Why Am I On Naltrexone?

QUESTION:

Dear Dr. Heller,

I have just recently been diagnosed with major depression and BPD.  I am on many medications, one of which is naltrexone.  My psychiatrist told me this was to decrease my impulsivity and to prevent my body from producing endorphins when I cut myself.

Well, I have been on it for a few months now, and it has done neither, yet my doctor wants me to stay on the medications.  I am not very familiar with this medicine.  The only other action I know that it has is an opioid antagonist.  Is there any other reason related to BPD for my doctor would want me to stay on naltrexone?

ANSWER:

Naltrexone (ReVia and Narcan) has been shown to stop flashbacks in some patients with BPD.  These flashbacks cause severe dysphoria (anxiety, rage, depression and despair) - which is often "treated" with cutting.  I have limited experience with it, but I have seen some dramatic positive effects.