The Potential Role of Naltrexone in Borderline Personality Disorder
Abstract
Objective: Management of borderline personality disorder (BPD) is a difficult challenge due to the complex features of
this disorder. This article reviews the use of naltrexone in the treatment of BPD.
Methods: Published articles and clinical trials were searched in Google Scholar, MedLine, ELSEVIER, and Cochrane
database of systematic reviews abstracts in English language between 1990 and 2017.
Results: Naltrexone (NTX), a nonspecific competitive opiate antagonist, has been noted to be helpful in controlling selfinjurious behavior (SIB) and dissociative symptoms in patients with BPD.
Conclusions: Further studies should be conducted on the effects of naltrexone to confirm the role of this medication in
the treatment of BPD.
Angstman KB, Rasmussen NH. Personality disorders: review and clinical application in daily practice. Am fam physician 2011;84:1253-1260
Grant BF, Chou SP, Goldstein RB, Huang B, Stinson FS, Saha TD, Smith SM, Dawson DA, Pulay AJ, Pickering RP, Ruan WJ. Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 2008;69:533-545.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. Arlington: American Psychiatric Association; 2013.
Prossin AR LT, Koeppe RA, Zubieta JK, Silk KR. Dydregulation of regionl endogenouse opioid function in borderline personality disorder. Am J Psychiatry 2010;167:925-933.
Dell’Osso B, Berlin H, Serati M, Altamura AC. Neuropsychobiological aspects, comorbidity patterns and dimensional models in borderline personality disorder. Neuropsychobiology 2010;61:169-179.
Thürauf NJ, Washeim HA. The effects of exogenous analgesia in a patient with borderline personality disorder (BPD) and severe self‐injurious behaviour. Eur J Pain 2000;4:107-109.
Saper JR. Borderline personality, opioids, and naltroxone. Headache 2000;40:765.
Bandelow B, Schmahl C, Falkai P, Wedekind D. Borderline personality disorder: a dysregulation of the endogenous opioid system? Psychol Rev 2010;117:623-636.
Soloff PH. Pharmacological therapies in borderline personality disorder. In: Paris J (ed). Borderline personality disorder: Etiology and treatment. Washington, DC: American Psychiatric press; 1993.
Roy A, Roy M, Deb S, Unwin G, Roy A. Are opioid antagonists effective in reducing self-injury in adults with intellectual disability? A systematic review. J Intellect Disabil Res 2015; 59: 55-67.
Milne GM,Johnson MR. "Narcotic Antagonists and Analgesics." Annual Reports in Medicinal Chemistry 1976,11: 23-32.
Modesto-Lowe V, Van Kirk J. Clinical uses of naltrexone: A review of the evidence. Exp Clin Psychopharmacol 2002;10: 213.
Tate BG, Baroff GS. Aversive control of self-injurious behavior in a psychotic boy. Behav Res Ther 1966; 4: 281-287.
Lovaas OI, Smith T. Intensive and long-term treatments for clients with destructive behaviors. In: Thompson T & Gray D (Eds). Treatment of destructive disabilities. Newbury Park, CA: Sage;1994.
Gualtieri CT, Schroeder SR. Pharmacotherapy for self-injurious behavior: preliminary tests of the D1 hypothesis. Psychopharmacol Bull 1989; 25: 364-371.
Thompson T, Symons F, Delaney D, England C. Self‐injurious behavior as endogenous neurochemical self‐administration. Ment Retard Dev Disabil Res Rev 1995;1:137-148.
McGee MD. Cessation of self-mutilation in a patient with borderline personality disorder treated with naltrexone. J Clin Psychiatry 1997; 58: 32-33.
Buzan RD,Thomas M, Dubovsky SL, Treadway J. The use of opiate antagonists for recurrent self-injurious behavior. J Neuropsychiatry Clin Neurosci 1995;7:437–444.
Kars H, Broekema W, Glaudemans-van Gelderen I, Verhoeven WMA, Van Ree JM. Naltrexone attenuates self-injurious behavior in mentally retarded subjects. Biol Psychiatry 1990; 27: 741-746.
