title: [Low dose naltrexone in the treatment of dissociative symptoms].
abstract: BACKGROUND
  Following the hypothesis that blocking opioid receptors leads to a decline in opiate-modulated dissociative phenomena, experiences with naltrexone as medication for dissociative symptoms have been gained since 1999 (mainly in doses of 25-100 mg/day).
  
  
  METHODS
  In this study patients with severe trauma-related and dissociative disorders were treated with naltrexone in doses of 2-6 mg/day (0.06 mg/kg body weight).
  
  
  RESULTS
  The low dose treatment with naltrexone proved to be effective whereby 11 out of 15 patients reported immediate positive effects and 7 described a lasting helpful effect. The majority of patients who felt positive effects reported a clearer perception of both their surroundings and their inner life. Assessment of reality and dealing with it improved as did the perception of their own body and affects as well as self-regulation. The treatment was very low in side effects.
  
  
  CONCLUSIONS
  Treatment with low-dose naltrexone may be a helpful element in the treatment of patients with complex posttraumatic stress disorder. However, it has to be realized that the decrease of dissociation may lead patients to a not yet resolvable challenge, in as much as dissociation had previously been a necessary mechanism of self-protection.
authors.affiliation: Rhein-Klinik, Krankenhaus für Psychosomatische Medizin und Psychotherapie, Luisenstr. 3, 53604, Bad Honnef, Deutschland, wiebke.pape@johanneswerk.de.
authors.forename: W
authors.initials: W
authors.lastname: Pape
authors.forename: W
authors.initials: W
authors.lastname: Wöller
mesh_terms: D000328:Adult; D004213:Dissociative Disorders / Q000175:diagnosis* / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D006801:Humans; D008875:Middle Aged; D009271:Naltrexone / Q000008:administration & dosage*; D009292:Narcotic Antagonists / Q000008:administration & dosage; D017060:Patient Satisfaction; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D009292:Narcotic Antagonists; D009271:Naltrexone