Griengl H, Sendera A, Dantendorfer K
Department of Psychiatry, University Hospital, Vienna, Austria.
Acta Psychiatr Scand. 2001 Mar;103(3):234-6. doi: 10.1034/j.1600-0447.2001.00087.x.
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.
The case and successful treatment of SIB with naltrexone in a patient with borderline personality disorder and dysthymia is described.
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.
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.
自我伤害行为（SIB）是一种与不同精神病理状况相关的现象，如精神病、智力发育迟缓，尤其是严重人格障碍——主要是边缘型亚型。有人提出，阻断内源性阿片系统可能会减少自我伤害行为的冲动。
描述了一名边缘型人格障碍和心境恶劣患者使用纳曲酮治疗自我伤害行为的病例及成功治疗过程。
在使用抗精神病药物、抗抑郁药物和丙戊酸盐进行治疗试验后，该患者接受了每日50毫克剂量的纳曲酮治疗，在32周的随访期内未出现自我伤害行为。
纳曲酮可能通过阻断由内源性阿片释放所引发的自我伤害行为的正性强化作用，从而有效减少精神疾病患者的自我伤害行为。应当开展关于纳曲酮治疗自我伤害行为疗效的安慰剂对照研究。
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