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Re: Refractory depression--naltrexone theories?

Posted by Elizabeth on April 14, 1999, at 18:01:47

In reply to Re: Refractory depression--naltrexone theories?, posted by Jim on April 14, 1999, at 7:37:18

> Actually, my unschooled hypothesis is somewhat different, though you're probably right to a certain extent. From what I've seen, however, most clinical efficacy of naltrexone seems to come from the opiate antagonism itself--one of the best supported examples of this might be in self-cutting patients, who are probably literally "addicted" to the endogenous opiates (endorphins) they can produce by hurting themselves.

This jumped out at me because, from having talked to "cutters," I really do get the impression that cutting is addictive for them, that they have "urges" the same way that a substance addict has "cravings." (Maybe other forms of self-injury can be addictive as well, but it's curious how people seem to discover cutting independently *so* often)

A researcher I've spoken to who has some experience using opioids of various sorts for depression says that naltrexone by itself often causes dysphoria. It might be that naltrexone works specifically in the type of cases you list (impulse-control type disorders). (I won't presume to guess why it would cause relief sometimes and dysphoria other times, since I imagine I'd just be proved wrong. :-})




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