Antiinflammatories May Attenuate SSRI Effects

A 32-year-old woman with recurrent major depressive disorder, borderline personality disorder, micro-psychotic episodes, and poor impulse control had multiple psychiatric hospitalizations because of dangerous cutting behavior. The self-injurious behavior had not been responsive to multiple pharmacological interventions or to dialectical behavioral therapy. Because it has been shown to reduce impulsive behavior and self-injury in patients with developmental delay, a trial of the opioid antagonist naltrexone (ReVia) was initiated. The patient was treated with 25 mg/day naltrexone, which was increased to 50 mg/day after 1 month, in addition to her regular medications.