# Which Medications have you had success with?



## MiketheAlien

Good Day Everyone,

I know this topic has been discussed at length, but I always like to hear updates, ideas, and new experiences.

For those of you who take medications or supplements, prescription or otherwise, Which of these have you had success with? Have they worked for DPDR or Depression? I'd love to hear some experiences from you all.

Myself, I have been on several different medications, then I was medication free for a few years, and now I am trying out different prescriptions again. I am trying to figure out what to try next and would appreciate some ideas.

For those of you who are anti-med or just believe they do more harm than good, thats fine, I thought that way for a long time during my med-free years, but I would like to give medications another try, so please bare with me. My diet, exercise, and sleep are doing great by the way, I just still feel Depersonalized, Detached, and Depressed.

Anyways, Thanks to anyone who chimes in, I know sometimes these threads fade away into the past but I will try to bump it time to time so others can get some ideas of which medications might provide some relief.

Thanks!


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## MiketheAlien

Possible Pharmaceutical Treatments

1. Benzodiazepines (Klonopin and Ativan etc.)

2. Antidepressants (mainly SSRIs <Lexapro/Celexa> and NRI-types such as Bupropion

3. Anti-convulsive drugs (other than benzodiazepines)-(mainly Lamictal, but also Keppra, Gabapentin, etc.)

4. Antipsychotic drugs (Seroquel and Abilify etc.)

5. ADD drugs (Methylphenidate)

6. Buspar

7. Beta-Blockers (Propranolol etc.)

8. Cushing's Disease drugs/abortion drugs

9. Parkinson's drugs/Restless Leg Drugs

10. Antihistamines (Benadryl)

11. Prednisone

12. Opiates

13. NMDA agonists/partial agonists

14. Nicotinic receptor agaonists

15. 5HT2a inverse agonists

Here are some suggestions from previous threads


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## Guest

First of all I take perphenazine, an antipsychotic, for symptoms other than Depersonalization.

Now, I have been on a handful of meds. I've taken abilify, seroquel, respirdal, lexapro and tried a GABA supplement. All of those made my delusions and hallucinations worse.

For anxiety I have taken Klonopin. It helped a lot. But I had an insight into the anxiety I felt. I realized anxiety is rooted in racing thought patterns and introspective loops. All the extra brain activity needed a fuel source, which of course is blood supply to the head. So I started taking aspirin 81mg twice a day. Aspirin, being a blood thinner, equalizes the circulation of blood evenly balancing it throughout the body. Thus the racing anxious thoughts lost their fuel and dissipated like a fever would. After a few months I didnt need to take it regularly anymore. And I became anxiety free after years of having anxiety even prior to dp/dr. Now I take it as needed which is maybe one 81mg every other week.

I also had depression prior to dp. I have found from experience that a daily multivitamin improves my mood more than any other supplement or medication for depression. Also drinking good clean water throughout everyday gives me a good natural body high. Junk food and soda is like dumping wood on a fire as far as depression goes.

Good thread.


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## MiketheAlien

ThoughtsOnFrost said:


> First of all I take perphenazine, an antipsychotic, for symptoms other than Depersonalization.
> 
> Now, I have been on a handful of meds. I've taken abilify, seroquel, respirdal, lexapro and tried a GABA supplement. All of those made my delusions and hallucinations worse.
> 
> For anxiety I have taken Klonopin. It helped a lot. But I had an insight into the anxiety I felt. I realized anxiety is rooted in racing thought patterns and introspective loops. All the extra brain activity needed a fuel source, which of course is blood supply to the head. So I started taking aspirin 81mg twice a day. Aspirin, being a blood thinner, equalizes the circulation of blood evenly balancing it throughout the body. Thus the racing anxious thoughts lost their fuel and dissipated like a fever would. After a few months I didnt need to take it regularly anymore. And I became anxiety free after years of having anxiety even prior to dp/dr. Now I take it as needed which is maybe one 81mg every other week.
> 
> I also had depression prior to dp. I have found from experience that a daily multivitamin improves my mood more than any other supplement or medication for depression. Also drinking good clean water throughout everyday gives me a good natural body high. Junk food and soda is like dumping wood on a fire as far as depression goes.
> 
> Good thread.


I stumbled upon using Aspirin and Coffee making me feel slightly better and less depressed in the morning one day. I have read about inflammation being related to Depression in some theories and NSAIDs being studied regarding Depression. Maybe I should start taking a low dose aspirin once in a while with my morning Tea(dont drink coffee anymore).

I wholeheartedly agree with the staying hydrated and staying away from junk food. The best habits I ever started in the 6 years of DP/Depression/MI have been to drink lots of water each day and stick to a healthy diet, alongside exercise and routine sleep as best I can.

I used to have extreme anxiety and panic attacks when my DP/DR first started. All those years ago, Benzos and SSRIs helped, Now I am free of those ailments but I still feel Numb. Anhedonia and Detached.

Thanks for the replys!


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## TDX

> Anti-convulsive drugs (other than benzodiazepines)-(mainly Lamictal, but also Keppra, Gabapentin, etc.)


I think Topiramate (kainat/AMPA-Antagonist) or Perampanel (AMPA-Antagonist) could be worth a try, because if overstimulation of postsynaptic non-NMDA-receptors causes depersonalization, both of them might work. Lamotrigine adresses this problem by inhibiting presynaptic glutamate release.

There is some speculation that depersonalization generally might be related to some sort of imbalance between the activation of NMDA and AMPA-receptors:

http://www.sciencedirect.com/science/article/pii/S0306987711002994

According to the author such an imbalance could be present, even if the speed of glutamate release is normal, for example by increased non-NMDA-receptor sensitivity. In this case Topiramate or Perampanel might work, while Lamotrigine would not.



> 12. Opiates


http://de.slideshare.net/FaridShagiakhmetov/aktualnost-kor-35665064



> 13. NMDA agonists/partial agonists


In the Ketamine-Model this did not work:

http://www.nature.com/npp/journal/v37/n4/abs/npp2011295a.html


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## 35467

I have tried Topimate for 12.weeks in a dose up 250.mg -no effect


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## TDX

> I have tried Topimate for 12.weeks in a dose up 250.mg -no effect


I would like to try it, but unfortunately the psychiatrists in germany are not very cooperative. But I think that the chances are higher, that they prescribe this, than nalmefene.

At least here there was a case, where it seemed to work:

http://www.dpselfhelp.com/forum/index.php?/topic/1851-topamax/


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## TDX

By the way, I've tried the following without success:

-St. Johns Wort

-Escitalopram

-Seroquel (But only 200 mg. I think I might later try a higher dose)

-Duloxetine

-Clomipramine

-Mirtazapine

-Tianeptine

I think next I will try Agomelatine or Wellbutrin.

@Mayer Gross: I have ordered the article "On Depersonalization" by Mayer Gross.


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## Guest

Melatonin is good as a sleep aid.


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## TDX

And in a paper I read that the effect on melatonine-receptors might release dopamine. This and it's 5-HT_2C-Antagonism could contribute to it's anti-anhedonic effect:

http://www.ncbi.nlm.nih.gov/pubmed/22959116


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## MiketheAlien

ThoughtsOnFrost said:


> Melatonin is good as a sleep aid.





TDX said:


> And in a paper I read that the effect on melatonine-receptors might release dopamine. This and it's 5-HT_2C-Antagonism could contribute to it's anti-anhedonic effect:
> 
> http://www.ncbi.nlm.nih.gov/pubmed/22959116


I have also had success with Melatonin, but here is the thing, The First time I tried it years ago, I tried a 10mg pill of Melatonin from the Vitamin Store. This made me feel weird and I had negative side effects, so I never took any more Melatonin for years. Now recently, like a few months ago, I read that the ideal dose is waaaaay lower than what I originally took. So I tried Melatonin again, this time at 0.75mg before bed and had really great results. I have now take it every night before bed at that dose, alongside Magnesium and 3g of Glycine. I have found this combo to be excellent at letting me drift fast asleep.


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## MiketheAlien

Here is a link to an old DropBox I made with Public articles and books on, and relating to, Depersonalization.

https://www.dropbox.com/sh/xaaz0wlu7b0aze4/AADWi1zAHdRNONFGjV-z2Zqya?dl=0


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## MiketheAlien

Just a few case reports about different approaches. Some might find these interesting. 

Desipramine: a possible treatment for depersonalization disorder

http://www.ncbi.nlm.nih.gov/pubmed/3435887

Treatment of depersonalization disorder with clomipramine

http://www.ncbi.nlm.nih.gov/pubmed/9715363

Feeling unreal: 30 cases of DSM-III-R depersonalization disorder

http://www.ncbi.nlm.nih.gov/pubmed/9247397

Depersonalization treated with fluoxetine

http://www.ncbi.nlm.nih.gov/pubmed/7485640

A placebo-controlled, cross-over trial of lamotrigine in depersonalization disorder

http://www.ncbi.nlm.nih.gov/pubmed/12680746

Quetiapine: focus on emotional numbing in depersonalization disorder: an fMRI case report

http://www.europsy-journal.com/article/S0924-9338%2805%2900133-1/abstract

[Depersonalization--current data]

http://www.ncbi.nlm.nih.gov/pubmed/15807226

Depersonalization disorder: pharmacological approaches.

http://www.ncbi.nlm.nih.gov/pubmed/18088198

Lamotrigine as an add-on treatment for depersonalization disorder: a retrospective study of 32 cases

http://www.ncbi.nlm.nih.gov/pubmed/16960469

The efficacy of lamotrigine in a resistant case of depersonalization disorder

http://www.ncbi.nlm.nih.gov/pubmed/21769750

Depersonalization disorder may be related to glutamate receptor activation imbalance.

http://www.ncbi.nlm.nih.gov/pubmed/21742442

Methylphenidate in depersonalization disorder: a case report.

http://www.ncbi.nlm.nih.gov/pubmed/21274825

Lamotrigine in the immediate treatment of outpatients with depersonalization disorder without psychiatric comorbidity: randomized, double-blind, placebo-controlled study

http://www.ncbi.nlm.nih.gov/pubmed/21192145

Depersonalization and derealization syndrome: report on a case study and pharmacological management

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462012000400021&lng=en&nrm=iso&tlng=en

Aripiprazole in depersonalization disorder comorbid with major depression and obsessive-compulsive disorder: 3 cases.

http://www.ncbi.nlm.nih.gov/pubmed/24992087

A Case of Depersonalization with Treatment-resistant Depression Successfully Treated with Sertraline-lamotrigine Combination.

http://www.ncbi.nlm.nih.gov/pubmed/25303205


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## TDX

If someone has access to the article "A Case of Depersonalization with Treatment-resistant Depression Successfully Treated with Sertraline-lamotrigine Combination" I would appreciate it if someone would sent it to me. I tried to get it via interlending, but this did not work.


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## MiketheAlien

Great Website with lots of case reports and studies regarding Depersonalization:

http://www.neurotransmitter.net/depersonalization.html


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## MiketheAlien

TDX said:


> If someone has access to the article "A Case of Depersonalization with Treatment-resistant Depression Successfully Treated with Sertraline-lamotrigine Combination" I would appreciate it if someone would sent it to me. I tried to get it via interlending, but this did not work.


Is there a way to view any of these studies at all, other than just the abstract? It would sure be nice to know the doses used, other details and methods. I guess you have to pay for the papers? Sigh... everything costs money these days.


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## TDX

At the moment I can get most of the full texts by using the network of my university or by using illegal russian websites. If both of them don't work I resort to interlending, which costs 1.5 Euros. Unfortunately in the case of the Sertraline-lamotrigine-paper all these options did not work.


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## beefyflamingo

i took 500mg of pregabalin the other day, felt pretty decent in the morning.


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## MiketheAlien

Psychiatrist suggested I try the supplement SAM-e. It may help a bit for depression, but I doubt it will have any effect on DP.

I think I may consider trying Moclobemide. Ive been reading a lot about it the last while and it seems like it may help my particular case of Depersonalization.

Either that, or my other plan is to try low dose Abilify combined with a TCA.

Keep in mind that I have more of an Anhedonic form of Depersonalization sans anxiety and panic.

SSRIs and Benzos originally put my DPDR into remission for years, but now I just have DP, no DR.

Hope you dont mind me using this thread for any updates to my medication/supplement trials and tests.

Cheers!


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## gaddis

If you have no anxiety about DP, why are you worrying about it?

TCA's might be 'dirty' drugs, but at least they never stopped working for me like the SSRI's and the SNRI's have.

No drug is consistently effective for DP, but Benzos and TCAs worked best for me.

Unfortunately my doc thinks TCA's are dangerous drugs because of the side f/x.


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## MiketheAlien

gaddis said:


> If you have no anxiety about DP, why are you worrying about it?
> 
> TCA's might be 'dirty' drugs, but at least they never stopped working for me like the SSRI's and the SNRI's have.
> 
> No drug is consistently effective for DP, but Benzos and TCAs worked best for me.
> 
> Unfortunately my doc thinks TCA's are dangerous drugs because of the side f/x.


Who said I was worried? Just because I have a vested interested in the quality of my well-being doesn't necessarily make me worried =)

I am very much involved in trying to find relief from my issues. I have overcome the anxiety and panic in my life for many years now. The next step in the process is trying to resolve the Anhedonia, Cognitive Fog, and Numbness. In my particular case, I do not believe these issues to be psychological in nature, I believe them to be physical and chemical.

