# Ongoing progress with pharmacotherapy...



## Nathanael.A. (Apr 16, 2013)

Hey there, its me again

Just thought i'd fill you guys in on some of the multitude of different supplements and meds which ive tried for my condition, if they changed anything for the better/worse and such and just to document my progress in general.

As you all will know depersonalisation/ derealisation is currrently an under-researched debillitating disorder, and this is reflected in the medical community when apparently there are only 2 clinics in the world which cater for it. I dont know what psychiatrists think when they I say to them im experiencing dp, and I dont care. Im pretty sure it goes in one ear and straigtht out the other, and they play it iff as anxiety/ depression etc, but ive taken dissociative drugs before the onset of my condition, so i Know what it feels like to be dissociated.

Anyway the guys at the mauds kcl clinic london really helped me in giving insight into what predisposes people to develop, but my ultimate conclusion is that regular cannabis consumption plays a large role, although childhood factors also okay a key role in its onset. As to whether any otherillicit substances contribute to it, I would say from whatIve herd MDMA doesnt exactly help the situation, on the other hand I dont havetoo much experience with LSD, more with psilocybe, but amongst my social group there are 1 or 2 cases where LSD has sent people 'wierd' for awhile, whether this is related to DP I dunno, but the first time I took acid, I did notice what retrospectivelly was a dissociative side, but that might just be me.

Psilocybe, (pre-onset of DP) I didnt really notice any dissociation, I did have 'Ego loss' one time where I took a very large dose, but this related more in the context of the 'cosmic' feeling of sensing your place in the universe, introspection into my personality and some telekinesis haha, so I diidnt really feel that these were dissociative psychomimetic effects altogether, and it was a fantastic experience, life changing one could say.

Anyway, Getting off topic here goes:

Lamotrigine:

Lamotrigine for mewas at firsta bit of a head scratcher. I was put on 100mg, then it took a whilefor my next review at the clinic, and when I went the specialisr guysaid basically in his study there hadnt been seen no improvement of symptoms at that dose, and that the dosage trend within the trialhe did was that the higher you go with the dosage, the more relief you feel from this sucky state of mind. 400mg was the maximum dosage, so I was eventually titrated up to that. At first I was doubtful, but then one mornin on an empty stomach I awoke bleary eyed and spaced to fuck, and I proceded downstairs to make some tea. With the tea I popped my 400mg of lamictal and within at least a miinute I notice rapidly sharpened vision, a marked clearing of the brain fog, and it was just like I had awoken from a dream state. It didnt feel like a stimulative acivation, nor an effect ofthe caffiene in the tea, but just a global improvement in my clarity of thought and ability to function, which people with DP know is hard to come by.

Since then i have continued at this dose, missing it infrequently, but my conclusion is that at a basal level it dose help.

Unfortunately, DP/DR I would of thought comes in differing amounts of severity of the primary symptoms and that versus variation of the symptoms vs complete presistence of the condition, with little variation of the smptoms either good or bad.

Also, I would ofthought that DP/DR occurs across a a spectrum of severity of the condition and its symptoms. Just to add I consider myself toward the lower end ofthe spectrum, so while lamotrigine may behighly beneficial in some pations with dp, in others in may only exhibit limited efficacy.

Prozac/ Fluoxetine:

My feeling is that in general prozac may be highly effective in those experiencingg stress/ depression from experiencing DP/DR in whatever form. When I took it, it was really a let down for me, but ive herd it can be quite effective in other ppl. My reason is that the day I felt it come on, I felt like the happiest person alive, and was doing the moonwalk around the psych unit I was in, felt alot more extroverted and confident (some would say over-confident), Improved my memory X a billion but also eleviated any anxiety that I was feeling from being in such a situation. But then, stayed awake all night, got up out of my room, took the second dose and nothing, the residual effects faded away and I was left feelin severely short changed. Dunno why this happened, could just be my body reacting to it so I could bean anomaly, I have my own theory's as to why it stopped which I'll give in brief:

