# med timeline



## Guest (Nov 22, 2004)

Relatively new to the site - glad I found you guys. Had been googling Dissociative disorders for a couple years and couldn't find anything productive. Finally found the word Depersonalization and Voila - That's Me!!!! A name to my silent horrible poisonous cocoon. Here is my med history. Sorry - I tend to be verbose.

8th grade - Tried Proxac - bounced off the wall, didn't sleep, no sleep, more dped, increased panic and anxiety

College - Another bout of panic and anxiety - had DP all along but had kind of blocked it out and operated with my new reality for some time - Tried Zoloft when Panic/anxiety increased DP/DR- again, insomnia, bounced off the walls, sexual disfunction (not impodence but took me a while). Got off after 1-2 weeks (the drug that is - hehehe)

After college - Age - 21 - Panic and Anxiety quagmire - tried Paxil. Bounced off the walls so much that I actually jumbped rope and shadow boxed for two hours after taking my first pill. Couldn't sleep - on top of anxiety now became insomniac which fed the fear cycle and led to lowest depression yet. Only lasted 3 days on this crap. Suspect these drugs induce some form of mania in me although I've never displayed Manic Depressive symptoms and have cross checked with shrink to make sure I don't have it. I'm kind of a wired anxious person though - does that mean SRI/SSRI's won't work for me ever?

Present day 31 years old - had health issues - IBS, Palps, sleeplessness that prevented me my best medicine - exercise. At this point I had to stop drinking - my other medication, because of the health problems. This lead me into the pit of depair and after having unburied my root DP/DR, I'm now taking another swing at the meds. I'm on Xanax XR which seemed initially to help alot with the sleep but doesn't seem to be working as well anymore (I guess because I'm building up a tolerance). Started taking Lamictal - got to 25mg. but had to stop because of Shortness of Breath. I plan on exercising and getting a bit healthier and then trying the lamictal again with potentially an extremely low dose of a newer SSRi (that's what Kings College in London recommends - Lamictal +SSRI). I'm doubtful but hopeful. Does anyone know of the least activating of all the SSRI's - ie Has anyone gotten hyper with most SRI/SSRI's but found one that didn't have the same response to others? I'm fearful of these drugs for obvious reasons listed above. Thanks for any feedback!!!  :wink: :wink:


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## David (Nov 23, 2004)

Hi there,

I went to see Mauricio Sierra-Siegert at the DP research unit at Kings College. Really good to talk with someone that actually knows about DP rather then the legions of psychiatrists and psychologists that I've seen who don't really know what they're talking about.

I just started taking lamotrigine at the beginning of October and have had no problems so far. I'm increasing the dose gradually and up to 125mg now. Will be up to final dose of 400mg by start of February. I was already on Prozac (20mg), which was handy as they have seen the best results with a combination of Prozac and lamotrigine. (Interestingly, their research shows that Prozac on its own has no effect on DP - so I was wasting my time these past seven years!).

I feel really lucky to have got in to the DRU - but I had to push for it. I had been OK for a while and had been off the Prozac for over a year but then things started to get much worse (caused by moving house and moving in with my boyfriend I think) and it was really hard to cope. Saw a psychiatrist who put me back on Prozac and this led to another psychologist assessment. I did some web research and found the DRU and said I wanted a referral but she hadn't heard of them - I even had to give her the phone number. Anyway, hopefully things will work out in the end.

I also took part in some research they are doing at the DRU, which involved spending an hour in a brain scanner while they showed me a bunch of pictures of nasty stuff (murder victims etc), pleasant stuff and neutral stuff to gauge how emotionally distant I was from things. One of the stranger experiences of my life! I'm going back when the lamotrigine has kicked in to see if there's any difference.

David


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## Guest (Nov 23, 2004)

Hi,

So did you noticed any difference for now with Lamictal? Because it seems that all people taking it doesn't notice much difference in derealization. And I have read about the website of Lamictal..... is there a big rash possibility? Di dyou notice a side effects on concentration, memory, panick etc.?

Thanks

Cynthia xxx


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## David (Nov 23, 2004)

No difference as yet in my DP, but I'm only up to 125mg compared with final dose of 400mg. It takes a while to build up to the right level in the body - much like Prozac. No side effects either. The rash problem is very rare - at the DP research unit they said they had never come across it in all their trials.

As for effect it might have, I think the problem is that many people have taken the lamotrigine on its own, which is pretty ineffective. Taking it in combination with Prozac or another SSRI makes it much more effective.

The DP research unit study shows that, for just over half of the participants, lamotrigine combined with an SSRI proved to be of great or significant benefit in reducing the symptoms of DP.

David


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## Guest (Nov 23, 2004)

Hi,

Do you think they can write (email) to people? Because I am in Canada and very troubled by my DP/DR obsessions, and panick, and depression.

I just wonder if they can write to us.

Thanks

Cynthia xxx


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## David (Nov 23, 2004)

I don't know - they are a research unit based in the UK so I wouldn't have thought so. There is a weblink in the links section in this forum so you can contact them via that. Alternatively you could mention their research to your doctor or psychiatrist and they could look into it


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## Guest (Nov 24, 2004)

Yeah - I've gotten most of my research from Kings COllege. I do wish that another hospital could back up their findings. I know Mt. Sinai Hospital in NYC had a research group going on DP/DR albeit a less focused group. Hopefully they could run a similar Lamictal/SSRI combo and measure its effectiveness. My problem is that I'm in a conundrum. I have DP/DR and I'm sensitive to SSRI's/SRI's therefore it will be hard for me to take Lamictal and and SSRI without having bad side-effects.