I appreciate your reply. I realize everyone is different, relief comes in a variety of forms, and there is not much consistency. I do enjoy the search for answers and possible treatments, no matter the case or condition, it brings me a valued interest.

I tried SAM-e Today, half the suggested dose since I like to start low and work up. So far it made me feel like my vision was blurry, stomach was slightly upset, and I felt dizzy at times. But other than those effects, no positive or negative effects were felt. I dont really even want to try this supplement, but my psychiatrist told me to try it... lol

May I ask which TCAs you have had luck with? =)


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## TDX

In the patent of Glover there is a case where SAM-e was used:

http://www.google.com/patents/US20040242974

"Mr. A. was started on SAM-e 400 mg. in divided doses before breakfast and lunch, which was increased to 800 mg. five days later. One week afterward he reported a marked improvement in mood and energy level. His GNS score further reduced to 40 and the BDI to 6. Both scores are clinically non-significant. Mr. A. appeared bright, alert, responsive, and interested in his usual activities which provided him pleasure and satisfaction. He felt reconnected to the outside world and others."


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## gaddis

MiketheAlien said:


> Who said I was worried? Just because I have a vested interested in the quality of my well-being doesn't necessarily make me worried =)
> 
> I am very much involved in trying to find relief from my issues. I have overcome the anxiety and panic in my life for many years now. The next step in the process is trying to resolve the Anhedonia, Cognitive Fog, and Numbness. In my particular case, I do not believe these issues to be psychological in nature, I believe them to be physical and chemical.
> 
> I appreciate your reply. I realize everyone is different, relief comes in a variety of forms, and there is not much consistency. I do enjoy the search for answers and possible treatments, no matter the case or condition, it brings me a valued interest.
> 
> I tried SAM-e Today, half the suggested dose since I like to start low and work up. So far it made me feel like my vision was blurry, stomach was slightly upset, and I felt dizzy at times. But other than those effects, no positive or negative effects were felt. I dont really even want to try this supplement, but my psychiatrist told me to try it... lol
> 
> May I ask which TCAs you have had luck with? =)


Back in 'prehistoric' times, when DP/DR were extremely esoteric terms, and the terms anxiety disorder and panic disorder didn't exist, I found myself trapped in the nightmare world of 24/7 100% DP/DR.

I went to a zillion docs, who did their best to make my condition even worse by trying things like hypnosis, metaphysics, chiropractery, group therapy, psychoanalysis, sex therapy (don't ask), Thorazine, Stelazine, Haldol, Navane, and other things that are too shocking for the young, sensitive minds here to digest.; - 0

Finally, when I was broke, unemployed and near the end of my rope, a medicaid doc told me he had no idea what was wrong with me, but I might as well try some Elavil, just to see what would happen.

I put on 50 lbs, but I came out of that hell after a few months. Back then, they were so scared stiff of TCA ODs, heart attacks, heart aryhtmias and low blood pressure symptoms that they were very hesitant to prescribe them, and the doc took me off Elavil ASAP.

I had a relapse about 15 years later, and after a Xanax trial, I was put on Imipramine, which again did the trick.

After being tossed from doc to doc by my health insurance, my present doc took me off Imipramine and put me on Pristiq, which he said was a much safer drug.


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## MiketheAlien

gaddis said:


> Back in 'prehistoric' times, when DP/DR were extremely esoteric terms, and the terms anxiety disorder and panic disorder didn't exist, I found myself trapped in the nightmare world of 24/7 100% DP/DR.
> 
> I went to a zillion docs, who did their best to make my condition even worse by trying things like hypnosis, metaphysics, chiropractery, group therapy, psychoanalysis, sex therapy (don't ask), Thorazine, Stelazine, Haldol, Navane, and other things that are too shocking for the young, sensitive minds here to digest.; - 0
> 
> Finally, when I was broke, unemployed and near the end of my rope, a medicaid doc told me he had no idea what was wrong with me, but I might as well try some Elavil, just to see what would happen.
> 
> I put on 50 lbs, but I came out of that hell after a few months. Back then, they were so scared stiff of TCA ODs, heart attacks, heart aryhtmias and low blood pressure symptoms that they were very hesitant to prescribe them, and the doc took me off Elavil ASAP.
> 
> I had a relapse about 15 years later, and after a Xanax trial, I was put on Imipramine, which again did the trick.
> 
> After being tossed from doc to doc by my health insurance, my present doc took me off Imipramine and put me on Pristiq, which he said was a much safer drug.


Thank you very much for sharing your story. I really appreciate it and I respect your struggle. After dealing with DPDR for so many years now, I have to admit that I am fascinated by it. It has evolved in me, but stayed the same. I know that doesnt make much sense.

Seeing as DP/DR is so varied for many people, but at the same time, exactly the same, I thought this thread might help people who are looking for different medication and treatment options. Myself included.

There are so many treatment options now, I am unsure of what to try next. If I find anything that helps me, I will definitely write up an update.

Thanks again for sharing your life.


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## MidwestMike

Hey Mike! I am on Fluoxetine (Prozac) 20mg and am doing so much better than i was in the beginning of my DP. Im not 100% better but I would say 50%. It helps with Depression and Anxiety which I got from DP that made it a lot worse.


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## MiketheAlien

MidwestMike said:


> Hey Mike! I am on Fluoxetine (Prozac) 20mg and am doing so much better than i was in the beginning of my DP. Im not 100% better but I would say 50%. It helps with Depression and Anxiety which I got from DP that made it a lot worse.


Howdy Mike! I have been reading a lot of studies  case reports involving Fluoxetine that show very positive results for some. I am sure glad that you are seeing some relief! I appreciate you sharing your story, I read your other thread and it seems like you are doing all the right things! Keep up the awesome work buddy =)

I may consider trying Prozac in the near future. I will definitely keep it in mind as an option.


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## TDX

> I have been reading a lot of studies involving Fluoxetine that show very positive results for some.


Unfortunately in a randomized double blind trial Fluoxetine was not superior to placebo. In the literature are some case-reports where serotonin-increasing drugs like Fluoxetin and Clomipramine worked, which suggests there is a subgroup of patients, that responds to SSRIs.


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## MiketheAlien

After a recent meeting with my Psychiatrist, We decided that Moclobemide is worth a shot and I will be starting it in a day or two.

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

Now, I know there are people out there who do not think this will do anything for DP/DR. My Psychiatrist and I believe it may, so I will update any positive results to this thread.

Thanks for reading,


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## TDX

It also blocks the breakdown of dopamine. Maybe this could help.


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## MiketheAlien

Update: While the Moclobemide helped somewhat, a lift of depression and mood, it also gave me slight anxiety/keyed up feeling all day. I have decided to end the trial. I will be trying another medication soon after my next Doctors appointment. I do not know which one but I will be sure to update when I decide.

If anyone has had any success with any medications, please feel free to use this thread to share your details. I appreciate all anecdotal evidence in getting relief from this disorder. Thanks!


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## winterphantom

I have noticed a lot of sites recommending SSRIs for treatment. Unfortunately for me, SSRIs actually triggered my DPDR. At 13 I went through several extremely traumatic events, which caused me to be diagnosed with PTSD. Several months later, I was put on Prozac. About three months after being on the drug, my depression and anxiety turned off as well as the rest of my feelings. And shortly after, I began feeling as if I was not in real life and constantly looking at "eyeball snow". I switched from Prozac to Celexa to Wellbutrin to a Wellbutrin/Lexapro combo to just Lexapro over the course of four years. Recently, since I have recovered from my PTSD, I asked to be taken off because of my depersonalization symptoms. It is actually quite common for SSRIs to induce or worsen symptoms, and the withdrawals are making my DP absolutely horrendous. Please be careful going on SSRIs and make sure you have a decent psychiatric doctor who knows what they are doing c:


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## MiketheAlien

winterphantom said:


> I have noticed a lot of sites recommending SSRIs for treatment. Unfortunately for me, SSRIs actually triggered my DPDR. At 13 I went through several extremely traumatic events, which caused me to be diagnosed with PTSD. Several months later, I was put on Prozac. About three months after being on the drug, my depression and anxiety turned off as well as the rest of my feelings. And shortly after, I began feeling as if I was not in real life and constantly looking at "eyeball snow". I switched from Prozac to Celexa to Wellbutrin to a Wellbutrin/Lexapro combo to just Lexapro over the course of four years. Recently, since I have recovered from my PTSD, I asked to be taken off because of my depersonalization symptoms. It is actually quite common for SSRIs to induce or worsen symptoms, and the withdrawals are making my DP absolutely horrendous. Please be careful going on SSRIs and make sure you have a decent psychiatric doctor who knows what they are doing c:


This is really good advice. I know that SSRIs do work for some people, but they can also make things worse, or in this case, actually be the cause of the Depersonalization.

Ive said before, on this forum, that a SSRI (escitalopram) took away the panic and anxiety when I first got Depersonalization. I was doing OK for a few years on it, but it did blunt my emotions and make me extremely apathetic. I came off of it a few years ago, and when I did, I started to experience a different kind of Depersonalization, which has stuck with me over the years, ever since coming off the medication.

So while it did help initially, My experience with it over the long run is viewed as negative. But this is just my experience, A lot of people do really well and there is a huge difference in different peoples experience on these medications. My only advice is to echo the previous comment, Do as much research as you can about any medication you may try, it is best to be informed as much as possible these days regarding medication. Doctors are there to help, BUT one must also be informed!

Thanks for sharing your view on this matter WinterPhantom, It adds very well to the purpose of this thread.

P.S. I am in a sort of Limbo as to if I would like to try Prescription medication again, I do not want a repeat of my negative experience with the SSRI, but I also still deal with 24/7 Depersonalization/Depression. I have tried to address my issues medication-free over the last few years, with exercise, diet, and good sleep being extremely beneficial, but I am still stuck in the DP void. I have also tried supplements and herbs, which have helped mildly, but havent really effected the Depersonalization. I have tried a few medications in the last few months, but no longer than a week on each since I couldnt tolerate the side effects. In the desperation of wanting my life back, I may keep trying some new medications and try to stick with them for longer and try my best to tolerate any side effects.

I apologize if this post seems a bit drawn out, I made the mistake of having expresso coffee today, hoping it would "wake me up", but now I am supremely jittery and feel the need to type out my thoughts.

Cheers!


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## MiketheAlien

A bit of an Update,

I see my Psychiatrist in 3 days. In my previous meetings we spoke about trying Vortioxetine. I believe this may be worth trying, I feel if I can treat my Depression, perhaps some of this Depersonalization will subside.

I will update once I speak with him, I am sure that I will come away with a prescription but I am just not sure for what medication. I just know that I do want to try medications again, give them a try, see what happens.

Anyways, if anyone has any experience with this medication or any medications, please use this thread to share your story! I would be very interested in other peoples experiences with treatments.

Thanks~!


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## TDX

Vortioxetine is mainly a SSRI. It also binds to some serotonin-receptors, which might increase noradrenaline, dopamine, acetylcholine und histamine and lower GABA at certain parts of the brain. It is assumed to improve cognition.

What might be interesting is the fact, that it also binds to an adrenergic receptor. I asked myself if maybe stimulation of the sympathetic nervous system could work in some cases against depersonalization.

At the moment I am taking mirtazapine and bupropion 150 mg/day. On the first day I noticed, that bupropion gave me some sort of stimulant effect, which felt artificial. It was quite similar to duloxetine and I think it might be caused by bupropions noadrenaline reuptake inhibition. After this bupropion did fucking nothing.

Up to now, the only good medication is mirtazapine. It allows me to sleep 10 hours per day instead of 7 hours. If I do not commit suicide I think I have another 50 years to go. Sleeping 10 hours instead of 7 would shorten my time 6.25 years...


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## luctor et emergo

After tapering of Klonopin, which I used for 7+ years, and surviving the horrible withdrawal, I'm starting with medications next week.

The options are unlimited, I have found an open minded psychiatrist, finally, but we have narrowed it down to three.

-sertraline: GAD and depression are active in my family (without dp, dr), >50% react positive to sertraline.

-dulaxetine: because of the more potent noradrenaline re-uptake component.

-vortioxetine: pharmacodynamics seem promising.

ssri's I have taken in the past, no effect, citalopram, clomipramine.

Which is the most logical medication to start with? Any input is appreciated!

I realize it will be trial and error. I have been down this road in 2007 and 2008 (see introduction).

However this time I will not stop trying medications untill there is one that alleviates my chronic dp, dr.


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## TDX

Sertraline should have fewer side-effects than duloxetine.

I've tried duloxetine and it gave me the following effects: A feeling of increased energy, which seemed artificial. I had somehow energy, but was unable to really use it. My sleep was without dreams, like pressing an on-off-switch. It also in a sense petrified my penis, but this didn't matter, because I don't have a sex drive anyway. And even if I had: Can't enjoy the orgasm. Anhedonia is fucking me. Apart from that, there was no positive effects.

I'm yet in another clinic and the psychiatrists there said that he has thought about a medication he wants to try for my "depression". But I do not know yet, what he wants to use, because he uses the medication as leverage, so that I make an appointment with a resident physician.

