# Drugs that target specific symptoms



## newera (Apr 12, 2015)

I want to know if there are any drugs out there that can do anything for symptoms like brain fog.

I have seen other people describe the symptom of losing there inner dialogue/monlogue (train of thoughts). My psychiatrist describes this as "thought blocking".

Are there any treatments for this. He's prescribing me lamotrogine, but I don't think it will treat this symptom.

Also another symptom that I find just as debilitating is the loss of my 'instinct'. Basically this is the disconnection I feel from my body, hence DP and not DR to be specific. I hear lamotragine is better for DR than DP.

I was thinking of trying Klonpin (benzodiazepine), but I'm worried it might be to extreme.

I would like to do everything to improve it. Honestly I've done everything I can through willpower alone, but it doesn't help with my everyday problems. (i.e., not being able to walk as freely/naturally as before is a problem. I learned to cope with this by shifting my attention elsewhere while I walk and sometimes flexing my shoulder muscles and back muscles to coordinate myself, but I still have trouble walking. Walking should feel spontaneous and natural, but this like many things I do everyday have been disrupted by DP/DR. Though I feel I have both disorders, DP bothers me more because I focus more on my problems adjusting to my environment. The detachment from thoughts is one thing, and the detachment from my own body feels just as bad. Will I ever achieve the same sort of connection as before? I don't know, but I feel like medication is the only option I have left.)

If someone can suggest treatment options that target these aspects of DPD, I would truly be indebted. I won't get my hopes up, but I really want to overcome this. I feel like my quality of life will never be the same unless I finally start to feel connected with myself, my thoughts and body once again.

Thank you for reading. I wish everyone out there who is facing the same struggle to find the hope and courage they need to overcome this.


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## TDX (Jul 12, 2014)

NMDA-Antagonists can cause emotional numbness, "thought blocking" and many other symptoms of depersonalization. Lamotrigine can reduce these symptoms if they are caused by increased stimulation of AMPA- and Kainat-receptors in response to increased glutmate release (like in the NMDA-Antagonist model). So Lamotrigine is not a bad idea.

It won't work if there is increased activity at AMPA- and Kainat-receptors *without* increased glutamate release, because Lamotrigine does not significantly decrease the normal firing rate. But drugs like Topiramate, which inhibit these receptors might be worth a try, if Lamotrigine does not work. Unfortunately Topiramate has never been tested for depersonalization, but I think that it reduced the effects of ketamine in animals.

Another possibility might be drugs, that increase dopamine-activity, like stimulants, dopamine-reuptake inhibitors, dopamine-agonists, MAO-B-inhibitors, COMT-inhibitors and kappa-opioid-antagonists or drugs which increase neurotransmission at NMDA-receptors like Sarcosine.



> I hear lamotragine is better for DR than DP.


There is no evidence for this.



> I was thinking of trying Klonpin (benzodiazepine), but I'm worried it might be to extreme.


There is some evidence that it may help against depersonalization symptoms.


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## newera (Apr 12, 2015)

Thank you for the thorough response. I will talk to my doctor about the drugs you mentioned. Sacrosine and Topirmate are new to me. I've heard of some other commonly used ones, but generally it is said that there is no specific treatment or medication specialized for DPD. This is depressing to know, so I'm willing to try anything at this point.


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## TDX (Jul 12, 2014)

This does not mean, there there is no drug that could help with these symptoms. If you look through many psychiatric disorders, you will see that most medications were developed for depression or schizophrenia. But many of them also work for many other psychiatric disorders, although they were not developed for this.

Sarcosine is tested for schizophrenia to enhance neurotransmission at NMDA-receptors. It's not the only one. There are others like glycine, D-serine or Cycloserine, but Sarcosine seems to be the most effective. It's not known if they also work for depersonalization.


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## newera (Apr 12, 2015)

TDX said:


> This does not mean, there there is no drug that could help with these symptoms. If you look through many psychiatric disorders, you will see that most medications were developed for depression or schizophrenia. But many of them also work for many other psychiatric disorders, although they were not developed for this.
> 
> Sarcosine is tested for schizophrenia to enhance neurotransmission at NMDA-receptors. It's not the only one. There are others like glycine, D-serine or Cycloserine, but Sarcosine seems to be the most effective. It's not known if they also work for depersonalization.


Thank you for the information. I think all are worth pursuing because my DPD was induced by weed. I heard that NMDA receptors could be a good place to start for this reason. I'm definitely going to try sacrosine and lamotrigine. It would be nice to be rid of the brain fog and have my thoughts back in order, but I don't think it's possible. Willpower and coping strategies have taken me far, but I have reached a fine line without medication. I think it's going to be useful to try these things out, but I'm just not sure what else I can try to help this symptom.

There are only 2 symtpoms that really annoy me with DPD.

Detachment from my physical self. And detachment from thoughts. I know they are still there somewhere, but its like there is a blockade preventing me from being spontaneous. I don't know if I will ever have myself back or my instinct. IMO 'instinct' was something important to me because thats where all the drives came from. I miss being able to go on auto pilot and being able to adapt to my surroundings, and honestly its such a struggle just to do anything.

I hope lamotragine and sacrosine will be enough to break these barriers and bring back my life to normal. But with all the comments I've seen I don't expect to be rid of this illness, potentially ever. This may be negative thinking, but with all my efforts being flaunted already I feel it is impossible without drugs.

There is no drug that can cure these symptoms, Only heard that they alleviate it.

I suppose all I can do is accept this is the way my life is gonna be from now on, and work with what I have.

If I could, I'd sacrfice a leg just to get my mind back to before.

Sorry for the rant. Just feeling frustrated after failing to overcome DPD. I know the battle is not over yet, and there will be many to come. But at this rate, the war already feels like its been... lost. I think it's time I just accept that some symtpoms will just stick around ... forever. Godamn. I need to find other ways to compensate for this! Its going to be tough, but my life is still far from over. Maybe if I make some good friends, and find a nice lady, and enough positive distractions, I will learn to live with my symptoms better.


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## TDX (Jul 12, 2014)

In the literature there are also some reports that SSRIs, Clomipramine or dopamine-increasing drugs worked for Cannabis-induced depersonalization disorders. For example the author Jeffrey Abugel found that the MAOI Marplan (which inhibits MAO- B) alleviated his Cannabis-induced depersonalization.

Seroquel might be also worth a try. There is a case report where it worked for a Cannabis-induced depersonalization disorder:

Mancini-Marïe, Adham, et al. "Quetiapine: focus on emotional numbing in depersonalization disorder: an fMRI case report." European psychiatry 21.8 (2006): 574-577.

His symptoms were: "[...] he felt emotionally numb and had the feeling that things were unreal. Mr A. described a feeling of mind emptiness and reported feeling beside his body."

Unfortunately a high dose (700 mg/day) was needed to reduce his symptoms. If you feel that a low dose does not make your symptoms worse you might try to reach that dose.


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## TDX (Jul 12, 2014)

Acetylstein might be worth a try, too. There are some studies where it worked for various psychiatric disorders. It's seems to reduce glutmate levels in certain parts of the brain, which might be useful for the treatment of depersonalization.


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