# Naltrexone Treatment of Depersonalization Disorder



## Nichole (Feb 22, 2011)

*Naltrexone Treatment of Depersonalization Disorder
*Depersonalization disorder (DPD) is characterized by recurrent dream-like episodes of feeling detached from one's mental processes or body.[sup]1[/sup] Typically, the episodes are egodystonic, with patients recognizing the unreality of their symptoms. Previously considered rare, DPD is now believed to affect approximately 2% of the population, with a course that is usually chronic and continuous. While often accompanied by anxiety, a condition that may respond to anxiolytics, data on the pharmacologic treatment of depersonalization disorder is relatively limited. In fact, DPD is one of the few psychiatric disorders for which no treatment guidelines exist. Two recent controlled medication trials, one with lamotrigine[sup]2[/sup] and the other with fluoxetine,[sup]3[/sup] failed to show efficacy. There is also no demonstrated efficacious psychotherapeutic treatment. As a result, DPD remains one of the few treatment-refractory illnesses in modern psychiatry. Now comes an open-label trial[sup]4[/sup] demonstrating some utility for the opioid antagonist naltrexone in the treatment of DPD.

Fourteen subjects with DPD (12 men and 2 women) 19-51 years of age enrolled in this study. Seven of the fourteen suffered from comorbid Axis I disorders including generalized anxiety disorder (3), social phobia (3), major depressive disorder (2), dysthymia (1), panic disorder (1), obsessive-compulsive disorder (1), and somatoform disorder (1). Concomitant medications included clonazepam (4), fluoxetine (3), citalopram (2), sertraline (1), amitriptyline (1), bupropion (1), and alprazolam (1).

The first seven subjects received naltrexone for 6 weeks at a maximum daily dose of 100 mg/day. Subsequently, the trial was extended in duration and dosing so that the next seven subjects received naltrexone for 10 weeks at a maximum daily dose of 250 mg/day. The mean final naltrexone daily dose across all subjects was 120 mg/day (range: 25-250 mg/day).

At study endpoint, there was, on average, a 30% reduction of symptoms as measured by three valid dissociation scales. On the Clinical Global Impression-Improvement (CGI-I) scale, three subjects were very much improved, one subject was much improved, four subjects were slightly improved, four subjects were unchanged, and one subject was slightly worse. All three of the very much improved subjects, who experienced a ≥70% reduction in symptoms, opted to continue naltrexone after completing the trial. There was no significant correlation between naltrexone dose and CGI-I score at termination.

Five subjects did not complete the entire trial duration, one of whom did not return after the baseline visit and who was therefore excluded from statistical analyses. Of the five noncompleters, two discontinued due to naltrexone-related side effects, one due to increasing depression, and the other two for unspecified reasons (lost to follow-up). Side effects reported by the 14 participants were as follows: sedation/fatigue (n=7), nausea (n=5), depression (n=3), diarrhea (n=1), insomnia (n=1), activation (n=1), tingling (n=1), feeling hot (n=1), and nightmares (n=1).

Opiate antagonists, such as naltrexone, nalmefene, and naloxone, have been reported to reduce dissociation and depersonalization in a few preliminary studies.[sup]5-7[/sup] Naltrexone is a nonspecific opioid antagonist that blocks μ receptors at low doses and other opioid receptors, such as the κ receptors, at higher doses. The κ opioid system has also been implicated in dissociation.[sup]8[/sup] Given the small number of subjects; the absence of a blinded, placebo-controlled group; and the paucity of validated medication treatments for this disabling condition, further studies using naltrexone, as well as other opioid antagonists, in the treatment of DPD are indicated.


----------



## Jayden (Feb 9, 2011)

great...so your saying there is no cure and its dp symptoms for life, thanks


----------



## Nichole (Feb 22, 2011)

no................... not at all. I am saying that there's some medications being tested for depersonalization and it's been proven effective for some people. And I am asking if some people have tried this and how effective it is?

There's also a magnetic process they do for DP.. as well as Benzos, as well as SSRIs, as well as Cognitive Behaviorial Therapy... AND SO ON.


----------



## TheStarter (Oct 19, 2010)

Work on anxiety or post traumatic experiences,
cause DP is only JUST a side effect of anxiety and/or ptsd.. believe me or not, its true.

ps: for the people who claim to have DP for their whole lifes, being born is one of the most (and first) traumatic experience ur brain has ever witnessed... just saying. its a fact.

Greetings,
TheStarter


----------



## Nichole (Feb 22, 2011)

TheStarter said:


> Work on anxiety or post traumatic experiences,
> cause DP is only JUST a side effect of anxiety and/or ptsd.. believe me or not, its true.
> 
> ps: for the people who claim to have DP for their whole lifes, being born is one of the most (and first) traumatic experience ur brain has ever witnessed... just saying. its a fact.
> ...


