# Trying Fluoxetine + Lamotrigine



## DP_swe (Jul 14, 2014)

Hey all,

I am starting a treatment of Fluoxetine and Lamotrigine today and would like to share the progress as it goes!

Background:

Age onset:* Early 20s*

Cause: *Drug induced (synthetic cannabinoids)*

Symptoms:


*Typical depersonalization/derealization symptoms*
*Vivid dreams*
*Mild headaches*
*Depression*

Symptom frequency: *constant*

Suffering time: *15 months*

Treatments tried


Zyprexa (Olanzapine)
Sertraline (SSRI)
Tegretol (Carbamazepine)

*None of the treatments listed above showed to be effective against my symptoms*

Diagnostic tests:

CT: Normal

MRI (3 testla): Normal

Blood-tests: Normal

*EEG: Abnormal activity in left temporal lobe (slowing)*

The plan:

A treatment with Fluoxetine (SSRI) and Lamotrigine with a very slow and gradual dose increase:

starting off at 25mg Lamotrigine and 10mg Fluoxetine with a dose increase off (25mg and 10mg respectively) every 10 days.

I am well-read to DPDR, have looked through most scientific research and papers and I am very hopeful to this treatment.

I don't think you can expect much update from me in the begining as it will take some time for the Lamotrigine to kick in but hopefully I will keep you guys posted.

God forbid that I forget updating this thread as I have seen many other similair threads with no treatment conclusion. And if that ever becomes my case then it's likely that treatment was successful and that I totally forgot about DPDR.

Feel free to ask any questions or share your thoughts! Anyone tried a similar treatment?


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## Thescamp (Mar 2, 2014)

Good luck mate !


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## DP_swe (Jul 14, 2014)

Okay it has been a while now - I'm back with an update:

I am currently on a relatively small dose (125mg Lamotrigine, and 20mg Fluoxetine). I chose yet not to increase the dose anymore because I am able to function good enough with this dose.

As I am not fully recovered I would like to claim that the medical combination has left me with some relief til the degree that I am not as obsessed with this illness anymore.

The illness still bothers me daily but not to the same extent. Since the meds I have been able to get back to the university and I function better than expected.

It has been a hell trying to convince arrogant doctors to give me these meds but I totally recommend anyone to try it out.

The only side effects I have noted are fatigue and very vivid dreams.

Good luck!


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## Guest (Dec 5, 2014)

DP_swe said:


> Okay it has been a while now - I'm back with an update:
> I am currently on a relatively small dose (125mg Lamotrigine, and 20mg Fluoxetine). I chose yet not to increase the dose anymore because I am able to function good enough with this dose.
> 
> As I am not fully recovered I would like to claim that the medical combination has left me with some relief til the degree that I am not as obsessed with this illness anymore.
> ...


Great to hear your progress- any relief is progress to me. Any plans to ask for an increase on the lamotrigine? I believe 200mg is the standard dose for many dp'ers.


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## jenny_11 (Aug 17, 2014)

Personally, Lamotrigine didn't work for me. It made my symptoms much worse & at first I thought that it was because taking the medicine every day reminded me of the condition. It also caused mood swings for me. I've heard that it works for some people though. Do you have any of the mood side effects?


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## DP_swe (Jul 14, 2014)

Selig said:


> Great to hear your progress- any relief is progress to me. Any plans to ask for an increase on the lamotrigine? I believe 200mg is the standard dose for many dp'ers.


Not yet, as I am able to function quite well as of now. I will be waiting for things to stabilize and then possibly try for an increase during the summer break.


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## DP_swe (Jul 14, 2014)

jenny_11 said:


> Personally, Lamotrigine didn't work for me. It made my symptoms much worse & at first I thought that it was because taking the medicine every day reminded me of the condition. It also caused mood swings for me. I've heard that it works for some people though. Do you have any of the mood side effects?


From the research papers it seems that Lamotrigine only works in combination with a SSRI. Did you use it in combination with a SSRI?

Also the dose increase for Lamotrigine is to be very slow, +25mg every two weeks. As with many drugs it might be a pain in the beginning but usually gets better when the body gets used to it. Lamotrigine is a slow acting drug, when you've reached the dose of 100mg you will feel the effects of 25mg. It needs at least 6 weeks to have full effect.

I find it strange that you mention mood swings, Lamotrigine is actually a mood stabilizer. And I feel much more stable in my mood since the new drugs.

For how long did you try Lamotrigine? And what dose did you reach? And how fast did you reach this dose? Did you take it in conjunction with a SSRI?

What meds are you on now?


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## thy (Oct 7, 2015)

Any updates on this?


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## Fatoush (Jan 15, 2016)

He probably got better


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## DP_swe (Jul 14, 2014)

Probably not 

Lamotrigine + Fluoxetine was only effective in regards to depression but no noticeable improvement in DPDR symptoms.

My next hope is N-Acetylcysteine (NAC) and Naltrexone.


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## Mjegull (Mar 13, 2016)

DP_swe said:


> Probably not
> 
> Lamotrigine + Fluoxetine was only effective in regards to depression but no noticeable improvement in DPDR symptoms.
> 
> My next hope is N-Acetylcysteine (NAC) and Naltrexone.


How did the NAC and naltrexone go?