In brief, the specialist guy at the clinic told me that his idea's behind the neuro-anatomical mechanisms behind dp (disregarding any psychological ones) was that a part of the prefrontal cortex in response to stress in inhibits emotion, and that this goes into overdrive in the onset of DP/DR. Basically, you, yourself, your'Ego' the 'I' and the emotional content of everyday normal life, including the experience of being in your 'own' body is blocked somehow. I followed on to say "so basically your sense of self is inactivated", but he deviated from this and and said that it wasnt, it was still there, but that it was just blocked from consiousness.

Anway, from this I eventually made the radical conclusionth that the majority of my 'higher cognitive' brain, recieving the most innervation from serotonin nerve cells, had progresivelly been blocked from consiousness aswell, so this is why I wasnt feeling the effects of the fluoxetine.

IMO SSRI's in general can be therapeutic in acute cases of depressive states which occur in dp, but may not be needed in a large proportion of sufferers due to the fact that they only really elevate your mood, and they do nothing to alleviate the primary symptoms of dp.

Modafinil:

This is the one ive most recently trialled on myself. Again in elevates mood, but in different way to fluoxetine, in that it makes me feel more satisfied and contented, aswell as optimistic about the future. Combined with Piracetam I experienced a fairly elevated mood state with a long duration of action (7+) hours. However Ive noticed theslight potential of its addictive qualities, and so I dont take it every day, I leave it 2-3weeks between each dosage which isthe best regimen in my opinion, not just due to tolerance issues, but it just gives u a little bit of a break once in a while. On more negative note, one the tapering off phase off the drug experience sometimes I have felt a slightly wierd lingering stimulative sensation, but thisis pretty miniscule, although in certain cases I have added some phenibut/ picamilon/ or somekind of benzo to alleviate this which generally works. Again mood elevation was really the only positive component of the experience, aswell as an increase in productivety and extroversion, but primary DP continued un-abated.

Picamilon (in brief):

There are a variety of calming, sleep facilitating supplements around which are available which may also alleviate anxiety.

Picamilon, when ingested in moderate doses has been effective in getting me to sleep, but upon waking I feel very foggy headed, which isnt nice, not comparable to the lingering intoxication of benzo's, but just like uve had a couple nights of no sleep, then went to bed for about3-4 hours and then awoke again, partly refreshed, but still in need of some R&R.

Phenibut:

For me this alleviated an appreciable amount of stress I was going throughat the time, But at the higher dosage range of 4 grams, I find it the perfect aid for sleep, seeing as it slowly sends me off to sleep, your not bed bound or debillitated physically as with benzo's, and whenever ive taken it ive awoken feeling like Ive got a really good nights sleep, refreshed and ready for the day. Again persisent usage can cause tolerance and withdrawal so I disencourage this kind of use.

Benzodiazapines:

Benzo's are only really appropriate in cases of severe stress/ anxiety/ depression. They are appreciably more psychoactive than the compounds listed above, but benzos tend to slightly numb your emotions, which isnt the best idea when your going through sever dp/dr. However, in cases of extreme anxiety, they are helpful. Forinstance I was hospitalised one time, but had a chemistry exam at my college, so they gave me my usual meds,but then I asked for some lorazepam. They seemed reluctant but I insisted (Iam considered a 'smart' person by man people, but I think this is a result of my ocd) and so they obliged. beforehand I was generally aware of the negative effects that benzo's tend to have on memory, but Ithink on the day, I had ingested a whole suitecase full of nootropics (Piracetam, Aniracetam, Sulbithiamine) aswell, and the prior night I had crammed alot so it wasnt much of a struggle, altho going into your college on a bunch of uppers and downers while bein completely DP'ed was intense to say the least, I ended up getting a B+ in the GCSE exam itself, so who knows, IMO best to stick with the low potency once, and preferably the ones with the shortest duration of action.

