Brian Daniel Smith1. 1. Dr. Smith is from the Department of Psychiatry, Michigan State University, East Lansing, Michigan.
Abstract
OBJECTIVE: To critically review clinical reports on the pharmacotherapy of self-mutilation. METHODS: PubMed search and review of articles dating back to 1950 contributing to the understanding of self-mutilation and its treatment, with a special focus on pharmacotherapy. Key word searches include self-mutilation, deliberate self-harm, and pharmacotherapy of borderline personality disorder. RESULTS: Clinical reports specifically demonstrating reductions in self-mutilation mainly consist of open studies and case reports. These reports support the use of SSRIs, naltrexone, atypical antipsychotics, mood stabilizers, and clonidine in the treatment of self-mutilation. Better constructed studies demonstrate general reductions in impulsive aggression, often in the context of borderline personality disorder, through treatment with antidepressants, antipsychotics, and mood stabilizers. CONCLUSION: There is evidence, albeit limited, for the pharmacologic management of self-mutilation. Further studies, especially double-blind, placebo-controlled trials, are needed to substantiate these preliminary findings.
OBJECTIVE: To critically review clinical reports on the pharmacotherapy of self-mutilation. METHODS: PubMed search and review of articles dating back to 1950 contributing to the understanding of self-mutilation and its treatment, with a special focus on pharmacotherapy. Key word searches include self-mutilation, deliberate self-harm, and pharmacotherapy of borderline personality disorder. RESULTS: Clinical reports specifically demonstrating reductions in self-mutilation mainly consist of open studies and case reports. These reports support the use of SSRIs, naltrexone, atypical antipsychotics, mood stabilizers, and clonidine in the treatment of self-mutilation. Better constructed studies demonstrate general reductions in impulsive aggression, often in the context of borderline personality disorder, through treatment with antidepressants, antipsychotics, and mood stabilizers. CONCLUSION: There is evidence, albeit limited, for the pharmacologic management of self-mutilation. Further studies, especially double-blind, placebo-controlled trials, are needed to substantiate these preliminary findings.
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