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 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 reached by the release of endogenous opioides. Placebo‐controlled studies of the efficacy of naltrexone in treating SIB should be undertaken.