Rw. Pies et Ap. Popli, SELF-INJURIOUS-BEHAVIOR - PATHOPHYSIOLOGY AND IMPLICATIONS FOR TREATMENT, The Journal of clinical psychiatry, 56(12), 1995, pp. 580-588
Background: Self-injurious behavior (SIE) is a common clinical problem
that affects a diverse group of patients and populations, Little is k
nown about the underlying pathophysiology and pharmacologic treatment
of SIE. Method: The authors selectively reviewed the clinical literatu
re on SIE and related aggressive/impulsive behaviors, with the aim of
formulating provisional guidelines far pharmacotherapy. Results: The s
erotonergic system is most directly implicated in the pathophysiology
of SIE and related behaviors. While there is no well-established ''dru
g of choice'' for SIE, the identification of specific subgroups of SIE
patients and associated symptoms such as psychosis permits the ration
al selection of medication, Serotonin selective reuptake inhibitors, o
ther serotonergic agents, antipsychotics, beta-blockers, and opiate an
tagonists all play a role in the treatment of SIE. Conclusion: SIE is
not a single entity and may have different pharmacologic treatments, d
epending on the associated symptoms and target population. Medications
that act on the serotonergic system appear to be the most promising.