Actually you're quite right. In my Depersonalization book it states that it is MAINLY caused by Trauma...... such as anxiety/panic/fear which are all connected. Or another reason is if you smoked marijuana, it sometimes has an altering effect.

For me, the Benzo "Ativan/Lorazepam" gets rid of my anxiety and panic making the DP much less noticable... new addition is Lamictal/Lamotrigine which hasnt been in my system very long but seems to be working. I have great faith that my DP will be gone by the summer.

Acceptance = less stress & anxiety... which gives the brain a chance to breathe and heal!


----------



## Jayden (Feb 9, 2011)

Do you have any advice for people who feel they have developed DP first, then developed anxiety after. Because I didnt have anything traumatizing happen to me in my life. I was a bit stressed for my first year of college and then after finals about a month later is when my world felt like it had changed.


----------



## Nichole (Feb 22, 2011)

you most likely unknowingly had anxiety and when the DP develops it only ENHANCES the anxiety, making it unbearable.

For me I went from NORMAL (unknowingly slightly bipolar) who experienced ups and down... nothing too out of the ordinary, some stress and anxiety.. then when I developed DP Anxiety was so bad I felt like I was going into a Coma/Dying AND going Crazy

I would suggest speaking to a doctor. they are the only people who can TRULY help... I do not like medication nor do I ever want to take any EVER. but sometimes in order to live a normal life theyre needed.


----------



## Nichole (Feb 22, 2011)

infinity.possibility said:


> you most likely unknowingly had anxiety and when the DP develops it only ENHANCES the anxiety, making it unbearable.
> 
> For me I went from NORMAL (unknowingly slightly bipolar) who experienced ups and down... nothing too out of the ordinary, some stress and anxiety.. then when I developed DP Anxiety was so bad I felt like I was going into a Coma/Dying AND going Crazy
> 
> I would suggest speaking to a doctor. they are the only people who can TRULY help... I do not like medication nor do I ever want to take any EVER. but sometimes in order to live a normal life theyre needed.


Check this link out, someone already made a thread in regards to this same medication procedure
Naloxone


----------



## shogun (May 15, 2010)

I've been researching the hell out of this for a while.

Just a question, how old is this study and where did you get the link??

From what i read a few months back naltrexone didn't work as good as naloxone, and the naloxone studies were about 10 years old, and it was abandoned cause the only way to take naloxone was through an infusion.

If you're interested in the hypothesis this works with here's some useful links

http://en.wikipedia.org/wiki/Kappa_Opioid_receptor

http://en.wikipedia.org/wiki/Dynorphin

http://www.biopsychiatry.com/stress-dynorphin.htm

http://www.opioids.com/dynorphin/depression.html

Pretty much i think dynorphin is responsible for feelings of DP/DR and blocking it's action on the kappa opiate receptor gets rid of it. Dynorphin is released during times of stress and i looked up dynorphin and cannabis and found this

http://books.google.com.au/books?id=HtGb2wNsgn4C&pg=PA258&lpg=PA258&dq=cannabis+and+dynorphin&source=bl&ots=jlt3rgqUTG&sig=8dGm3AVv1D3-UHYwAOFBeUi7w28&hl=en&ei=qa4tTb--J4-CvgPD_LSrCQ&sa=X&oi=book_result&ct=result&resnum=1&ved=0CB0Q6AEwAA#v=onepage&q=cannabis%20and%20dynorphin&f=false

which would explain why cannabis can cause it.


----------



## ValleyGirl (Nov 10, 2017)

infinity.possibility said:


> *Naltrexone Treatment of Depersonalization Disorder
> *Depersonalization disorder (DPD) is characterized by recurrent dream-like episodes of feeling detached from one's mental processes or body.[sup]1[/sup] Typically, the episodes are egodystonic, with patients recognizing the unreality of their symptoms. Previously considered rare, DPD is now believed to affect approximately 2% of the population, with a course that is usually chronic and continuous. While often accompanied by anxiety, a condition that may respond to anxiolytics, data on the pharmacologic treatment of depersonalization disorder is relatively limited. In fact, DPD is one of the few psychiatric disorders for which no treatment guidelines exist. Two recent controlled medication trials, one with lamotrigine[sup]2[/sup] and the other with fluoxetine,[sup]3[/sup] failed to show efficacy. There is also no demonstrated efficacious psychotherapeutic treatment. As a result, DPD remains one of the few treatment-refractory illnesses in modern psychiatry. Now comes an open-label trial[sup]4[/sup] demonstrating some utility for the opioid antagonist naltrexone in the treatment of DPD.
> 
> Fourteen subjects with DPD (12 men and 2 women) 19-51 years of age enrolled in this study. Seven of the fourteen suffered from comorbid Axis I disorders including generalized anxiety disorder (3), social phobia (3), major depressive disorder (2), dysthymia (1), panic disorder (1), obsessive-compulsive disorder (1), and somatoform disorder (1). Concomitant medications included clonazepam (4), fluoxetine (3), citalopram (2), sertraline (1), amitriptyline (1), bupropion (1), and alprazolam (1).
> ...