Casner JA, Weinheimer B, Gualtieri CT. Naltrexone and self-injurious behavior: a retrospective population study. J Clin Psychopharmacol 1996;16: 389-394.
Griengl H, Sendera A, Dantendorfer K. Naltrexone as a treatment of self‐injurious behavior—a case report. Acta Psychiatr Scand 2001; 103: 234-236.
Stiglmayr CE, Ebner‐Priemer UW, Bretz J, Behm R, Mohse M, Lammers CH, Anghelescu IG, Schmahl C, Schlotz W, Kleindienst N, Bohus M. Dissociative symptoms are positively related to stress in borderline personality disorder. Acta Psychiatr Scand 2008;117:139-147.
Schmahl C, Kleindienst N, Limberger M, Ludäscher P, Mauchnik J, Deibler P, et al. Evaluation of naltrexone for dissociative symptoms in borderline personality disorder. International clinical psychopharmacology 2012; 27: 61-68.
Hoairbanks J, Fallon B, lein Dllander E, Liebowitz, Decaria C. Treatment of Depersonalization with Serotonin: Reuptake Blockers. J Clin Psychopharmacol 1990;10: 200-202.
Pitman RK, van der Kolk BA, Orr SP, Greenberg MS. Naloxone-reversible analgesic response to combat-related stimuli in posttraumatic stress disorder: a pilot study. Arch Gen Psychiatry 1990; 47: 541-554.
Nuller YL, Morozova MG, Kushnir ON, Hamper N. Effect of naloxone therapy on depersonalization: a pilot study. J Psychopharmacol 2001;15: 93-95.
Simeon D, Knutelska M. An open trial of naltrexone in the treatment of depersonalization disorder. J Clin Psychopharmacol 2005;25:267-270.
Bohus MJ, Landwehrmeyer GB, Stiglmayr CE, Limberger MF, Bohme R, Schmahl CG Naltrexone in the treatment of dissociative symptoms in patients with borderline personality disorder: an open-label trial. J Clin Psychiatry 1999; 60: 598–603.
Kleindienst N, Bohus M, Ludäscher P, Limberger MF, Kuenkele K, Ebner-Priemer UW, et al. Motives for nonsuicidal self-injury among women with borderline personality disorder. J Nerv Ment Dis2008;196: 230-236
Schmahl C, Bohus M. Translational research issues in dissociation. In: Vermetten E, Dorahy MJ, Spiegel D (Eds). Traumatic Dissociation. Neurobiology and Treatment. London: American Psychiatric press; 2007.
Aman MG. Pharmacotherapy in the developmental disabilites: New developments. J Intellect Dev Disabil 1991;17:183-199.
Thompson T, Hackenberg T, Cerutti D, Baker DT, Axtell S. Opioid antagonist effects on self-injury in adults with mental retardation: Response form and location as determinants of medication effects. Am J Ment Retard 1994; 99:85-102.
Herman BH. A possible role of proopiomelanocortin peptides in self-injurious behavior. Prog Neuropsychopharmacol Biol Psychiatry 1990;14: S109-139.
Crews WD, Bonaventura S, Rowe FB, Bonsie D. Cessation of long-term naltrexone therapy and self-injury: A case study. Res Dev Disabil 1993; 14: 331-340.
Zingarelli G, Ellman G, Hom A, Wymore M, Heidorn S, Chicz-DeMet A. Clinical effects of naltrexone on autistic behavior. American journal of mental retardation: AJMR 1992; 97: 57-63.
Campbell M, Anderson LT, Small AM, Adams P, Gonzalez NM, Ernst M. Naltrexone in autistic children: behavioral symptoms and attentionallearning. J Am Acad Child Adolesc Psychiatry 1993; 32: 1283-1291.
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Issue | Vol 12 No 2 (2017) | |
Section | Short Communication(s) | |
Keywords | ||
Borderline Personality Disorder Naltrexone Self-Injurious Behavior Dissociative Symptoms Psychiatry and Psychology Category |
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