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Efficacy of naltrexone in borderline personality disorder, a retrospective analysis in inpatients
Author(s) -
Timäus Charles,
Meiser Miriam,
Wiltfang Jens,
Bandelow Borwin,
Wedekind Dirk
Publication year - 2021
Publication title -
human psychopharmacology: clinical and experimental
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.461
H-Index - 78
eISSN - 1099-1077
pISSN - 0885-6222
DOI - 10.1002/hup.2800
Subject(s) - naltrexone , borderline personality disorder , medicine , odds ratio , opioid , endogenous opioid , opioid antagonist , logistic regression , retrospective cohort study , nalmefene , psychiatry , (+) naloxone , receptor
Objective The endogenous opioid system is assumed to be involved in the pathophysiology of borderline personality disorder (BPD), and opioid antagonists may improve core features of BPD. The aim of this retrospective chart analysis was to evaluate the relative contribution of the opioid antagonist naltrexone and other psychotropic drugs in the improvement of overall symptomatology in BPD. Methods One hundred sixty‐one inpatients with BPD treated between January 2010 and October 2013 were classified as either treatment responders or non‐responders. Treatment responders were defined as subjects with significant improvements in four or more symptoms from a defined symptom list. The relative contribution of all psychotropic drugs to improvement of BPD symptomatology was assessed by means of a stepwise logistic regression. Results None of the drugs applied contributed significantly to improvement, with the exception of naltrexone (odds ratio [OR] 43.2, p ≤ 0.0001). Patients treated with naltrexone ( N = 55, 34%) recovered significantly more often. Higher doses of naltrexone were more effective (OR 791.8, p ≤ 0.0001) than lower doses (OR 26.6, p ≤ 0.0001); however, even low‐dose treatment was better than any other pharmacological treatment. Conclusions Naltrexone was associated with improvement in BPD in a dose‐dependent manner. The present study provides additional evidence that dysregulation of the endogenous opioid system is implicated in the pathophysiology of BPD symptoms.