Have you seen the study about transcranial magnetic stimulation on the right side of the brain? The study showed that "After 3 weeks of right temporo-parietal junction (TPJ) rTMS, 6/12 patients responded. Five responders received 3 more weeks of right TPJ rTMS showing 68% DPD symptoms improvement. Right TPJ
rTMS was safe and effective"

That, to me, would be a better route to go than the naltrexone. It shows more people responded and great improvement.


----------



## nabber (Feb 13, 2009)

nevermind


----------



## Journey27 (Mar 25, 2011)

infinity.possibility said:


> Actually you're quite right. In my Depersonalization book it states that it is MAINLY caused by Trauma...... such as anxiety/panic/fear which are all connected. Or another reason is if you smoked marijuana, it sometimes has an altering effect.
> 
> For me, the Benzo "Ativan/Lorazepam" gets rid of my anxiety and panic making the DP much less noticable... new addition is Lamictal/Lamotrigine which hasnt been in my system very long but seems to be working. I have great faith that my DP will be gone by the summer.
> 
> Acceptance = less stress & anxiety... which gives the brain a chance to breathe and heal!


I have read that benzos are dangerous and addictive. 
That the study that had been done with Lamictal showed no effectiveness and others that it didn't help.
My shrink was leery about the idea of lithium because the toxicity is so tricky that it has to be constantly monitored. 
HELP! How has anyone on here done with those meds? Or other things that they've had good experiences with,or things that they've had bad experiences with?

I found the sublingual form ( disolves under the tongue) of Naloxone called Suboxone it is actually a combo of naloxone and buprenorphine. Cant find out if this has had success with DP. And not sure how safe it is as its supposed to be for short term use only (to reduce cravings in addicts, induce withdrawal symptoms if they DO shootup)Also, the doctor has to be certified to prescribe it by taking a special 8 hr course. It had also said "compared to methadone" it has a lower risk of abuse, dependence and side effects. Hmmm... uh, that still sounds addictive.
However, I'm getting despert!
I have been spending hours online researching this and am getting very little sleep. I work all day, come home and research between 3 and 6 hours ... which makes the DP and depression worse.

I know that ALL meds will have SOME side effects but despertly trying to find the best one to try.

I have an appointment with my doctor in less than two weeks and would like to know what to ask him I could try.
Since so little is known about DP I'm taking the best of what I find with me.
However everything is so scary! I've already tried Celexa,Lexapro and Prozac all with Abilify. No effect whatsoever on the DP and depression. Was also unable to handle the side effects with any of them, mainly the lethagy and uh.... sexual dysfunction.







That really sucked! 
I was falling asleep at work, so they were out for that reason. Also sex wasnt fun anymore, so I didn't want to because I just felt used. At it's worst there was six week period we didn't at all. My marrigae can't handle that even if I could, which I can't. Even now that's still hit or miss. Hmmm... maybe I'll ask about a female form of Viagra! Haha. No,really. I'm serious!

What has anyone shown ANY IMPROVEMENT ON... what has anyone had REALLY BAD EXPERIENCES WITH, such as addiction/severe withdrawals, really bad side effects, or making the DP/DR worse?


----------



## Guest (Jan 26, 2012)

*Cialis Compare Prices - benefits of cialis generic drugs* 
*canada cialis generic difficulty breathing* 
of dutasteride and tamsulosin has been properly studied in patients with BPH and it was shown high effectiveness and safety profile. Dutasteride helps reduce the size of enlarged prostate gland. Tamsulosin lowers the tone of smooth muscles in the prostate gland, prostatic urethra and urogenital passages. By relaxing smooth muscles, tamsulosin relives the symptoms of obstruction and irritation associated with benign prostatic hyperplasia. Vice president, R&D medicine development leader at Glaxo Smith Klein Anne Phillips shows that is the first time when dutasteride and tamsulosin will be available at one capsule. The drug is contraindicated for use in women and children, as well as patients with hypersensitivity to dutasteride or tamsulosin. is cialis available in generic 
*cheap generic cialis* 
This blog has moved buy generic cialis free 
*viagra for ladies cialis generic* 
п»їhttp://doxycyclinecheap.com nexium and buy doxycycline doxycycline ic doxycycline hyclate 100mg http://amoxilcheap.com/ amoxicillin impetigo bacterial skin infection amoxicillin amoxil amoxicillin mixed with alcohol 
*indian buy generic cialis* 
Fluconazole is usually well-tolerated. In rare cases patients complain on gastrointestinal manifestations: nausea, stomach pain, diarrhea and meteorism. Some patients experienced skin rash, headache. voucher cialis generic drugs


----------