More recently ive trialled something called Diclazepam, but extremely infrequently, apparently its 2-5 x more potent than Valium (diazepam). Very well sleep aid, altho you feel intoxicated upon awakening and there is pronounced ataxia so try and walk slowly. Again no effect on the primary symptoms of DP/DR,maybe even a slight worsening.

Centrophenoxine:

Centrophenoxine is drug which i used in the treatment of senile dementia, and Alzhiemers disease. It is also used as a nootropic drug by healthy individuals who seek to obtain its purported cognitive enhancing effects. #1. Let me just say, this substance has the most horrific taste imaginable, so if u intend on trialling, u better have capsules and a cap em quick kit at the ready. It doesnt dissolve in water, it tastes like something akin to paint stripper, but 1 million fold worse. After tryin loads of differents ways to obscure the taste, which btw lingers as well, I ended up putting a small dose on a piece of bread, rolling it up into something like a doe ball, covering the seems with ketchup and swallowing it like a pill, tho it was kinda big. Pretty much worked for me, but I havnt touched it since. As for the effects

they are VERY pronounced, u feel like u can multi task, think clearly and do a thousand things at once. This drug is perfect for exam conditions IMO, but didnt really make me feel any more connected, just enhanced my cognition alot.

In Brief:

Piracetam:

Piracetam has always been a mind opening compound for me, leading to mood lift and a completely natural sense of highly improved optimism and clarity, took it before I got DP, and took it after and had the same anxiety reducing, moodlifitin effect, didnt really effect the DP tho.

Aniracetam:

Shortened duration of action compared to the above chemical, similar sensations as with piracetam but with a more anxiolytic side and more clarity of thought. usually lasts only 2-3 hours tho.

Selegiline:

Moderate stimulative action and increase in productivity, but together with its absence of effect on DP, and its questionable metabolism into L-Methamphetamine and L-Amphetamine (which are the far less versions of the substance widely known as 'Crank'), I try to avoid it.

Sarcosine:

Im not 100% on this one, at first I thought it was just another dud, but then I started trialing again and noticed a consistent improvement in my mood that did not vary or go significantly up of down, but it was pretty noticeable, so maybe it does hold potential, altho I didnt notice any effect on dp.

Omega 3 fish oil:

No need to explain effects, this should already be in your supplement regimen if u have one.

to end, I have also found meditation to help me greatly,

Regards


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## beefyflamingo (Nov 6, 2013)

Great post man, found this very interesting. I'm interested in trying some drugs myself. I am hoping to sort out some modafinil next week Lamotrigine is on the list.


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## Nathanael.A. (Apr 16, 2013)

Imo, after a while I found modafinil too taxing, something to do with the long duration maybe I dunno but, I gave ritalin a shot and I think that one is more suitable depending on the person and his/her severity of DP/DR.


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## MiketheAlien (Nov 7, 2013)

Can I ask what dose and how long you were on Selegiline? Thank you for this post, so much great anecdotal information.


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## Nathanael.A. (Apr 16, 2013)

When I took it I stuck within the 2.5-5mg dosage range, and when its taken at those levels its very noticeably active. It turned me into a maths whiz basically, which is something ive herd a few times before about compounds which raise dopamine levels. And in regards to your query regarding the duration of time I was taking it for, I didnt take it as a course or on cosecutive days, I only took it very in-frequently, as when needed, seeing as it works straightaway and has no latency. For me it tended to help with general functioning, memory and most of all energy levels, as well as possessing an appreciable mood-lifting component to it.

Nath.


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## Visual (Oct 13, 2010)

You mention vision being sharper with Lamotrigine. Is your vision also 'brighter' with it? What visual anomalies, if any, do you have with your condition?


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## Nathanael.A. (Apr 16, 2013)

Yeah it tends to, and I dunno, I was already in a bright room at the time, but it brushed the 'anomalies' underneath the carpet aswell. If u wanna brighten ur vision tho, i'd recommend piracetam.


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