I conjecture that he'll take away my mirtazapine, because I use it as a palliative sedation and will prescribe lithium.


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## TDX

By the way: I've read your introduction and saw that you've never tried antipsychotics. While it is true that they make things for most people worse, there are also some people who benefit from them. If a low dose of Seroquel does not make your symptoms worse you could try antipsychotics.


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## luctor et emergo

Wow TDX, that are some serious side effects. Hope they will fade as soon as you switch medications.

Thanks for the antipsychotics tips. Actually I have used pimozide / orap a classic antipsychotic.

The strange thing is I don't remember to much from the time I have used all the meds posted in my introduction.

What I do know is I was stupid for sometimes using cocaïne while on different meds.
That's really f*cking up your own brain chemistry... (dopamine system)

As for the antipsychotics, risperdal has been mentioned.


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## TDX

> Wow TDX, that are some serious side effects. Hope they will fade as soon as you switch medications.


They are already gone. I took duloxetine several months ago.


----------



## luctor et emergo

Today I'm starting with Vortioxetine, I don't expect miracles.

I'm concerned it will mess with my brain chemistry even more.

But it has been 5 months since the last Klonopin pill
and the PAWS are milder compared to 5, 4, 3 months ago.

Over the last 2 months it seems like I'm at a standstill.

Is there any reliable measurement of dp, dr, besides the cambridge dp scale?

Is there any reliable measurement of your cognitive skills?

Is there any reliable measurement of anxiety?

I would like to establish a baseline measurement.

TBC...


----------



## TDX

> Is there any reliable measurement of dp, dr, besides the cambridge dp scale?


The only alternative might be the Fewtrell Depersonalization Scale, but I was not able to get it.



> Is there any reliable measurement of your cognitive skills?


Yes, several.


----------



## luctor et emergo

TDX said:


> The only alternative might be the Fewtrell Depersonalization Scale, but I was not able to get it.


Maybe it's in this book: Fewtrell & O'Connor, Clinical Phenomenology and Cognitive Psychology


----------



## TDX

In Google Books I had access to some pages on this chapter, but couldn't find it.

Concerning medication my psychiatrist has increased my Bupropion to 300 mg/day (no effect yet. 150 mg did nearly nothing) and decreased my Mirtazapine to 45 mg/day, because I told him the truth, which is that I use the Mirtazapine as "palliative sedation". Honesty is penalized in psychiatry.


----------



## TDX

After one week with increased Bupropion I feel somehow more activated, but there is absolutely no improvement of my symptoms.


----------



## xryan68

Prozac and beer.


----------



## luctor et emergo

After 2 weeks of Brintellix, nothing.


----------



## TDX

Same for bupropion. It's making me more irritable but I am still feeling like the living dead. My psychiatrists told me that my inceased irritability is a sign for improvement.

While I recognize that it is somehow activating I think that it's effect is lightyears away from being sufficient. If my psychiatrist refuses to increase the dosage to 450 mg/day I'll most likely throw it away. I'd like to try some of the supposedly anti-depersonalisative anti-convulsives like Lamotrigine, Keppra, Topiramate or Perampanel, but I think I have to go through some other meds for my "depression".


----------



## Mochan

Started with 5mg Lexapro today, so far no side effects.


----------



## luctor et emergo

Starting with a 7 day trial 600mg mifepriston. Used in (psychotic) depression. The aim is to reset my dysregulated HPA axis and lower cortisol plasma concentration.


----------



## MiketheAlien

Hey y'all,

Been a while since I posted last. I have been traveling and working abroad, having a blast, making good money, new friends, and awesome experiences. But I still am dealing with Depersonalization and Depression or something. Last medication I tried was Brintellix, It had some minor good effects, but nothing that would make me want to continue on it, plus it made me feel sick all the time, yuck. I was on it just over a month. Then I was using SAM-e for a week or two, felt some benefit again, but nothing that really addressed my issues. I have been managing with diet, exercise, and supplements.

I have a Doctors meeting coming up in the next few weeks and, at this point, I have no idea what to try next, it seems like I am running out of options other than trying AP or MAOIs. Anyone have any interesting ideas of what medication to try next?

This was my next idea

http://www.ncbi.nlm.nih.gov/pubmed/21274825

The full paper is quite interesting, the subject literally tried all the failed meds I have, then tried Methylphenidate which had great success. Might be an idea lol.

DP/Depression/Anhedonia suuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuccccck. My life could feel so much more engaged and real! Even though Ive had some good times this past while, I dont feel connected to the memories and feel in a haze, no emotional connection to anything/anyone, and time doesnt exist to me hahah, shit.

Anyways, all the best to you all, keep on trying to improve your life! Dont give up and stay positive when you can! Cheers

Mike


----------



## TDX

What medications did you try?

If you have not tried anything dopaminergic then stimulants might be a good idea. Ritalin and Adderal come to my mind. The MAOI Selegiline might be a good choice because it seems to have amphetamine as an metabolite:

http://dmd.aspetjournals.org/content/25/6/657.full

Amisulprid might be another drug of choice, because in a low-dosage it can increase dopamine release.

By the way: Did you try an Opioid-Antagonist in a high dosage?

If you wanna try Antipsychotics you should start with a very low dose to see if it makes your symptoms worse. If it does not they might be worth a try. But only atypical antipsychotics. I would start with Abilify or Seroquel.

I have taken Seroquel 200 mg/day for sleep for some months without any worsening of my symptoms (but also no improvement).


----------



## luctor et emergo

Also posted in http://www.dpselfhelp.com/forum/index.php?/topic/51085-dp-medications-treatments/page-2

So an update after the 7 day mifepriston treatment. Very surprising outcome.
The purpose of this treatment was to reset the HPA axis,
a few weeks ago my plasma cortisol level after the DEX supression test was 52 nmol/L,
where 27 nmol/L is considered normal and 100 nmol/L is an indication for Cushing's syndrome.

Started with 200 mg/d building up to 800 mg/d and lowering to 200 mg/d.
During the first 3 days of taking mifepristone, nothing really happened.
Ofcourse I wasn't expecting miracles but nothing?
Then after reaching the 800mg/d there was an effect, but this wasn't a desired effect.
My sleeping pattern became disturbed, to the point I woke up in sheer panick at night.
Negative thoughts were raging and I felt all worse things imaginable would happen to me.

This nocturnal experiences resembled the ones I had in the first weeks after Klonopin withdrawal,
only at that time I also woke up with extremely sore muscles in my body.
A theory is that heigtened cortisol (cortisol rushes) causes muscle pains.

Last saturday I went to a metal music festival "into the grave" with 7000 visitors.
Previous years under the influence of Klonopin and beer no panic attacks or anxiety.
This year I was expecting the worst after a few bad nights of sleep and no Klonopin and beer.
Surprisingly I felt relaxt all day! Offcourse most metal fans are very laid back en friendly. :smile:
Atmosphere was great and I actually enjoyed the day. A milestone, since 6 months ago I was afraid to go outside.
Depersonalization, derealization were the same as ever, alas...

Last Sunday I had the follow up DEX supression test to determine my plasma cortisol level.
My psychiatrist had the results this afternoon. The level was 673 nmol/L !!!

Would like to read views from you guys / girls as to why the level is 13 times higher then 4 weeks ago.
I have some explanations after reading a few articles like http://www.aetna.com...0_499/0465.html

Other sources mention that after 8 weeks the levels should be back to normal,
but no idea if the original goal, resetting the HPA axis has been or will be reached.

edit: tinnitus is still present, sleep pattern is a little bit better than 10 days ago.


----------



## TDX

My next date with my psychiatrists is on August the 25th. I don't know yet which medication I wanna try next. I'm thinking about Agomelatine, Vortioxetine or Parnate.

But I think I may take the Bupropion longterm. It may not improve any of my psychiatric symptoms, but I noticed some weeks after reaching the dosage of 300 mg/day that the (probably neuropathic) pain in my finger tips disappeared almost completely.


----------



## TDX

Time for the next round. My psychiatrists prescribed: Abilify.


----------



## Angela2006

TDX said:


> Time for the next round. My psychiatrists prescribed: Abilify.


Abilify by itself? I always thought it was part of a cocktail. In any event, the only drugs that ever helped me with the DP/DR were two MAOIs - Nardil and Marplan, but I couldn't deal with the side effects. They didn't completely take away the DP/DR. That has been there nonstop for 41 years. I have tried every drug out there. I have learned to live with it, and I take Xanax (.5 mg) daily to take the edge off and to help me sleep. I had a dream the other day that I woke up and the DP/DR were gone. I also had a dream the next night or so that I won the lottery. In both dreams, all I could do was cry uncontrollably because I was so happy!!


----------



## TDX

> Abilify by itself? I always thought it was part of a cocktail.


Yes, but even in the article where it was part of a cocktail it had an significant effect on it's own.

I'll also try MAOIs if necessary.

Interestingly I've found that Nardil increases GABA-levels in the brain:

http://www.ncbi.nlm.nih.gov/pubmed/8749840

http://www.ncbi.nlm.nih.gov/pubmed/1610412

Parnate makes some people anxious, so it might not have this effect. If Marplan also elevates GABA this might explain an anti-depersonalisative effect in some people.


----------



## didep

TDX said:


> Yes, but even in the article where it was part of a cocktail it had an significant effect on it's own.
> 
> I'll also try MAOIs if necessary.
> 
> Interestingly I've found that Nardil increases GABA-levels in the brain:
> 
> http://www.ncbi.nlm.nih.gov/pubmed/8749840
> 
> http://www.ncbi.nlm.nih.gov/pubmed/1610412
> 
> Parnate makes some people anxious, so it might not have this effect. If Marplan also elevates GABA this might explain an anti-depersonalisative effect in some people.


Moclobemide is a reversible MAOI know nothing?


----------



## TDX

> Moclobemide is a reversible MAOI know nothing?


???

I took 10 mg/day Abilify for 3 days, but I could not stand the side-effects. It created an inner restlessness which made sleep impossible. Dosage reduced to 5 mg/day. If I can tolerate this I'll take it for the next 5 weeks.

Just like Seroquel I don't notice any worsening of my symptoms, but also no improvement.


----------



## MiketheAlien

(Trigger warning)

I think I am going to ask my psychiatrist if he would be willing to treat me with a MAOI. I've tried ssri, vyvanse, lamotrigine, brintellix, moclobemide, all for more than 6-8 weeks, and where they have had some slight benefit for small issues, like moclobemide and vyvanse helped depression a bit, none have helped with dissociation and depersonalization. years ago, the ssri lexapro cured my panic attacks and anxiety, I've been anhedonic and depersonalized continuously. Excercise, being social, traveling, eating healthy, have all helped me, but I still cannot connect emotionally to any memories, nothing has meaning and time doesn't feel real. At this point in my life I feel like I am in a major, major depression, the worst I've ever had because I'm losing hope and having thoughts of suicide since I don't see a point of living like this. It's scary because it's a numb feeling of suicide, I've lost all meaning.

Sorry for the negativity, this is my only outlet until I see my doc next week. Fingers crossed that he understands how desperate I am, I've held strong and positive and hopeful for far too long without proper help.

I'll update next week when I have my meeting. All the best to everyone, and please don't let my particular feelings get you down, I have a long history of emotional trauma, substance abuse, depression, body appreciation issues, isolation, violence, blah blah blah. The past 5 years I've had a positive, healthy life though. Anyways, sorry for wall of text, just on mobile. Later


----------



## TDX

Have you ever tried an opioid-antagonist? Kappa-Opioid-Antagonists are expected to work for Depression, Anhedonia and DP.

I'd like to try Nalmefene, but the no psychiatrists I've met was willing to prescribe it. If ALKS-5461 would not come next year I would certainly try to get it illegally. But maybe you're more lucky with your shrink.


----------



## MiketheAlien

I have been on low dose naltrexone for about 2 years, it helps a lot with my crohns disease, which I was diagnosed with this year. I originally started the LDN for fatigue, dp, and aches/pains, my doc is a huge fan of LDN. never tried it at high doses though. Pretty sure I need to address my major depression first.


----------



## TDX

> Pretty sure I need to address my major depression first.


Kappa-Opioid-Antagonism might just do that. ALKS-5461 even got a fast track designation for the treatment of depression.

You could try to raise the dosage of Naltrexone. But be careful, it can damage the liver at high doses, which Nalmefene doesn't do.


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## MiketheAlien

Lol sorry, I just copied and pasted it from an older thread.


----------



## TDX

I seem to tolerate the 5 mg Abilify. So now I've got to wait for my next meeting with my psychiatrist:

http://www.webcountdown.de/?a=AQXGyAg&k=jiXy


----------



## MiketheAlien

So I have a prescription for Ritalin and modafinil, about a year old sitting in my closet, I'm sure the shelf life is still good. Never tried them because I was scared of reading their side effect profiles, but now idgaf so will be trying one tomorrow morning. Lol


----------



## Nathanael.A.

*All Information provided herein is purely for those who have tried the majority, if not all the other Indicated or 'Off-Label' Medications which have been noted to lead to an improvement in the symptoms of the disorder in question in other individuals, but Have failed to provide any relief for his or herself, Please consult Your own Physician/ Psychiatrist before attempting any of the pharmacotherapeutic methods listed below, All information provided is experimental and has been sourced from scientific journals, studies and published papers.*

Depending on the severity of the condition in question, Clomipramine (Anafranil) combined with minimum dose Prozac which is 20mg (You can combine SSRI's with TCA'S but be *Extremely* careful, *consult your Doctor/ Physician first*) if not then just go with the Clomip.

