Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany.
Int Clin Psychopharmacol. 2012 Jan;27(1):61-8. doi: 10.1097/YIC.0b013e32834d0e50.
Data from a pilot study suggest that naltrexone might reduce dissociative symptoms in patients with borderline personality disorder. However, the interpretation of these data is limited by the lack of a control group and by the nonblind nature of this study. Hence, we examined the effects of naltrexone using a more rigorous design that controlled for major confounders such as spontaneous reduction of dissociation over time and placebo effects. Unmedicated patients with BPD [according to Diagnostic and Statistical Manual of Mental Disorders-IVth edition (DSM-IV)] were included in two small double-blind placebo-controlled randomized trials (total n=29). Patients received both 3 weeks of naltrexone (50 or 200 mg/day) and 3 weeks of placebo in a randomized order. Twenty-five patients completed the study according to protocol. Dissociation under naltrexone and placebo, respectively, was compared by repeated-measures analyses of variance. In either trial, both the intensity and duration of dissociative symptoms were numerically lower under naltrexone than under placebo. However, the effects were too small to reach statistical significance. Our data provide the first estimate of the pure pharmacological antidissociative efficacy of naltrexone from a rigorously designed trial.
一项初步研究的数据表明，纳曲酮可能会降低边缘型人格障碍患者的分离症状。然而，由于缺乏对照组和这项研究的非盲性，这些数据的解释受到限制。因此，我们采用了一种更严格的设计来检验纳曲酮的效果，该设计控制了主要混杂因素，如随着时间的推移分离的自发减少和安慰剂效应。未接受药物治疗的边缘型人格障碍患者（根据《精神障碍诊断与统计手册》第四版（DSM-IV））被纳入两项小型双盲安慰剂对照随机试验（共 29 名患者）。患者以随机顺序接受为期 3 周的纳曲酮（50 或 200 毫克/天）和 3 周的安慰剂治疗。25 名患者按照方案完成了研究。通过重复测量方差分析比较了纳曲酮和安慰剂下的分离情况。在这两项试验中，纳曲酮下的分离症状强度和持续时间均低于安慰剂下，但这些差异太小，无法达到统计学意义。我们的数据提供了首次从严格设计的试验中估计纳曲酮的纯药理学抗分离作用的估计。
