Naltrexone for Self-Injury in Borderline Personality With Venlafaxine-Associated Hyponatremia

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To the Editors
Inpatients with borderline personality disorder (BPD) who frequently mutilate themselves are more likely to use psychiatric services and at particularly high risk for suicidal behavior.1 Literature has demonstrated use and tolerability of the opioid antagonist naltrexone as pharmacotherapy for self-injurious behaviors in adults including patients with BPD.2,3
Hyponatremia, defined as a serum sodium level of less than135 mmol/L, is the most frequently encountered electrolyte disorder in clinical practice and can be caused by medication use, leading to a spectrum of symptoms ranging from subclinical to those of more neuropsychiatric concern (confusion, lethargy, seizures, and coma).4 The presented case reports use of naltrexone for self-injury in a case of BPD with venlafaxine-associated hyponatremia.
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