Some minor success with Lamotrigine, but nothing earth-shatteringly noticable.

5HT1A Receptor Partial, Full or even 'Super' Agonists might work pretty well, the most popular Serotonin1A receptor agonist is Buspirone, but most people who've taken it and practically every Doc I've spoken to bout it sais it doesn't work, Mainly cos its only got an 'Intrinsic Activity' at the receptor in question of 35%-45%, which basically does jack in terms of psychoactivity ('Intrinsic Activity' is a measure of How effectively the Exogenous Medicine ( i.e Buspirone) stimulates the receptor in question (Serotonin1A) relative to the Natural Endogenous binding ligand I.e Intrinsic activity of Buspirone at 5HT1A = 35%-45%, while the instrinsic activity of Serotonin at the 5HT1A= 100%.

Depending on where u are situated, the most viable medicine with an I.A (anything above an I.A of 60%) which might make a slight bit of a difference is relatively recently developed medication is a 'SMAS' (Serotonin Modulator And Stimulator) called Vortioxetine, which activates the 5HT1A receptor with an I.A of 80%, apparently, although its non-specific, so it does rattle other Serotonin receptors aswell (agonizing some, antagonizing others), and just to note it is also an effective Serotonin Reuptake Inhibitor.

The Other more effective 5HT1a Receptor agonists are only available in Japan, unfortunately, so I dunno if it would be possible to aquire any of them through some sort of means, but here they are anyway:

Selective 5HT1A Receptor partial/ full/ super-agonists in descending order of Intrinsic Activity, Lowest to Highest:-

- Tandospirone- I.A = 60%-70%

- Eptapirone- I.A = 100% ( A Full Agonist, equal to that of Serotonin)

- Befiradol- I.A = 125% (a so-called 'Super-agonist').

Oh, and last but not least, Something called Mifepristone, been trying to get my hands on this one for time, Blocks Stress- Hormone (Cortisol) receptors in the Brain, has been shown to be very effective as a mood-brightening agent, plus being DP'ed = Stress/ Anxiety = Cortisol release and higher stress hormone levels in-general, which, to put it bluntly Kill your brain cells ( the ones in ur Hippocampus and Prefrontal cortex are particularly vulnerable to this effect) which leads to long-term and sometimes even *Permanent, physical, structural changes in the Brain.* Either way, not good. Please if anyone has a link or a source for this stuff ( *Mifepristone*) PM me. Anyways,

Peace.


----------



## luctor et emergo

Nath. In the previous page is my Mifepristion experience. Glad to have at least tried it even though it hasn't been succesful on dpd, drd.

I have some documentation, will send it to you!

Last week they took 3 blood samples aigain. My morning cortisol was measured WITHOUT dex-suppression,

value was 694 nmol/L, where around 500 nmol/L is normal. ACTH was within normal values and 11-deoxycortisol / cortodoxone

will be presented to me this Friday. There *must* be some correlation between the endocrine system, HPA axis imbalance and dpd, drd.

Vortioxetine: based on the promising mechanism of action, I've been taking this since early June. After 6 weeks the dose was 20 mg and

I continued to updose to 30 mg until a few days ago.

Apparently I am a fast CYP2D6 metabolizer which means in short my liver enzymes break down medications more than average, so high doses are needed.

The effects of Vortioxetine...(and maybe the one week Mifepristone trial) well my mood has lifted a bit, I can enjoy tennis again, this is progress compared to

6 months ago when I was in full blown depression.

My wish is that everyone on this forum will get the proper help of understanding doctors and therapists that aren't afraid to experiment. Stay strong!


----------



## TDX

> My wish is that everyone on this forum will get the proper help of understanding doctors and therapists that aren't afraid to experiment. Stay strong!


That how I see it, too.


----------



## Nathanael.A.

Recently Ive felt that ive Experienced some actual improvement with the condition in question primarily down to a substance known as MDAI (https://en.wikipedia.org/wiki/MDAI), Where-as before any actual amelioration of primary symptoms (DP/DR) happened only naturally, now when MDAI is ingested, I feel that The substance direcly interacts with and decreases the sensations that are typical of said condition.


----------



## TDX

Interesting. What have you tried before? And what symptoms were improved by the MDAI?


----------



## luctor et emergo

Yes please be more specific Nath. If you have the time and energy that is. Great news!


----------



## TDX

Today was my date with my psychiatrist. The Aripiprazole will be removed and the Bupropion, too, because it makes me smell bad which is bad for my parents. I got 2 new medications as replacement:

*Amisulprid*: An atypical antipsychotic which can stimulate the release of dopamine in a low dosage. It's known to work for anhedonia in some cases and on this forum there is some anecdotal evidence that it can work for depersonalization, too:
http://www.dpselfhelp.com/forum/index.php?/topic/15561-solian-amisulpride/

*Pregabalin*: An anticonvulsive which is used for generalized anxiety disorder and neuropathic pain. It's meant to help against my pain, since I have to come off from Bupropion. But it seems to be able to decrease the release of glutamate, which might make it interesting for the treatment of depersonalization:
http://www.dpselfhelp.com/forum/index.php?/topic/12575-thank-flower-success-with-lyricaremission/
http://www.longecity.org/forum/topic/58615-depersonalization-nootropics/?view=findpost&p=674289


----------



## TDX

Unfortunately the *Amisulprid* is not working. It's doing nothing, much like a placebo. On Friday I will increase the dosage, but I doubt that this will work.


----------



## Guest

How is the pregabalin working?


----------



## TDX

Haven't yet tried it, because I wanted to see how the *Amisulprid* worked alone.


----------



## TDX

I stopped the *Amisulprid* because it did not bring my emotions and thoughts back, but made me more depressed. In 1 week I will have my next date with my psychiatrist. I wonder what will be my next medication.

I'm still taking the *Pregabalin* because it makes me more calm. I don't know if this is the placebo effect or maybe the anti-anxiety effect of *Pregabalin.*


----------



## MiketheAlien

I'd like to give a quick update.

I've been on the combination of vortioxetine 10mg and vyvanse 30mg for the past 10 days. It was a bit rough the first day, but now I'm doing better than I have in a long time. It's probably way too early to tell anything, but since I've been on this med combo, I've been able to quit smoking ciggs, create resumes and cover letters, and attend several interviews, feeling calm and confident. No side effects other than slight nausea which goes away. I don't know if these MEDS are gonna be safe for long term, but at least I can finally function like a normal person. All I can say is I hope this keeps up and fingers crossed. Any opinions on this update would be greatly appreciated. Thanks


----------



## TDX

Tomorrow is my date with my psychiatrist. I'm curious what he will prescribe me.


----------



## luctor et emergo

Mike. Fantastic that you are able to function on this combo! Any significant effects on the feeling of unreality?

Tried Vortioxetine for 3+ months. Only slight nausea the first days. Updosed to 30 mg/d. No real significant positive effects. Slowly tapered, no harm done.

TDX, what do you want to get prescribed?

Due to private issues I have been forced to temporarely quit Nalmefene... next year new attempt.


----------



## TDX

> TDX, what do you want to get prescribed?


Nalmefene or Lamotrigine...

At the psychiatrist the following scene took place:

Me: "I would try every medication that even has a small chance to resolve my symptoms and I'm willing to tolerate many side-effects and risks. I would even try Clozapine if necessary.".

Result: He prescribed *Clozapine!!!*

He said that he had some patients, who had the same symptoms like me (no emotions + blank mind) who responded to Clozapine. At my stay in the psychiatric clinic I also met whose depersonalization symptoms went away with Clozapine.

There is also a publication where Clozapine was used to treat depersonalization disorder:

http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0447.1982.tb04502.x/abstract

Nuller used it on 15 patients and 9 patients responded to it.

It's mechanism of action might consist of upregulating NMDA- and AMPA-receptors and improving glutamatergic neurotransmission.


----------



## MiketheAlien

luctor et emergo said:


> Mike. Fantastic that you are able to function on this combo! Any significant effects on the feeling of unreality?
> 
> Tried Vortioxetine for 3+ months. Only slight nausea the first days. Updosed to 30 mg/d. No real significant positive effects. Slowly tapered, no harm done.
> 
> TDX, what do you want to get prescribed?
> 
> Due to private issues I have been forced to temporarely quit Nalmefene... next year new attempt.


I previously tried vortioxetine alone and didn't get much results, the same with vyvanse, it was only when I started to combine them that I noticed a better effect. But that's just me haha. I wouldn't say I'm cured of dp, but this is the best I've felt in a long time in regards to being able to function


----------



## TDX

I can't believe that psychiatrists precribe a dangerous medication like Clozapine without problems, but refuse to do so when it comes to a fairly harmless anticonvulsive like Lamotrigine or a medication that is used for alcohol dependence like Nalmefene.

But I never heard that someone with my symptoms tried Clozapine. So, let's get dangerous...


----------



## luctor et emergo

Good luck with Clozapine. Stay safe. 
Can you clarify your last remark versus your post on 23 Nov? 
First you mention having met dpd people during your stay at the clinic who used Clozapine. In your last post you say you never heard of people trying Clozapine.


----------



## TDX

> In your last post you say you never heard of people trying Clozapine.


Not on the internet. And the person in the clinic may have had psychosis...

It's quite surprising that so few people on the internet have tried clozapine, although Nuller had a 60% succes rate with it.


----------



## luctor et emergo

Ah thanks for clarifying. 60% is promising! Your blood will be tested each month determining white blood cell count?


----------



## MiketheAlien

Oh I totally forgot to mention this and it is very important. I finally convinced my doc to test my testosterone levels, after bugging him several times. Turns out my hunch was correct. I have very very low testosterone levels for my age. I've been on testosterone injections every 2 weeks for 2 months now, a low dose, and it has helped me feel better. Just a thought for you to look into. Not saying everyone is like me, but it's definitely worth looking into.


----------



## TDX

> Ah thanks for clarifying. 60% is promising! Your blood will be tested each month determining white blood cell count?


Yes. For the first 18 weeks it will be each week.


----------



## Zed

What an awful way to treat your body's and mind's.. putting this toxic crap down your throats! Do you honestly expect recovery whilst your doing this? It's no coincidence the people who shovel cocktails of mind altering meds down their throats are the ones who struggle the most and the longest.

From reading through this thread it's pretty obvious you have no idea what you're doing. This is more akin to self-abuse than anything else. The way your doctors hand out these 'meds' proves to me they really don't have any morals nor expertise.

Why do you have no faith in your own strength and ability to recover? Has anyone ever taught you the benefits of being kind to yourself?

Someone had to say this....


----------



## TDX

> What an awful way to treat your body's and mind's.. putting this toxic crap down your throats!


At the moment I'm so full of suicide thoughts that I would happily put poison down my throat if I just had one to just end it all. For me the Clozapine-Induced Agranulocytosis is not a risk, but rather a welcome effect, because it's deadly. I think if my parents wouldn't be on guard I just would take the Clozapine without the weekly blood tests.



> Do you honestly expect recovery whilst your doing this?


I am not very optimistic, but the 60% remission rate in Nullers publication cannot be overlooked. All these patients were treatment-resistant according to Nuller: "All patients were previously treated with various antidepressants, neuroleptics, stimulants and ECT without success." I don't think this would translate to the real world, but this result is so remarkable that I just cannot ignore it.

Also according to Pikwers Hypothesis Clozapine might make sense. He proposed that some people with depersonalization disorder have a low NMDA-receptor sensitivity, so some sort of NMDA-receptor hypofunction like in schizophrenia. Clozapine upregulates NMDA-receptors and increases activity at these receptors, so from this point of view it would make sense that it helps for a subgroup of patients with depersonalization disorder.



> Why do you have no faith in your own strength and ability to recover?


Because I know that there is just no way for me to ever recover from this. My symptoms show no fluctuations or an underlying psychological cause they could be tied to. It won't matter what I do: Nothing will change. It's evident that in my case this is a neuropsychiatric disorder. I'm determined to use the puny knowledge about depersonalization disorder to the fullest, but I won't resort to anything dubious.



> Has anyone ever taught you the benefits of being kind to yourself?


I sense how it all will end sooner or later (nothing works). So, if I was kind to myself I would kill myself right now.


----------



## didep

I am taking clozapine a week ago and I improved dp / dr. Also I am taking lamotrigine and bupropion.
My doctor told me that quite prescribed clozapine to other patients and never had any case of agranulocytosis.


----------



## TDX

> I am taking clozapine a week ago and I improved dp / dr. Also I am taking lamotrigine and bupropion.


This is interesting, because a combo of Clozapine and Lamotrigine is sometimes used to treat treatment-resistant psychosis.

Did the Lamotrigine do nothing for your symptoms without the Clozapine?


----------



## TDX

On monday I'll get my first blood test. I will have to wait until then for my first Clozapine "intoxication".

Today I was really fucked up. Maybe tomorrow I'll do better.


