Naltrexone as a treatment of self-injurious behavior - a case report

Objective: Self-injurious behavior (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 opioid system might lead to a reduction of the urge to SIE. Method: The case and successful treatment of SIE 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 SIE over a follow-up period of 32 weeks. Conclusion: Naltrexone could be effective in reducing SIE in patients with psychiatric disorders by blocking the positive reinforcement of SIE, which is reached by the release of endogenous opioides. Placebo-controlled studies of the efficacy of naltrexone in treating SIE should be undertaken.