# new hope: Repetitive Transcranial Magnetic Stimulation



## luctor et emergo (May 22, 2015)

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3968882/

Not easy to read, but for people extensively researching depersonalization, derealization literature like myself, rTMS is a promising method.

Having been on a variety of medications, which have had zero effect, this article gives hope.

Lamotrigine is mentioned as a beneficial medication, when combined with an SSRI showing symptomatic improvement in DPD.

In 2007 I have used 200mg Lamotrigine, which is now known to be an insuffcient dosage, for about 5 to 6 weeks.
I took Lamotrigine in combination with 75mg Citaprolam for about 4 weeks.

Results

In patients with DPD, rTMS to VLPFC led to increased electrodermal capacity, namely maximum skin conductance deflections. Patients but not controls also showed increased SFs post rTMS.

Patients who had either VLPFC or TPJ rTMS showed a similar significant reduction in symptoms. Event-related electrodermal activity did not change.

Conclusions

A single session of right-sided rTMS to VLPFC (but not TPJ) significantly increased physiological arousal capacity supporting our model regarding the relevance of increased VLPFC activity to emotional numbing in DPD. rTMS to both sites led to reduced depersonalization scores but since this was independent of physiological arousal, this may be a non-specific effect. TMS is a potential therapeutic option for DPD; modulation of VLPFC, if replicated, is a plausible mechanism.

Hopefully the clinic I am visiting has the proper instruments to give rMTS. My new doctor is willing to explore every angle in treating my chronic depersonalization, derealization. To be continued...


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## TDX (Jul 12, 2014)

> In 2007 I have used 200mg Lamotrigine, which is now known to be an insuffcient dosage, for about 5 to 6 weeks.
> I took Lamotrigine in combination with 75mg Citaprolam for about 4 weeks.


Then you should try it again and aim for a much higher dosage. The maximum is said to be 600 mg/day, but I've read in epilepsy-forums that some people take up to 1000 mg/day. Alternatively you could try other anticonvulsives like Topiramate, Perampanel and Levetiracetam. Levetiracetam has worked for some people on hppdonline.com. Topiramate and Perampanel make sense from a theoretical point of view.



> Hopefully the clinic I am visiting has the proper instruments to give rMTS. My new doctor is willing to explore every angle in treating my chronic depersonalization, derealization. To be continued...


I am not so optimistic. TMS has been researched as a treatment for various disorders in the previous decades, but there still no disorder where is established.

But if you find someone who is willing to try rTMS you should go for it. You should first try stimulation of VLPFC. TPJ might be good if your symptoms are dominated by disembodiment and loss of agency-feelings. The effects, if present, will most likely be temporary.


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## Guest (Jun 25, 2015)

Kind of agree with TDX, TMS was a study done by Dr. Simeon many years ago, she had insufficient results to say the least. I'm skeptical of it.


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## luctor et emergo (May 22, 2015)

That's why the title has the word hope in it.

The first link refers to a study performed by Sierra.

Do you mean this study? http://www.europsy-journal.com/article/S0924-9338%2813%2976793-2/abstract?cc=y=

Anyway

As someone who has gone through several therapies.

I certainly don't think rTMS is the holy grail.

However, I'm am lucky to have finally found a psychiater who is willing to help,

my wish is that everyone suffering will find the help they need. :smile:


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## TDX (Jul 12, 2014)

I am not aware that Simeon ever conducted a study about TMS. The only studies up to now are the one of Montovani et al and Jay et al which had somewhat promising results.


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