Children who tend to have fairly normal social responsivity to begin with, are probably less likely to obtain benefits. If undesirably high levels of emotionality or clinginess do emerge, it is necessary to reduce dosage. Hence it typically requires skillful cracking of the tablets to obtain accurate doses. Also it is important to remember that NTX is very bitter, so it must be disguised as much as possible in a favorite tasty food or dissolved in sweet drinks. Some parents find it difficult to use the medicine, since they did not take initial precautions to hide the bitterness in their first few attempts.
Some pharmacists are willing to make a sweetened elixir that is easier to use.
Again, there is no way to know beforehand whether your autistic child will be a responder or whether a specific dose will be optimal. Thus, the only way to find out whether any specific child can be helped by this medication is to give it a try. NTX is a very safe drug with no major side-effects at low doses. At high doses it will reduce appetite, and in some early adult trials for obesity that used VERY high doses, liver toxicity was observed. At least 4 child studies with low doses have never seen any abnormalities.