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## luctor et emergo (May 22, 2015)

Trying it, 40mg/d and 600mg/d, nothing...


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## hopefuluk2 (Aug 20, 2015)

Most of the cases that I see at this forum do not show improvement with lamotrigine! I started to doubt that this medication is effective in large percentage as the DP research unit claims..


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## TDX (Jul 12, 2014)

I also think so. On this forum it's more likely 25% to 35%, depending on how you generously you interpret the statistics. I conjecture that there may be subgroups who do not resond to Lamotrigine:

1. People who get worse on antipsychotics (because this effect was not observed in the NMDA-Antagonist-Model).

2. People with Cannabis-induced-DPD (never saw such a case respond to Lamotrigine).

According to David Kozins statistics group 1 might make 20% to 40%. Regarding group 2 the forum might not be represantive. It's at least my impression that here more than 15% have Cannabis-induced DPD.


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## hopefuluk2 (Aug 20, 2015)

TDX said:


> I also think so. On this forum it's more likely 25% to 35%, depending on how you generously you interpret the statistics. I conjecture that there may be subgroups who do not resond to Lamotrigine:
> 
> 1. People who get worse on antipsychotics (because this effect was not observed in the NMDA-Antagonist-Model).
> 
> ...


I know someone whose DP was triggered by DP and lamotrigine seem to have worked for him but he is not on this forum.


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## luctor et emergo (May 22, 2015)

TDX said:


> 2. People with Cannabis-induced-DPD (never saw such a case respond to Lamotrigine).
> 
> Regarding group 2 the forum might not be represantive. It's at least my impression that here more than 15% have Cannabis-induced DPD.


So TDX, what is according to you(r research) the most benificial medical route for cannabis induced dp?

If lamotrigine in hindsight has a more negative effect than promised in the trials, we might as well quit after a few months?


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## TDX (Jul 12, 2014)

> I know someone whose DP was triggered by DP and lamotrigine seem to have worked for him but he is not on this forum.


I have yet to see someone like this. People who read this should clearly not take my conjecture as fact. It may be wrong, so please try Lamotrigine. This will help answer this question.



> So TDX, what is according to you(r research) the most benificial medical route for cannabis induced dp?


I just don't know. I have read about people responding to Clomipramine (I remember a case on Youtube), high dose Quetiapine (in a case-report published in a journal) and 2 cases with Adderall on this forum. One of them called himself scienceguy, or so. Unfortunately the effect was not sustainable for him, while for the other one it was.

Cannabis-induced DPD (and generally drug-induced DPD) might be like HPPD: A group of disorders with similar symptoms, that are heterogenous in their underlying pathophysiology, which would imply that different drugs work for different persons. I don't like to say it, but there is also the possibilty that there are cases where no drug exists that could work for them.

My data is probably not big enough to compare between drug- and non-drug-cases. At least I will have finished Andys Forum soon.



> If lamotrigine in hindsight has a more negative effect than promised in the trials, we might as well quit after a few months?


If it does not do anything positive in a reasonable dose and after some weeks there is no point in continueing to take it.


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## luctor et emergo (May 22, 2015)

Cannabis-induced DPD (and generally drug-induced DPD) might be like HPPD: A group of disorders with similar symptoms, that are heterogenous in their underlying pathophysiology, which would imply that different drugs work for different persons. I don't like to say it, but there is also the possibilty that there are cases where no drug exists that could work for them.

I have tried ritalin in 2008, made me jittery + heart poundig. Tried keppra for months and even Sinemet + Tolcapone (which is supposed to be fast-acting). Nothing.

http://perspectivesinmedicine.cshlp.org/content/2/8/a012229.full.pdf+html

So if dopamine depletion is a factor then a-typical antipsycotics could work.

Ex-cannabis users need to try Rimobanant (at least I do).

Elliott, you mentioned acquiring all sorts of medications through darknet, what about this one?


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## TDX (Jul 12, 2014)

> So if dopamine depletion is a factor then a-typical antipsycotics could work.


But they block dopamine-receptors... wouldn't that make things worse? But if you haven't tried atypical antipsychotics yet, this might be an idea. But don't expect too much. While there seem to be some cases where they work, the success rate seems to be very low.



> Ex-cannabis users need to try Rimobanant (at least I do).


Maybe Cannabidiol might be worth a try. But I read conflicting opinions of it being an antagonist and an agonist.

But even if you were able to get hold of Rimobanant this does not necessarily mean that it works. The evidence for the involvement of the endocannabinoid system in depersonalization seems to be quite slim. We don't really know if it's really the action on cannabinoid-receptors that causes Cannabis depersonalisative effect. And even if this was the case, this does not imply that blocking these receptors would help Cannabis-induced DPD. It might be like LSD where blocking serotonine receptors does nothing to alleviate DPD or HPPD.


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## luctor et emergo (May 22, 2015)

I will try every medication, even the ones that have a 1% succes rate.

Still waiting for Elliott's 100+ list, but he doesn't respond to my PM's.

CBD-oil, yes I have tried this last year, it is really expensive so didn't have much,

I believe it was for 2 or 3 weeks, maybe a longer time or higher dose is beneficial.

The rimobanant theory is way too simple, but hey... never trying = never knowing.


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