----------



## TDX

Hmmm. Didn't take Mirtazapine -> Still awake.


----------



## luctor et emergo

MiketheAlien said:


> Oh I totally forgot to mention this and it is very important. I finally convinced my doc to test my testosterone levels, after bugging him several times. Turns out my hunch was correct. I have very very low testosterone levels for my age. I've been on testosterone injections every 2 weeks for 2 months now, a low dose, and it has helped me feel better. Just a thought for you to look into. Not saying everyone is like me, but it's definitely worth looking into.


http://www.dpselfhelp.com/forum/index.php?/topic/50664-dpd-and-testosterone/?hl=testosterone

And there is bignoknow on youtube who adresses the importance of normal testosterone levels.






http://vidzvid.com/watch/9WUYS6t4CCQ/how-i-healed-from-severe-depersonalization-derealization.html



didep said:


> I am taking clozapine a week ago and I improved dp / dr. Also I am taking lamotrigine and bupropion.


Fantastic news, in what way have your dpd, drd symptons improved?



TDX said:


> On monday I'll get my first blood test. I will have to wait until then for my first Clozapine "intoxication".
> 
> Today I was really fucked up. Maybe tomorrow I'll do better.


How are you feeling today?


----------



## TDX

> How are you feeling today?


Very shitty. I fear that the Clozapine might be the last med my psychiatrist might precribe for me.


----------



## MiketheAlien

Stay strong and keep trying to feel better. I'm here if you ever need anyone to talk to. This goes out to everyone.


----------



## luctor et emergo

Do not give up TDX. You are in our thoughts. Stay strong.


----------



## Zed

TDX said:


> At the moment I'm so full of suicide thoughts that I would happily put poison down my throat if I just had one to just end it all. For me the Clozapine-Induced Agranulocytosis is not a risk, but rather a welcome effect, because it's deadly. I think if my parents wouldn't be on guard I just would take the Clozapine without the weekly blood tests.
> 
> I am not very optimistic, but the 60% remission rate in Nullers publication cannot be overlooked. All these patients were treatment-resistant according to Nuller: "All patients were previously treated with various antidepressants, neuroleptics, stimulants and ECT without success." I don't think this would translate to the real world, but this result is so remarkable that I just cannot ignore it.
> 
> Also according to Pikwers Hypothesis Clozapine might make sense. He proposed that some people with depersonalization disorder have a low NMDA-receptor sensitivity, so some sort of NMDA-receptor hypofunction like in schizophrenia. Clozapine upregulates NMDA-receptors and increases activity at these receptors, so from this point of view it would make sense that it helps for a subgroup of patients with depersonalization disorder.
> 
> Because I know that there is just no way for me to ever recover from this. My symptoms show no fluctuations or an underlying psychological cause they could be tied to. It won't matter what I do: Nothing will change. It's evident that in my case this is a neuropsychiatric disorder. I'm determined to use the puny knowledge about depersonalization disorder to the fullest, but I won't resort to anything dubious.
> 
> I sense how it all will end sooner or later (nothing works). So, if I was kind to myself I would kill myself right now.


Sorry you're feeling so awful. It'd be a good idea to talk to someone about how low you feel - even a call to a helpline can help.

It's important to understand that side effects of some medications can cause suicidal ideation.


----------



## TDX

> It's important to understand that side effects of some medications can cause suicidal ideation.


At the moment I only take Mirtazapine and it doesnt't cause the suicidal ideation. The cause is a strong sense of hopelessness, because if the psychiatrist precribes Clozapine he might be at the end.


----------



## didep

TDX said:


> This is interesting, because a combo of Clozapine and Lamotrigine is sometimes used to treat treatment-resistant psychosis.
> 
> Did the Lamotrigine do nothing for your symptoms without the Clozapine?


Lamotrigine me somewhat improved mood and perception of time


----------



## didep

luctor et emergo said:


> Fantastic news, in what way have your dpd, drd symptons improved?


Yes, I improved a little Derealization.


----------



## TDX

> We were suicidal before we started taking medication. Realistically, we haven't got much to lose. It's sad but true.


I have read that Clozapine is very sedating. This could be a very welcome side-effect for me, because then I could use sleep as time machine, as I always wanted. I built somewhat a tolerance to Mirtazapine.


----------



## TDX

> I can't speak for anyone else but I try a lot of psychological stuff as well. CBT, ACT, meditation, trauma therapy (which two therapists have now agreed doesn't seem to be relevant for me personally), exposure therapy... I try everything.


In my opinion most of that is crap for us.



> We were suicidal before we started taking medication.


I've been reading again at the forum of dignitas. Up to now it's the best forum about suicide methods that I have found.


----------



## luctor et emergo

Not liking the fact that suicide again is in your thoughts.

I do understand the desperation though...

thankfully there a people who care about you, keep (the) faith.


----------



## TDX

The first intake of Clozapine will be a bit delayed, because my mother fears the side-effects, especially diabetes. She wants that we talk with our family doctor about this.


----------



## didep

TDX said:


> The first intake of Clozapine will be a bit delayed, because my mother fears the side-effects, especially diabetes. She wants that we talk with our family doctor about this.


low doses can also cause diabetes?


----------



## TDX

I don't know. But maybe it would be a good idea to conduct regulary checks for diabetes to avoid this risk.


----------



## TDX

The day has finally come. My parents are against me taking clozapine, because of the deadly side effects that I like so much, but I know I don't have a choice. Tonight I will take the first pill.

I think I'm the first one on this site who has ever taken clozapine.


----------



## TDX

I have done it!! I have taken the first half pill. For this week I will continue taking 12.5 g. Clozapine is a drug that has to be titrated slowly...

Let's see what it does...


----------



## didep

TDX said:


> I have done it!! I have taken the first half pill. For this week I will continue taking 12.5 g. Clozapine is a drug that has to be titrated slowly...
> 
> Let's see what it does...


How do you feel?


----------



## TDX

No change.


----------



## TDX

I took the second half pill. It will be only half pills until next Saturday.


----------



## TDX

My current dosage is 25 mg in the morning and 50 mg in the evening. So far I don't feel an effect. Side effects are also minimal.


----------



## TDX

At the moment I'm taking Clozapine 50 mg/day in the morning and in the evening. Unfortunately I don't feel an effect, other than sedation (good) and drooling when I sleep. Today is my next date with my psychiatrist. Let's see what will happen.


----------



## Guest

[deleted]


----------



## Guest

meds will generally only help take off some edge with DP symptoms like K etc. I've been on and off a lot, the ssri's are lousy and i wouldnt trust a antipsych cause of sides thanks.


----------



## TDX

We decided that I will increase the Clozapin dosage to 150 mg/day.

Good news: If this does not work I will finally get *LAMOTRIGINE.*


----------



## luctor et emergo

Hooray TDX. Your perseverance pays off!

With Lamictal you probably have planned some combinations with ssri's?

First things first though, good luck with the 150 mg/d Clozapine.


----------



## TDX

> With Lamictal you probably have planned some combinations with ssri's?


I would take it alone and only add a SSRI if it does not work.

I think I might have a chance that Lamotrigine works for me, because just like it the Ketamine model antipsychotics don't make my symptoms worse.


----------



## socky_b81

Hi. I am just coming across this thread for the first time. I'm new to this site as I am experiencing my 3rd bout of DR/DP in 20 years. The first episode occurred when I was 16 then again at 26 and now at 35. For me, DR/DP and anxiety go hand in hand and are related to stress and not dealing with root cause emotional issues.

To sum it up, at 16 I shoved all my emotional trauma aside. This was burying the fact that I was gay but didn't have a clue how to process it let alone accept it.

At 26 I was in University, working 2 jobs, eating a bad diet routinely, and of course socializing far too much at the campus pub with friends.

Today I have overburdened myself with personal and professional obligations, experienced a couple family deaths, become relatively antisocial.

I'm currently taking 75 mg of Effexor on a daily basis. This is the same medication I took in my 20s. I'm on my 5th week of Effexor and have noticed a difference however I think the improvement has been a result of more physical activity, healthier diet, discussing issues with a therapist, practicing breathing exercises and progressive relaxation techniques every night to help put me to sleep, and become more social with friends again. I have also had to take Ativan every now and then to ease even the slightest of DR feelings.

I'm not a fan of taking medication but I started again to level out my DR/DP feelings. The techniques listed above, I believe, have helped me progress faster so that I don't have to rely on medication in the long-term. I am also taking a vitamin B complex and vitamin D tablet every day. Out here on the west coast of Canada we get so much rain and cloudy weather, that alone makes me feel depressed!


----------



## TDX

The pharmacy called me, because there are interactions between Clozapine and Lamotrigine. Because of this they phoned my psychiatrist and asked if this is okay. Unfortunately he hasn't answered yet. So I will have to wait for the Lamotrigine. No Lamotrigine until monday.


----------



## TDX

Today no Lamotrigine either. I hate waiting.


----------



## TDX

And today no Lamotrigine, too. Fuck.


----------



## TDX

Lucky: 2 minutes after I wrote this post the pharmacy called me and said I can get the Lamotrigine.

At this moment I have the 2 packages of Lamotrigine. Nothing will prevent me from taking it. I have a chance of 50 to 70% that it improves my symptoms.


----------



## luctor et emergo

Go for it! What will be your updosing schedule? Best of luck TDX.


----------



## TDX

> What will be your updosing schedule?


First week: 25 mg/day.

Each week 25 mg will be added. The dose is divided. I will take it in the morning and in the evening.


----------



## TDX

I've done it. I took my first pill Lamotrigine. Don't notice an effect, which I expected at this low dosage.


----------



## TDX

Today took my second pill Lamotrigine. No positive or negative effects.


----------



## simonlebon

For what it's worth, I had been on a low dose of seroquel for many years. Around 50, and then even down to 25, which isn't even therapeutic dose. But I was fine. As soon as I tried going completely off of the seroquel I went into DP. I went back on a low dose (37mg) , but tried to stick it out and have been trying more "holistic" methods for almost a year now. I ended up being hospitalized a few weeks ago. They pushed my Lexapro from 20 to 30 and bumped my seroquel to 50 (still low dose) and then added a little klonopin. I was doing good enough to go home, but still having some really rough days. I've had two doctors tell me I should try upping my seroquel. So I went to 75mg a couple days ago and I am already feeling a significant difference. I may even end up just going to 100. Therapeutic dose for depression is 150. 100 is the most I've ever been on.

Long story short, for me I believe seroquel is the drug for me. It allowed me to live DP free for many years and I only entered back into DP once I got off of it. And now I believe getting back on a therapeutic dose of it could be my ticket out. But of course, we are all different. And on top of meds I'm still in therapy, exercising, doing yoga, meditation and eating a healthy diet.

I'm pulling for everyone on here!


----------



## TDX

> Long story short, for me I believe seroquel is the drug for me. It allowed me to live DP free for many years and I only entered back into DP once I got off of it. And now I believe getting back on a therapeutic dose of it could be my ticket out.


If I find a drug that improves my symptoms I will most likely never try to get off it. Never change a running system...


----------



## simonlebon

TDX said:


> If I find a drug that improves my symptoms I will most likely never try to get off it. Never change a running system...


ABSOFRIGGINLUTELY! I have learned that lesson a very very very hard way. My logic was ... "oh, i'm only on this little 25mg dose of seroquel... might was well just try to get completely off of it". Which really isn't all that illogical considering I did taper extremely slowly. But our bodies can be so sensitive to this stuff, that just keeping on that small little maintenance dose could be the difference between life and hell. For me it was. I may decrease my dosage again , but I will most likely never try to go completely off of it again. Why risk it, after this experience?


----------



## thy

TDX said:


> Today took my second pill Lamotrigine. No positive or negative effects.


noticed anything yet?


----------



## TDX

> noticed anything yet?


No. There is no beneficial effect, but no side-effects, too. But I'm still at 25 mg/day, which is the lowest dosage. According to the DPRU most patients don't notice an effect below a daily dosage of 100 mg/day.


----------



## thy

TDX said:


> No. There is no beneficial effect, but no side-effects, too. But I'm still at 25 mg/day, which is the lowest dosage. According to the DPRU most patients don't notice an effect below a daily dosage of 100 mg/day.


ok, good luck


----------



## TDX

> ok, good luck


Thanks. On next monday the dosage will increase: 25 mg in the morning and 25 mg in the evening.


----------



## frenchguy

hi everyone, i'm new here,

been depersonalised for 7 month now

at first got precribes *abilify (aripiprazol)* and did nothing but worsen by dp at both low dose (*5mg*) and higher dose (*15mg*).

now got prescribed* lamictal (lamotrigine) *by my doctor started 3 weeks ago at 25mg and am now at *50mg* and going in 2 days at 75mg. so far might have seen some slight improvement as less OCD and elevation in mood but nothing drastic but i am still at a low dose.

i'll keep you update if your interested.

i'm also seeking other treatment such as *TMS* and *tDCS*, but am currently applying for the program waiting for answerr

i'm also very curious about what *oxytocin* nasal spray can do, as it improves both processing emotion better socializing skills, face recognition, empathy. i have a great paper about it but it's in french.. google it if you're interested, might post some study later if i find some research.

and finaly i see that *ibogaine* as not been mentioned here, as i saw that can really help with anhedonia.