One other questions for David - can you ask your contact at the research unit whether I should start both drugs at the same time or is it ok to start one before the other. What are the potential risks for starting Lamictal on its own? Any help/advice is appreciated.


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## Guest (Nov 24, 2004)

Me too,

I am interested in Lamictal, but I have read - too much - and saw that 1/10 cases there is a mild rash. Is it true? Not a fatal one, but kind of like a sunburn.

I wonder too if I could try it, but I am VERY sensitive to meds. I will try Anafranil or go back to a SSRI soon.

Thanks,

Cynthia xxx


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## David (Nov 23, 2004)

Hi both,

At the bottom of this post is an abstract of research they have done which shows that lamotrigine on its own is not effective but when combined with an SSRI it is effective. A study has also found that an SSRI on its own is not effective for DP.

They have also had results with clonazepam, I believe in combination with an SSRI.

Regarding whether to start one or both at the same time I was already on Prozac at the time I started lamotrigine. There should be no problems starting lamotrigine on its own - many people have done so.

It does seem to have a limited effect, though the research below is contradictory. In the double blind trial (which in theory should be more accurate) the effect wasn't great but in the open trials results were 'encouraging'. If you are particularly sensitive to SSRIs might be worth starting lamotrigine on its own. You don't need a high dose of Prozac though - I am only on the standard 20mg (well, actually 5ml which is the liquid equivalent as I am crap at taking pills!).

I've had no problems with a rash and, as far as I know, this is not a big problem at all. Even if you do get a rash it's probably worth it for the supposed effects on DP.

Hope this helps

David

Research extract from DP research unit website:

Lamotrigine as sole agent was not found to be effective in a previous double-blind randomised crossover trial although open trials were encouraging. We carried out an open label trial of lamotrigine in patients with DPD seen in a specialist clinic. The majority were also receiving other medications, mostly selective serotonin re-uptake inhibitors. 32 patients agreed to participate and had complete follow-up data. 16 (50%) showed a significant improvement (mean 40%) in their depersonalisation symptoms, as rated by standard and novel scales, assessed 16.6 months after commencing treatment. Concomitant symptoms of depression also showed improvement but this did not account for the specific effect on DPD. There were no serious adverse effects. The results of this trial suggest that a significant number of patients suffering from DPD may respond to lamotrigine, particularly when combined with antidepressant medication.


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## Guest (Nov 29, 2004)

David - thank you very much for sharing such good information with all of us.

For Cynthia - The rash part scared me too but I looked up the drug stats. - only 1 in 1000 developed severe rashes. They can be fatal rashes (Steven Johnson's syndrome) but knowing about the rashes is the majority of the battle. Typically by stopping or lowering the dose, the rash goes away. Just be sure to report any rashes to your shrink immediately. The people that get into trouble are the ones that don't take immediate action.

Good luck - I too share in your pill phobia - I dealt with Anxiety, Depression and of course DP/DR for 10 years without any pills. Only Booze - which has much worse side effects when you think about it (more depression, liver problems, laziness, headaches, poorer sleep quality etc..). I'm tentatively and cautiously approaching meds and take them only sparingly. I'm hopeful that this Lamictal + SSRI combo will help me. Lets keep this thread going and keep giving each other updates.


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## David (Nov 23, 2004)

I know what you mean about limiting the pills - though I think if anything can help you it's worth giving it a go.

Check out the thread Gimpy's WMDs in this section and my response- maybe it was a bit harsh but I think some people do wear their meds as a badge of how ill they are. Brings to mind a theme raised in Prozac Nation about how Elizabeth's depression defined her and when she got betters she wondered if she was 'interesting' anymore.

David


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## Guest (Nov 30, 2004)

I've checked the post out - you're right some do wear as a badge of honor. I think your point is clear. But perhaps some are looking for empathy as well when describing their sojourns with meds. Some of the people posting may have been trying meds for much longer than us so their frustration levels have grown as their lists have. Also Psychiatrists can be as much to blame as patients for overprescribing. You have to be well researched and strong of will to deal with shrinks. They often think they know everything but really they only know a fraction of what we know because we have been our own test subjects. That's why its so important for people to find a well respected Psychiatrist as the absolute most critical step. Also critical is that doctors ability to bring out all of the information from the patient. Most of us are communicators but some don't have the blessings to impose their wills on doctors. Just food for thought


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## David (Nov 23, 2004)

Yeah, I totally agree. It's been tough enough for me and I am middle class, well educated and eloquent so I can demand what I want - and I have had to. To get a referral to the DP research unit I had to really push and even give the psychologist their contact details! It also helps that I now live in London rather than some out of the way place.

David


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## Guest (Nov 30, 2004)

Lucky you to live in London!!!

Anyway I will try to show it (trials) to my psychiatrist.

See ya!

Cynthia xxx


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## Guest (Dec 2, 2004)

You lucky SOB - I'm in Washington DC!!!


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