Treatment of borderline personality disorder with opioid antagonists: buprenorphine, nalmefene, naloxone and naltrexone in the treatment of dissociative symptoms, self-mutilation and suicidal behavior

Abstract

Objective: Recenttheory has proposed that a dysfunction of the opioid system modulates mood, reward and pain; seems to be unstable
in people with Borderline Personality Disorder.
Our purpose is analyze the evidence on the efficacy of the use of buprenorphine, nalmefene, naloxone and naltrexone, in the treatment of dissociative symptoms, self-mutilation and suicidal behavior of these patients. Method: We conducted a systematic search of MEDLINE and LILACS databases, to retriever elevant articles. Included studies were experimental and observational design of borderline personality samples in which dissociative symptoms, selfmutilation or suicidal behaviour was reported as an outcome and evaluated with some measure of impact. Results: A total of 8 studies were reviewed. These provided interesting expectations about posible treatment lines in Borderline Personality Disorder using opioid antagonists.
The subgroup most benefited was the one who has analgesia and highest number of diagnostic criteria. Conclusions: Studies of higher methodological quality are needed, in larger population samples and using control of confounding variables that allow us to estimate a value power calculation, and thus be able to support firm conclusions.