----------



## thy

frecnhguy said:


> i'll keep you update if your interested.


please do


----------



## TDX

> i'm also seeking other treatment such as *TMS* and *tDCS*


In France they conduct a study about TMS at the moment:

https://clinicaltrials.gov/ct2/show/NCT02476435?term=depersonalization&rank=3

This could be something for you, if medication fails to improve your symptoms.


----------



## frenchguy

TDX said:


> In france they conduct a study about TMS at the moment:
> 
> https://clinicaltrials.gov/ct2/show/NCT02476435?term=depersonalization&rank=3


wow thank you, didn't saw that. unfortunly i live in Lyon with is pretty far from paris (4hr drive or 2hr train)



thy said:


> please do


took 75 mg today, might be a little more in touch but not sure, nothing really to mention


----------



## thy

TDX, are you taking in combination with an SSRI?


----------



## TDX

No. I want to do this, if Lamotrigine does not work alone. I think I'd ask for Vortioxetine.


----------



## thy

TDX said:


> No. I want to do this, if Lamotrigine does not work alone. I think I'd ask for Vortioxetine.


Interested, why not start with an SSRI as well? Im probably going to start lamotrigine in a week or so and am wondering whether to combine with an SSRI. I don't see any disadvantages to starting with both. At what dose of lamotrigine would you add SSRI?


----------



## TDX

> Interested, why not start with an SSRI as well? Im probably going to start lamotrigine in a week or so and am wondering whether to combine with an SSRI. I don't see any disadvantages to starting with both.


I want to see if Lamotrigine works alone, because I do not want to take an SSRI for nothing. There is also no known neurobiological reason why Lamotrigine+SSRI should work better than Lamotrigine alone.



> At what dose of lamotrigine would you add SSRI?


At 600 mg/day.


----------



## thy

TDX said:


> I want to see if Lamotrigine works alone, because I do not want to take an SSRI for nothing.


This is understandable.



TDX said:


> There is also no known neurobiological reason why Lamotrigine+SSRI should work better than Lamotrigine alone.


Though the trials show that it does...


----------



## TDX

> Though the trials show that it does...


To know whether Lamotrigine+SSRI is better than Lamotrigine alone there should be a trial which compares both treatments. But this doesn't exist. The trials of Sierra et al point to this, but there is no definitive proof.


----------



## frenchguy

TDX said:


> I want to see if Lamotrigine works alone, because I do not want to take an SSRI for nothing. There is also no known neurobiological reason why Lamotrigine+SSRI should work better than Lamotrigine alone.
> 
> At 600 mg/day.


600 mg/day of lamotrigine?! that's a lot. didn't know you could reach that, isn't 200mg/day the usual dosage?


----------



## thy

frecnhguy said:


> 600 mg/day of lamotrigine?! that's a lot. didn't know you could reach that, isn't 200mg/day the usual dosage?


I think the maximum is normally around 400 mg/day but some people do go higher.


----------



## TDX

> I think the maximum is normally around 400 mg/day but some people do go higher.


The maximum I want to reach is 300 mg in the morning and 300 mg in the evening, which would be 600 mg/day. They used a one-time dosage of 300 mg Lamotrigine in the Ketamine-study. This is why I want to reach this dosage.

Such a dosage is possible. I read in epilepsy forums that some people even take Lamotrigine *1000 mg/day*. Side-effects may be a barrier, but I'm willing to endure much, because Lamotrigine is, after Clomipramine, the only medication I took that has, according to some clinical trials, a reasonable chance to work. I hope my psychiatrist will agree with this and continue to be a good prescription machine.


----------



## luctor et emergo

TDX said:


> The maximum I want to reach is 300 mg in the morning and 300 mg in the evening, which would be 600 mg/day. They used a one-time dosage of 300 mg Lamotrigine in the Ketamine-study. This is why I want to reach this dosage.
> 
> Such a dosage is possible. I read in epilepsy forums that some people even take Lamotrigine *1000 mg/day*. Side-effects may be a barrier, but I'm willing to endure much


What are the side-effects in dosages from 600mg/d to 1000mg/d?

In 2007 I have tried 200mg/d Lamotrigine for 6 weeks in combination with 75mg/d Citaprolam.

No effect, which makes perfects sense as the period was way too short... little did I know back then.

Tomorrow I will start with Lamotrigine for the second time, we will have more simultaneous anecdotal experience.

When is the moment you may want to add an SSRI TDX, at what dosage or after how much months?

Fluoxetine is well tolerated and helpfull in my family against anxiety, so I will try this SSRI in time.


----------



## frenchguy

luctor et emergo said:


> In 2007 I have tried 200mg/d Lamotrigine for 6 weeks in combination with 75mg Citaprolam.
> 
> No effect, which makes perfects sense as the period was way too short... little did I know back then.


what period of time do you consider good enough for lamotrigine to kick in?

I hope my psychiatrist will agree with this and continue to be a good prescription machine.

lol, you're lucky.


----------



## luctor et emergo

frecnhguy said:


> what period of time do you consider good enough for lamotrigine to kick in?


This is exactly my question for TDX or Elliott as they have done considerably more reseach on this matter. :smile:

edit: this topic gives us some more anecdotal information: http://www.dpselfhelp.com/forum/index.php?/topic/45547-ongoing-lamotrigine-progress-thread-w-several-members/page-11?hl=lamotrigine#entry359814


----------



## frenchguy

luctor et emergo said:


> This is exactly my question for TDX or Elliott as they have done considerably more reseach on this matter. :smile:


I guess it varies for people,but an approximate view would be great


----------



## TDX

> What are the side-effects in dosages from 600mg/d to 1000mg/d?


Don't know. I want to get as high as side-effects permit or to a maximum of 600 mg/day.



> I guess it varies for people,but an approximate view would be great


If 600 mg/day don't work I will ask for Vortioxetine.


----------



## luctor et emergo

Lamotrigine round 2, let's get ready to rumble (again)!


----------



## frenchguy

started taking100mg of lamotrigine today.havn't noticed anything yet. i am starting to feel like medication just have no effect on me


----------



## thy

frenchguy said:


> started taking100mg of lamotrigine today.havn't noticed anything yet. i am starting to feel like medication just have no effect on me


Still early days, I wouldn't give up hope yet.

TDX, update?


----------



## TDX

I decided to drop the Clozapine over the course of the next days, because I read that the longterm usage of antipsychotics can cause *brain damage*. If the Clozapine had actually improved my symptoms I would have continued to take it nonetheless. I like it's sedating effect, but this alone is not worth the risk. I think I will later add Mirtazapine again as sleep aid.

At the moment I'm taking Lamotrigine 75 mg/day: 25 mg in the morning and 50 mg in the evening. I don't notice any effects. No good effects, but also no bad effects. At the moment it's like a placebo.


----------



## simonlebon

HOLY COW! I'm gonna down some tylenol!!

http://www.theatlantic.com/health/archive/2013/04/whats-tylenol-doing-to-our-minds/275101/

"When people feel overwhelmed with uncertainty in life or distressed by a lack of purpose, what they're feeling may actually be painful distress ... We think that Tylenol is blocking existential unease in the same way it prevents pain, because a similar neurological process is responsible for both types of distress."


----------



## Taliana

MiketheAlien said:


> Here is a link to an old DropBox I made with Public articles and books on, and relating to, Depersonalization.
> 
> https://www.dropbox.com/sh/xaaz0wlu7b0aze4/AADWi1zAHdRNONFGjV-z2Zqya?dl=0


----------



## Taliana

Thanks for sharing


----------



## frenchguy

so so far i might be seeing a little improvement with 100 mg lamictal, i'm really not sure, as it's seems to work by stabilizing me.

i've also started taking bacopa and piracetam, might also add some choline. not sure what type to use tho?


----------



## TDX

I'm now taking Lamotrigine 100 mg/day.

Effects: None.


----------



## thy

TDX said:


> I'm now taking Lamotrigine 100 mg/day.
> 
> Effects: None.


how about side effects, nothing at all?


----------



## simonlebon

TDX said:


> I read that the longterm usage of antipsychotics can cause *brain damage*. I


Where did you read this? You can read just about anything on the internet. The question is the source reliable or reputable.


----------



## TimMis

simonlebon said:


> Where did you read this? You can read just about anything on the internet. The question is the source reliable or reputable.


All medication cause long term damage, that's why you don't buy it with the butcher.


----------



## TDX

> Where did you read this? You can read just about anything on the internet. The question is the source reliable or reputable.


It was in a blog, that cited some studies. That's because I'm taking this seriously. If the Clozapine had reduced my symptoms I would have continued to use it regardless the risks.

But if nothing helps I think I will use the Clozapin again in spite of it's risks to use sleep as a time machine.



> All medication cause long term damage, that's why you don't buy it with the butcher.


That's exaggerated in my opinion.


----------



## TimMis

TDX said:


> It was in a blog, that cited some studies. That's because I'm taking this seriously. If the Clozapine had reduced my symptoms I would have continued to use it regardless the risks.
> 
> But if nothing helps I think I will use the Clozapin again in spite of it's risks to use sleep as a time machine.
> 
> That's exaggerated in my opinion.


Have you tried without medication for a longer period mate? Honestly I tried 3 antidepressants without benefit. No good no bad. I stopped and now I'm recovering.


----------



## thy

TimMis said:


> Have you tried without medication for a longer period mate? Honestly I tried 3 antidepressants without benefit. No good no bad. I stopped and now I'm recovering.


Anti-depressants are virtually useless for DP.


----------



## TimMis

thy said:


> Anti-depressants are virtually useless for DP.


 nah not useless. It helps people get rid of depression or anxiety but if you don't feel depressed or anxious, all medication is shit for you.


----------



## frenchguy

TimMis said:


> nah not useless. It helps people get rid of depression or anxiety but if you don't feel depressed or anxious, all medication is shit for you.


why would you say all medication when you only tried antidepressant, and medication treat other disease than anxiety and depression


----------



## thy

TimMis said:


> if you don't feel depressed or anxious, all medication is shit for you.


interesting theory


----------



## luctor et emergo

Lamotrigine: 150mg/d after two weeks. Yes updosing is very fast. But I'm taking the risk based on my previous experience with Lamotrigine. I did not have side effects back then and currently there are also none.

Also no positive effects but it seems too early.


----------



## thy

TDX, update?


----------



## TDX

Some days ago I was at my psychiatrist. Next week I will increase to 150 mg/day and afterwards I will add 50 mg each week until I hit the 600 mg/day.


----------



## TDX

At the moment I'm taking Lamotrigine 300 mg/day and Mirtzapine 7.5 mg in the morning and 15 mg in the evening.

Effect: NOTHING. But at least there are no side-effects.


----------



## Guest

I started Lamictal/Lamotrigine 50 mg/day one week ago and I have virtually NO DP or DR. Also, Zyprexa/Olanzapine 5 mg/day is helping tremendously.

My target dose for Lamotrigine is 150 mg/day.


----------



## luctor et emergo

Great that such a low dose is benificial for you. Or is it (the combo with) zyprexa?

This week I will reach 8O0mg/d lamotrigine. Seriously wondering if glutamate antagonists are helpfull for me as keppra 3000mg/d also did nothing on dp, dr.

Topimarate is still a option or maybe changing the combination with an ssri into an a-typical antipsychotic instead.


----------



## TDX

I'm at Lamotrigine 500 mg/day. The effects: NOTHING. It's nooooooooooooooooooooooooothing.

I do not know on how to progress after this. I thought about adding an SSRI, but my favourite Vortioxetine was taken off the market in Germany, because price negotiations failed and so the pharma company withdrew it.

But well, maybe it starts to pull the lever at 600 mg/day. But I don't really believe it. For the most part I have given up on it, and only take to be sure, beyond reasonable doubt that it does not work.


----------



## TDX

I finally reached 600 mg/day. No effects.


----------



## TDX

As Lamotrigine is not helping alone I will add Fluoxetine. If I do not notice at least a minor effect of this combination after 4 weeks I am done with Lamotrigine and try Moclobemide.


----------



## luctor et emergo

Isn't 4 weeks for fluoxetine a bit short?

Best of luck. We shall overcome.


----------



## Sportsdude8

Having success with Ritalin!!!


----------



## luctor et emergo

TDX said:


> As Lamotrigine is not helping alone I will add Fluoxetine. If I do not notice at least a minor effect of this combination after 4 weeks I am done with Lamotrigine and try Moclobemide.


Fingers crossed.

How did you come up with Moclobemide?


----------



## luctor et emergo

Sportsdude8 said:


> Having success with Ritalin!!!


Excellent news. Please share your positive experiences.


----------



## Guest

Vraylar and Remeron have been the biggest help to me in combo with Prozac.

If you can't get Vraylar (it's brand new and really expensive) ask your doctor for samples of it. If they don't have it, ask for Abilify because Vraylar works similarly to Abilify and it also comes in generic form now.


----------



## Guest

Sportsdude8 said:


> Having success with Ritalin!!!


That's awesome! I was just prescribed Adderall and am scared to try it. I took 2.5 mg and had anxiety so I took a Xanax with it. Than I felt GREAT and really alive for about an hour or 2! I wonder what 5 mg would do for me.


