RE: LDN and BPD and DID symptoms

[Guest guest]

Dear Ms. Gottardi,

Thank you for sharing some of your history with us.

The question whether opiate antagonists (blockers) may be helpful with

dissociation has not been properly studied. There is a German paper that

uses standard dose NTX, 50 mg with some success:

1. Schmahl, C.; Stiglmayr, C.; Bohme, R., and Bohus, M. [Treatment of

dissociative symptoms in borderline patients with naltrexone]. Nervenarzt.

1999 Mar; 70(3):262-4.

In our lab at Columbia, we have seen short lasting dissociation-like

symptoms with very high dose opiate blockers (naloxone, not NTX).

So it's an open question.

Bottom line, one needs to use any medication at whatever dose carefully and

in collaboration with a competent and caring physician.

In dissociation/PTSD, individual psychotherapy and sometimes group therapy

are key. The talking cure (or at least relief) now has good neurobiological

supporting data (see oxytocin literature). Medications can and should be

used, cautiously, for symptom relief (e.g., nightmares, insomnia, chronic

pain).

Best wishes,

Maurice Preter, M.D.

Psychiatry and Neurology

Assistant Professor of Clinical Psychiatry

Columbia University College of Physicians & Surgeons

1160 Fifth Avenue, Suite 112 NY, NY 10029

+1-212-713-5336 www.psychiatryneurology.com

Maurice Preter, M.D.

Psychiatry and Neurology

Assistant Professor of Clinical Psychiatry

Columbia University College of Physicians & Surgeons

1160 Fifth Avenue, Suite 112 NY, NY 10029

+1-212-713-5336 www.psychiatryneurology.com

LDN and BPD and DID symptoms

Dear DR,

I responded to you via the list but saw I could email you saw I am.

I am 47 years old and have BPD traits that interferre with my daily life.

I am a NUrse so I have a little background in drugs and I have been

searching the net for some answers to my condtion.

Not sure how much info to write here but I will skip to the details.

I am in therapy.. I see a therapist in Toronto, though I live in nJ.

I fly back and forth every month and do phone therapy in between.

I Go there because I have been doing EMDR with her and have had pretyt bad

disscociative symtoms. I am a victim of SA and RA, with bPD traits and left

of center DID.

I ound some studies that had been done by a dr in canada DR Lanius, and he

was getting some good results wih LDN to help contain some of the symtoms of

BPD. I have had some success but I do not have any DR that I can find who

can give me any good info on th stuff as far as use with EMDR and daily use.

Any chance you know something you could share or point me ina good

direction.

I spoke with DR Simeon n NY once but when she found out I was doing LDN she

blew me off never to be heard from again.

This is the short version.. But wanted to see if you could help before I say

more.

By the way, I can't get on your web site.

deb

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[Guest guest]

On second thought, there is (some) more literature:

,_._,___

Reference List

Bohus, M. J.; Landwehrmeyer, G. B.; Stiglmayr, C. E.; Limberger, M. F.; Bohme, R., and Schmahl, C. G. Naltrexone in the treatment of dissociative symptoms in patients with borderline personality disorder: an open-label trial. J Clin Psychiatry. 1999 Sep; 60(9):598-603.

Nuller, Y. L. ; Morozova, M. G.; Kushnir, O. N., and Hamper, N. Effect of naloxone therapy on depersonalization: a pilot study. J Psychopharmacol. 2001 Jun; 15(2):93-5.

Simeon, D. and Knutelska, M. An open trial of naltrexone in the treatment of depersonalization disorder. J Clin Psychopharmacol. 2005 Jun; 25(3):267-70.

My prior caveat applies.... Note this is very high dose NTX.

Best wishes,

Maurice Preter, M.D.

Psychiatry and Neurology

Assistant Professor of Clinical PsychiatryColumbia University College of Physicians & Surgeons

1160 Fifth Avenue, Suite 112 NY, NY 10029

+1-212-713-5336 www.psychiatryneurology.com

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