Naloxone in the treatment of acute dissociative states in female patients with borderline personality disorder

Pharmacopsychiatry. 2004 Sep;37(5):196-9. doi: 10.1055/s-2004-827243.

Abstract

Background: Acute dissociative states are common in patients with borderline personality disorder (BPD). However, there are no established pharmacotherapeutic treatment options for this severe clinical condition.

Methods: The effect of 0.4 mg naloxone administered intravenously in acute dissociative states was examined as compared to placebo in a double-blind crossover study in nine patients who met DSM-IV-criteria for BPD. Dissociative symptoms before and 15 min after a single dose of naloxone or saline placebo were assessed using a self-rating instrument for dissociation and aversive inner tension (DSS) and the observer-based items of the Clinician Administered Dissociative States Scale (CADSS).

Results: Dissociative symptoms before treatment with naloxone or saline placebo were moderate to severe. After injection of either naloxone or placebo, dissociative symptoms significantly decreased on the DSS (p < 0.01) and the CADSS (p < 0.05). However, there were no significant differences between naloxone and placebo in the reduction of symptoms. Patients who showed the most prominent response to naloxone fulfilled the highest number of DSM-IV-criteria for BPD.

Conclusions: Although it is difficult to draw definite conclusions from this small sample of patients, this study does not support the assumption that naloxone in a single dose of 0.4 mg is superior to placebo in acute dissociative states in patients with BPD. Further studies will investigate whether patients benefit from naloxone in a higher dose or whether subgroups of patients with BPD profit from naloxone in acute dissociative states.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Acute Disease
  • Adult
  • Borderline Personality Disorder / complications*
  • Borderline Personality Disorder / diagnosis
  • Cross-Over Studies
  • Diagnostic and Statistical Manual of Mental Disorders
  • Dissociative Disorders / complications*
  • Dissociative Disorders / diagnosis
  • Dissociative Disorders / drug therapy*
  • Double-Blind Method
  • Female
  • Humans
  • Injections, Intravenous
  • Naloxone / administration & dosage
  • Naloxone / therapeutic use*
  • Narcotic Antagonists / administration & dosage
  • Narcotic Antagonists / therapeutic use*
  • Severity of Illness Index

Substances

  • Narcotic Antagonists
  • Naloxone