsive Behaviors: A Report of Two Cases

## TL;DR

This paper reports two cases where naltrexone, an off-label treatment, helped reduce pica symptoms and improve mental health in children with comorbid conditions.

## Contribution

The novel contribution is the successful off-label use of naltrexone for treating pica and related compulsive behaviors in children.

## Key findings

- Naltrexone significantly reduced pica symptoms in both patients.
- Discontinuation of naltrexone led to a resurgence of symptoms, supporting its efficacy.
- Improvements in depression and anxiety were observed alongside reduced pica behaviors.

## Abstract

Pica is known to the medical community as an eating disorder in which individuals may ingest non-food items due to a nutritional deficiency and cause unintentional physical harm to themselves. This article discusses the cases of children with pica in addition to other comorbidities such as trichotillomania, depression, autism, and anxiety. Both patients were trialed on typical first-line treatments to address pica symptoms, including antidepressants, psychotherapy, and neurology consults, which were ineffective in treating pica symptoms. The introduction of naltrexone resulted in significant improvements, including decreased pica symptoms and improvements in depression, anxiety, and overall behaviors. These effects of naltrexone were further bolstered by the effects that occurred when both patients discontinued naltrexone for some time.