----------



## BlueTank

Clonezepam / Klonopin. That is a numero uno for me. I did not get addicted at all. I followed the rules. And as best as I can tell it was probably the best drug that I tried.

Zoloft was hard to tell if it helped or not and wow the tapering was horrible! Never miss a dose!

I took seroqeul for a very short period. It was scary stuff and i swear i was getting myoclonic jerks. So I got off it quick. BUT. It is possible (hard to say) that Seroquel jump-started my ability to sleep again. I wasn't sleeping at all. Like literally at all. And I think it may have helped that a bit. But I'll probably never take it again!

Outside of drugs a good nice diet and exercise is paramount.


----------



## Sportsdude8

Ritalin at 10mg. Makes my vision feel normal and focused.. Also helps me not pace as much or want to move all time like I was before.. Still have concentration issues tho.. And sometimes have trouble sleeping. Overall tho it's been helping me with feeling less stressed and more alive/normal. Still not 100 percent tho.. But I get moments


----------



## TDX

At the moment I'm on Fluoxetine 30 mg/day and Lamotrigine 400 mg/day. Lamotrigine did not have any effect and it seems like the addition of Fluoxetine does not change anything to the better. I think I will take the dosage up to 40 mg/day. If it does not work at this point then bye bye Fluoxetine.


----------



## TDX

Today I took my first pill Moclobemide (150 mg/day). I do not really believe that it will help, but I will have to go through it, before I can finally get Tranylcypromine.


----------



## tomeer

Aura said:


> That's awesome! I was just prescribed Adderall and am scared to try it. I took 2.5 mg and had anxiety so I took a Xanax with it. Than I felt GREAT and really alive for about an hour or 2! I wonder what 5 mg would do for me.


Same here. The only medication that have worked for me is 15 mg Ritalin and 1 mg Xanax (I presume other benzos would work too) combo - it can get me through the day feeling almost 100% normal and even the next day I feel quite fine. I usually redose after two or three days since the tolerance for Xanax builds up quite fast. It sucks to acknowledge that I have to take something to feel like human again but I guess it is better than to live in the fog of DP.


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## mezona

TDX, what are your main symptoms??


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## TDX

In my signature you can read: Emotional numbness, anhedonia, blank mind, cognitive decline


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## TDX

At the moment I'm at 300 mg/day. My sleep is affected, but I cannot say for sure if it's the Moclobemide or the absence of Mirtazapine. I think next week I will increase to 450 mg/day.

Positive effects: No.


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## luctor et emergo

Tried:

30mg/d Lexapro + Abilify 5 to 5 mg/d, extreme tiredness, no effect on anxiety, dpd, drd

30mg/d Lexapro + Seroquel 50mgXR/d, mild tiredness, no effect on anxiety, dpd, drd

Next:

30mg/d Lexapro + Risperdal 1mg/d

I wil try as much Lexapro + (A)AP combinations as possible

Lexapro as a stand-alone seems to have a mild positive effect on my anxiety, panic attacks


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## Hedgehog fuzz

What about lamotrigine or naltrexone?


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## TDX

I already tried Lamotrigine without success. I want to try Naltrexone, but only together with Buprenorphine.


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## dreamedm

I've heard Maclobemide + NSI-189 may be a very good combo...

Still waiting for my NSI-189 to come, and praying and hoping for a miracle.


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## TDX

> I've heard Maclobemide + NSI-189 may be a very good combo...


Most likely because someone in a certrain anhedonia subforum in a greater depression forum had (temporary) success with it.



> Still waiting for my NSI-189 to come, and praying and hoping for a miracle.


I hope that it's really NSI-189.


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## Hedgehog fuzz

Why only taking the naltrexone with buprenorphine?


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## TDX

Because it's probably not working in a low dosage for most people, because a high dosage is needed to block the kappa-opioid-receptor. Unfortunetely this is not feasible, because for 3 reasons:

1. Even one pill of Naltrexone can have unpleasant side-effects and I suppose they only increase with higher doses, so many people won't be able to tolerate high dose Naltrexone.

2. High dose Naltrexone can damage the liver.

3. In my opinion the main reason: Naltrexone is expensive. If you only have to take 1 or 2 pills per day the price is tolerable, but not if you have to take 250 mg/day or even more.

If I ever get a prescription of both I would do it like this: Take one Naltrexone pill to test if it works alone and if it doesn't use the Buprenorphine prescription.


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## dppara

Lamotrigine , cymbalta, propranolol seems to be an ok combo.


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## luctor et emergo

Started with 30mg/d Lexapro + Risperdal 1mg/d.


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## TDX

I had a meeting with my psychiatrist today. The time has finally come: I'm going to try tranylcypromine.

But first I must figure out if I can combine it with mirtazapine. The pharmacy found in a database that this can cause serotonine syndrome, but my psychiatrist had no problems with the combination. A closer look at the literature supports his view:

https://www.researchgate.net/profile/Ken_Gillman/publication/7428208_A_systematic_review_of_the_serotonergic_effects_of_Mirtazapine_in_humans_Implications_for_its_dual_action_status/links/5769092808aef9750b10b713.pdf

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/52112573CADFD3303357C09E80617422/S1092852916000651a.pdf/div-class-title-much-ado-about-nothing-monoamine-oxidase-inhibitors-drug-interactions-and-dietary-tyramine-div.pdf

Tranylcypromine is interesting, because it does not only increase dopamine by inhibiting MAO, but also seems to be amphetamine-like by itself. However large doses seem to be necessary to make use of this effect.

This medication is special for me, because it is probably a much stronger dopaminergic drug than all the others I have tried (bupropion, amisulpride, aripiprazole) and there seems to be some anecdotal evidence in forums that it COULD help against the deadly numbness-blankness combo.


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## faios

I recovered with the use of Clomipramine (250 mg)...


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## TDX

I alreday tried clomipramine without success.


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## JaoDP123

50mg of naltrexone and 70% relief. The only side effect I've noticed is my alcohol tolerance has diminished.


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## bintuae

Are dp and anhedonia interconnected? I don't give significance to anything since I feel nothing is real. I have ZERO interest in music, work, friends, hobbies, sex. My 'down there' feels very numb. Meds have caused all this shit and The worst part is I can't get off of them because then I'd turn into a mean bitch from hell and would suffer from severe social anxiety, depression, etc. Even quitting them doesn't make dp, dr, anhedonia any less severe. Now, my doc says I have to give Prozac a try. I'm 5 days into taking it at the lowest possible dose. I'm feeling extremely spaced out, unmotivated and lazy. I read that others without dp also experience the same symptoms but they've dissipated after a month or so. I'm not sure what to do anymore.


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## luctor et emergo

Since last week on 30mg/d Lexapro and 2x150mg/d Lyrica.

My overall anxiety levels seemed to have dropped a bit.


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## omarmm

updates anyone?


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## TDX

I'm about to add Venlafaxine to my Mirtazapine, yielding a special combination treatment, called "California Rocket Fuel". However I haven't read anywhere that it works for anhedonia or related symptoms many on this forum have. Hence my expectations are fairly low.


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## 106473

ever considered a ADHD stimulant TDX?


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## TDX

> ever considered a ADHD stimulant TDX?


Of course. However the problem usually is, the better my ideas are, the worse they are received by psychiatrists.


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## SRR

TDX said:


> I'm about to add Venlafaxine to my Mirtazapine, yielding a special combination treatment, called "California Rocket Fuel". However I haven't read anywhere that it works for anhedonia or related symptoms many on this forum have. Hence my expectations are fairly low.


My first SSRI (or rather SNRI) was Venlafaxine (Effexor) and it did help me coop with brain fog, DP/DR and depression-like symptoms. Started with 75mg and after 2 weeks went to 150mg.
After about 6 weeks I upped the dosage to 225mg. The side effects were tollerable, but expect sweating and heavily reduced libido and the ability to orgasm for a couple of months. It does get slightly better after prolonged use.

Be aware that stopping with Venlafaxine is quite painful, resulting in headaches, brain zaps and other crazy withdrawel symptoms. But judging by your massive medication list I don't have to explain anything to you.

I had a lot of issues with reducing the dosage so my psych added Mirtazapine to coop with withdrawl symptoms. The combination of Mirtazapine (7,5 to 15mg) and about ~ 100 mg Venlafaxine did quite an ok job at helping my mood and DP/DR.

But since you've already tried Duloxetine, which is really quite similar to Venlafaxine, I can imagine your low expectations. Only way to find out is to try it for a few weeks at least. Best of luck man!

Now back to the topic of medications. I've been suffering from a mild depression, DP/DR, stumach pain, headache pain and permanent brain fog for the past 5 years.

I have a really awesome psych that is willing to think outside the box and she prescribes any medication without hesitation. I've tried the following medication:

*Venlafaxin (effexor)* - helped with the depression, minor improvement on DP/DR. Quitting is hell though

*Mirtazapine (Remeron*) - Helps me sleep and has had the biggest impact on my DP/DR. Currently on 7,5 mg (half a tablet) and it helps quite a bit. Tried quitting but that resulted in massive DP/DR. Sadly the side effects are heavy on me, even at small dosage. Can however really recommend a try.

*Citalopram - *Made my DP/DR much worse, quit after 2 weeks

*Clomipramine* - Made my DP/DR much worse, quit after 3 weeks

*Prozac* - Made my DP/DR much worse, quit after 2,5 weeks --> low 'other' side-effects though, a more easy-going SSRI in my opinion and worth a shot because of its very long half life characteristic.

*Naltrexone - *Tried Naltrexone 2 weeks ago for 2 days, 25 mg (half at tablet). This was my worst experience so far with massive increase of headache and DP/DR + brainfog. Was still interesting though - worth a shot, its nothing like an SSRI.

*Bupropion (Wellbutrin)* - Just started this morning with my first tablet of 150mg. Thusfar I'm not really liking it - headache increased and I feel a bit off. Hopefully I'll get used to the medication over the next couple of days because I want to give it a fair shot.

I'm not really sure why all SSRI's are not helping at all while Venlafaxin did help me quite a bit.

It's possibly beacuse of the Mirtazapin (remeron) combination, unsure though.

*If you have any medication recommendations/suggestions please let me know*, I'm willing to try anything and my psych also allows me to.


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## TDX

Looks like all serotonin enhancing drugs like Fluoxetine, Clomipramine and Citalopram increase your symptoms. Still strange that Venlafaxine didn't do that, because it's a SSRI, too. On the other hand Mirtazapine blocks some serotonin receptors, which might have prevented this effect and helped for your symptoms. Perhaps some other serotonin antagonists could help:

https://en.wikipedia.org/wiki/Serotonin_receptor_antagonist



> Be aware that stopping with Venlafaxine is quite painful, resulting in headaches, brain zaps and other crazy withdrawel symptoms. But judging by your massive medication list I don't have to explain anything to you.


At the moment I'm discontinuing Venlafaxine. Haven't noticed any effects from reducing the dosage from 225 mg/day to 150 mg/day yet. At the same time I'm taking Mirtazapine, just like you.



> It's possibly beacuse of the Mirtazapin (remeron) combination, unsure though.


Some psychiatrists believe that the combination of Venlafaxine and Mirtazapine is indeed special.


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## SRR

TDX said:


> Looks like all serotonin enhancing drugs like Fluoxetine, Clomipramine and Citalopram increase your symptoms. Still strange that Venlafaxine didn't do that, because it's a SSRI, too. On the other hand Mirtazapine blocks some serotonin receptors, which might have prevented this effect and helped for your symptoms. Perhaps some other serotonin antagonists could help:
> 
> https://en.wikipedia.org/wiki/Serotonin_receptor_antagonist
> 
> At the moment I'm discontinuing Venlafaxine. Haven't noticed any effects from reducing the dosage from 225 mg/day to 150 mg/day yet. At the same time I'm taking Mirtazapine, just like you.
> 
> Some psychiatrists believe that the combination of Venlafaxine and Mirtazapine is indeed special.


Thanks for the link on serotonin antagonists, I always find it very interesting to read!

It's indeed strange because my first SSRI (SNRI actually) was Venlafaxine and I've used it for about 1,5 years without Mirtazapine on the side. That was however a period where my symptoms were quite severe, so perhaps I experienced the build-up phase as less painful/struggeling.

Too bad however that Venlafaxine did not improve your quality of life. It must be quite tough to have tried so many different medications without any success whatsoever.

All I can say is: keep going, keep trying.

Any other medication you are considering for your next attempt?

I'm currently on my second day of 150mg Wellbutrin (Bupropion). The side-effects are already heavily reduced. Less sweating, less tension and no increased headache symptoms. It's still quite hard on my stumach though, but I'm hoping that will fade away in 1 or 2 weeks of usage.

I'm quite happy that my DP/DR brain fog is just 'normal' today and not increased by the Wellbutrin. I'm really curious how this drug will perform over the next couple of weeks. It's also used to 'treat' AD(H)D and I happen to have ADD, so this drug could perhaps help me in multiple ways.

Will keep everyone here posted on my progress!


