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Naltrexone as a treatment of self-injurious behavior--a case report
H Griengl1, A Sendera, K Dantendorfer
1Department of Psychiatry, University Hospital, Vienna, Austria.
Objective:
Self-injurious (SIB) is a phenomenon associated with different psychopathological conditions such as psychosis, mental retardation and especially severe personality disorders--mainly of the borderline subtype. It has been suggested that a blockade of the endogenous opoid system might lead to a reduction of the urge to SIB.
Method:
The case and successful treatment of SIB with naltrexone in a patient with borderline personality disorder and dysthymia is described.
Results:
After treatment trials with neuroleptics, antidepressants and valproate the patient was treated with naltrexone in a dosis of 50 mg/day and did not show SIB over a follow-up period of 32 weeks.
Conclusion:
Naltrexone could be effective in reducing SIB in patients with psychiatric disorders by blocking the positive reinforcement of SIB, which is released by the release of endogenous opoides. Placebo-controlled studies of the efficacy of naltrexone in treating SIB should be undertaken.
