Self-mutilation and pharmacotherapy

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.