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## bintuae

SRR said:


> Thanks for the link on serotonin antagonists, I always find it very interesting to read!
> 
> It's indeed strange because my first SSRI was Venlafaxine and I've used it for about 1,5 years without Mirtazapine on the side. That was however a period where my symptoms were quite severe, so perhaps I experienced the build-up phase as less painful/struggeling.
> 
> Too bad however that Venlafaxine did not improve your quality of life. It must be quite tough to have tried so many different medications without any success whatsoever.
> 
> All I can say is: keep going, keep trying.
> 
> Any other medication you are considering for your next attempt?
> 
> I'm currently on my second day of 150mg Wellbutrin (Bupropion). The side-effects are already heavily reduced. Less sweating, less tension and no increased headache symptoms. It's still quite hard on my stumach though, but I'm hoping that will fade away in 1 or 2 weeks of usage.
> 
> I'm quite happy that my DP/DR brain fog is just 'normal' today and not increased by the Wellbutrin. I'm really curious how this drug will perform over the next couple of weeks. It's also used to 'treat' AD(H)D and I happen to have ADD, so this drug could perhaps help me in multiple ways.
> 
> Will keep everyone here posted on my progress!


You're lucky. Wellbutrin actually GAVE me brain fog, derealization. I took it for 2 months. Thank god I did not cause a car accident because of how stupid I felt while I was on it.


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## SRR

bintuae said:


> You're lucky. Wellbutrin actually GAVE me brain fog, derealization. I took it for 2 months. Thank god I did not cause a car accident because of how stupid I felt while I was on it.


Damn, that doesn't sound good. I'm not sure if I'm 'lucky' though since I tried about 4 SSRI's + Naltrexon and they made my brain fog far, far worse.

I'm now 1 week into the Wellbutrin and the side effects aren't too bad. The only annoying side effect is sleep disturbance. I wake up 5+ times per night and have difficulties getting back to sleep, even with my Mirtzapine.

But I've read that this should soften out of the next course of days/weeks, so let's wait and see. I really hope Wellbutrin will/can help me, even a 5% reduction of brain fog is a win.


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## SRR

It's been 1 month since I last posted here, but the Wellbutrin was sadly not a good fit. After 2 to 3 weeks of usage I was barely sleeping because of it and it obstructed my daily work at the office.

My psychiatrist has opted the following medications:

- Acetylcysteine

- Pregabalin, Gabapentin or Depakene

- Imipramine or Nortrilen (TCA's)

- Go back to Venlafaxine (SNRI)

- I can come up with any suggestions myself

Currently Mirtazapine is the only medication that has really benefitted me. I wish I could up the dosage of it to like 15 to 30mg, but for some reason my body reacts quite badly to Mirtazpine.

It helps me quite a bit but at the same time causes irritated dry skin, really dry eyes, nightmares and a 'hangover' effect when I wake up. I think TCA's like Imipramine or Nortrilen won't be a smart pick because they are likely to cause similar side effects as Mirtazapine.

If anyone has any suggestions please let me know, I don't mind acting as a guinea puig to try out different types of medication


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## TDX

> Currently Mirtazapine is the only medication that has really benefitted me. I wish I could up the dosage of it to like 15 to 30mg, but for some reason my body reacts quite badly to Mirtazpine.


You could try Mianserin. Mirtazapine is a slightly modified variant of Mianserin. Perhaps they are sufficiently different, so that Mianserin is more tolerable.



> I think TCA's like Imipramine or Nortrilen won't be a smart pick because they are likely to cause similar side effects as Mirtazapine.


Not necessarily. Although grouped in the same class, there are still differences between each of the TCAs, that may be significant enough to cause different side-effects. From my own experience I can say that Amitryptiline, Clomipramine and Mirtazapine differed much in terms of side-effects.



> Pregabalin, Gabapentin or Depakene


Perhaps they work against your visual snow. If you have anxiety, they might help against that.



> Go back to Venlafaxine (SNRI)


If you need a NRI, you might better try Nortrilen.



> Acetylcysteine


In my opinion Acetylcysteine is worthy of a clinical trial for depersonalization disorder. This is for theoretical reasons. We don't know if it really works. But it's somewhat rare that a psychiatrist suggests this.



> I can come up with any suggestions myself


In terms of depersonalization and visual snow, there is anecdotal evidence that Levetiracetam works against these symptoms when they appear in HPPD. We don't know if it also does so, when people have both symptoms, but don't have HPPD.


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## 106473

controversial but i can chime in with Mirtazapine, first time i had it I was sensitive to it, 15mg had me sweating and a total wreck, i'm a lot further down the line and it's totally different, so listen to your body. I rate Mirtazapine, I'm currently about to add Effexor to make http://www.anxietyhack.com/the-truth-behind-the-popular-prescription-cocktail-california-rocket-fuel/


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## TDX

I tried the California Rocket Fuel. Didn't work for me.


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## DPFighter

SRR said:


> If anyone has any suggestions please let me know, I don't mind acting as a guinea puig to try out different types of medication


If you don't mind being a guinea pig I suggest finding a way to get an intravenous injection of Naloxone. I heard it is becoming easier to obtain because of the opioid epidemic in the U.S. right now. I read a guy on here say that he took a class on treating heroin overdose because they want to train as many people as they can. They sent him home with some vials and an injector. He claims it had a great positive affect on reducing dp

this was his post:

http://www.dpselfhelp.com/forum/index.php?/topic/66850-i-tried-naloxone/


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## SRR

Thanks for all the suggestions TDX and DPFighter. Naloxone injections sound quite hardcore, I think that's something I would try if everything else failed. But I'll keep it in mind and do some reading on it!

I have scheduled an apointment and I'll let you know what I'll try next. I think Nortrilen or Acetylcysteine might be the next attempt.


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## freezeup

Lexapro 15mg and klonopin used sparingly has brought me the farthest into DP recovery after having it for 8 years. No idea why this worked, every other SSRI and benzo combo I tried never had this effect. I'm guessing because my DP\DR was highly fueled by anxiety and OCD that once I was able to get a control over them, it in turn started to deactivate my flight or fight response.


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## TDX

> Lexapro 15mg and klonopin used sparingly has brought me the farthest into DP recovery after having it for 8 years. No idea why this worked, every other SSRI and benzo combo I tried never had this effect. I'm guessing because my DP\DR was highly fueled by anxiety and OCD that once I was able to get a control over them, it in turn started to deactivate my flight or fight response.


If I had to guess I would say that clonazepam was the game changer.


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## PeaceSeeker

I was on clonazepam which was pretty good and it definitely helped me with going out during the day but it kind of sucks at night, because it doesn't really quiet the mind and physical symptoms when trying to relax, now I switched over to diazepam which works faster, but I need more time to see how it helps in comparison; it seems to be better at treating symptoms at night in comparison to clonazepam. All I can say is, coffee seems to mitigate the effects of anti-anxiety medications because I still get jitters and nervousness after taking them, so I guess it's pointless to take them after a cup of coffee on the same day since they're just canceling each other out.


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## SRR

Had a meeting with my psych. I'm going to try to discontinue the Mirtazapine and slowly reduce the dosage. Mirtazapine has greatly helped me, but he side effects are for some reason a bit too much. I was on 7,5 mg (half a tablet) and reduced that to about 1/3, but I had quite some withdrawel symtpoms. Really poor sleep & increased DP + brainfog. I have now however reduced the dosage to 3,75 mg (quarter tablet) and it's pure hell. I only barely fall asleep, wake up about 15 times per night and the next day my DP + brainfog are quite extreme. I'm having trouble going to work. It's really frustrating that I react so extreme to a small dosage decrease. I'm going to ask if there's liquid Mirtazapine to more steadily and slowly decrease the dosage.

I've also tried 600 mg of Acetylcysteine for during the day. I didn't really notice much (positive or negative), although it did make me a tiny, tiny bit more active or 'real'. This could be a placebo effect though.

Will try a doubel dosage (1200 mg) tomorrow and see if I notice a difference.

Since sleep is a big issue for me, my medication after Mirtzapine might be Trazodone. It might cause less side effects and help me sleep more peaceful.

Besides that we talked about Risperdal and Quetiapine, but those would be a 'wild guess'. I do appreciate my psych for having an open mind and thinking outside the box.

I'll keep you all posted on my progress. I'd also like to thank you all for your suggestions and idea's, much appreciated!


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## TDX

> I only barely fall asleep, wake up about 15 times per night and the next day my DP + brainfog are quite extreme. I'm having trouble going to work. It's really frustrating that I react so extreme to a small dosage decrease. I'm going to ask if there's liquid Mirtazapine to more steadily and slowly decrease the dosage.


Interesting how differently you react to it. I never had any side-effects from it and also never really problems to discontinue it, even after taking it for years.



> I've also tried 600 mg of Acetylcysteine for during the day. I didn't really notice much (positive or negative), although it did make me a tiny, tiny bit more active or 'real'. This could be a placebo effect though.
> 
> Will try a doubel dosage (1200 mg) tomorrow and see if I notice a difference.


In clinical trials for various mental disorders dosages of up to 3000 mg were used:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3044191/



> Since sleep is a big issue for me, my medication after Mirtzapine might be Trazodone. It might cause less side effects and help me sleep more peaceful.


Trazodone has mCPP as a metabolite, which was used in challenge studies to induce depersonalization. However it might be possible, that it doesn't do it when using trazodone at a normal dosage.



> Besides that we talked about Risperdal and Quetiapine, but those would be a 'wild guess'. I do appreciate my psych for having an open mind and thinking outside the box.


I took Quetiapine for some time, but found Mirtazapine to be better.


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## Fenway95

Latuda has saved my life on multiple occasions. I was on 80mg for about two years and it kept the DPDR controlled. Recently I had a set back and the DPDR returned at an intense level, so the Latuda was increased.


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## TDX

I promised myself to never try an antipsychotic again, but for Cariprazine I will make an exception. Hopefully my psychiatrist will prescribe it next week.


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## SRR

TDX said:


> I promised myself to never try an antipsychotic again, but for Cariprazine I will make an exception. Hopefully my psychiatrist will prescribe it next week.


Interesting, let's hope for the best! Why did you promise to never take an antipsychotic again? I'm guessing bad luck with previous attempts?

Quitting Mirtazapine is turning out to be another painful ride. I barely sleep at night and the next day I feel horrible.

For some reason I react insanely sensitive to side-effects and withdrawel. I would love to be able to quit in just a few weeks, but this will take some time.
It took me about 1 year to fully quit venlafaxine. Oh well, I'll just have to accept this. It does make switching meds a slow exercise though.

I've requested liquid Mirtazapine, but apparently it is no longer covered by health care and costs 70+ euro's per tiny bottle.

So I've decided to make my own liquid Mirtazapine by crunching 4 pills (=60 mg), adding 30ml water and 30ml syrup and mixing it all together. So 1ml should be 1mg now.

I'll use a 3 ML syringe (without needle of course..) to measure out 3 mg and work my way down from there. No idea if this will work, but it's the only way for me to slowly decrease dosage  I'll try it for the first time this night.

The whole situation does make me smile though, I had to buy a really tiny measuring cup (100 ml) and buy 100 sterile syringes since they only came in bulk... I only needed 1, oh well.

It might however be smart to start with either Trazodone or Quetiapine because the lack of sleep is the worst problem right now.

When I sleep sufficiently I can tolerate the withdrawel symptoms a lot better.

What was your experience with Quatiapine? I'm currently more 'tempted' to choose Trazodone.


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## TDX

> Why did you promise to never take an antipsychotic again? I'm guessing bad luck with previous attempts?


I don't see a reason why any of the other antipsychotics should have a chance to work for me. On the other hand there is the risk for tardive dyskinesia. It's also known that longterm use is associated with atrophy of some areas of the brain, although it's unknown if this is irreversible and what functional impact this actually has. I would only take an antipsychotic longterm if it markedly improved my primary symptoms.



> It took me about 1 year to fully quit venlafaxine.


I did not really have problems. I just decreased every week. Problems only arose after I was completely off it, but they went away after a few days.



> What was your experience with Quatiapine? I'm currently more 'tempted' to choose Trazodone.


It made me tired and in the first few nights my mouth was dry.


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## SRR

Will start with 50mg Trazodone this week and see what it does for my sleep and symptoms, combined with 3.5 mg Mirtazapine (which I will reduce over time to 0).

If it doesn't help me sleep I will increase to 75mg or 100mg.

Will also give Acetylcysteine (Fluimucil) another shot for a longer period of time at a slightly higher dose.

@TDX: Did you manage to see your psych yet about the Cariprazine?
I can't find a lot of info about this medication in my country, it's quite rare I guess?


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## nicewon

none because i know it wont help and im too much of a pussy to try and scared of side effects and fucking up my brain even more. although i do take a benzo every now and then to sleep but that does fuck all to dp


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## TDX

> @TDX: Did you manage to see your psych yet about the Cariprazine?


I'm going to do that on friday this week.



> I can't find a lot of info about this medication in my country, it's quite rare I guess?


It is fairly new and depending on where you live the local authorities might not have approved it yet.


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## SRR

Alright Trazodone basically did nothing, tried 50 mg and also 100 mg. It didn't help me sleep at all, but at least I've tried it.

Next on the list is Quetiapene (Seroquel) in low dosage. Not a big fan of taking an antipsychotic for sleep, but in low dosage it's worth a shot.

@TDX: did you try Cariprazine yet? Under your profile picture it says you're banned, but I hope that's not true?


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