# My psych is prescribing anti-psychotics.



## meowster (Jun 7, 2013)

Hi, I'm new here. Well my name is Daniel and I'm not sure what to do. My depersonalization is incredibly bad and getting worse. My psychiatrist put me on Prozac and Geodon, an SSRI and an anti-psychotic. I've heard that the most effective treatment is Klonopin, and SSRI, and Lamictal. The meds I'm on right now aren't doing anything so what do I say to my psych?


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## coco6996 (May 15, 2013)

Find a reliable website that says that Klonopin and an SSRI work tremendously. Just that without the Lamictal has seriously helped me start recovery. It really calms you down. I'm only about 5 days into feeling a little better but it really does give you hope.


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## GroupHug (Jul 6, 2012)

I don't understand the reason you're on an anti-psychotic


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## Hosscat (Oct 23, 2012)

Did you talk about obsessive thoughts? I know aps are used sometimes to help ease those.


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## Guest (Jun 23, 2013)

Hi Daniel,

If I were you, I'd ask my psych why they have recommended all these meds. I think you are worthy of knowing why he/she has made these choices for you. I don't know about your individual case but DP/DR is not a form of psychosis and that's why anti psychotics don't work.

These 'experts' seem to prescribe even without knowing much about the condition, often during the first visit.

Ask your psych what they know about dissociative disorders and how much experience they have in helping people with them.

Phil


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## Guest (Jun 23, 2013)

meowster said:


> Hi, I'm new here. Well my name is Daniel and I'm not sure what to do. My depersonalization is incredibly bad and getting worse. My psychiatrist put me on Prozac and Geodon, an SSRI and an anti-psychotic. I've heard that the most effective treatment is Klonopin, and SSRI, and Lamictal. The meds I'm on right now aren't doing anything so what do I say to my psych?


You always have the right to speak up to any doctor. If the meds are making things worse, you don't have to stay on them. If you need a gradual tapering, then get a schedule from your doctor.

Older anti-psychotics I tried years ago made my DP/DR HORRIBLE. The only meds that have helped me are Klonopin, 6mg/day and Lamictal 200mg/day. I do take an antidepressant, but that is strictly for clinical depression I've had my entire life.

Doseage depends on response -- and it takes a while for these things to kick in. And I think some have felt better with atypical antipsychotics such as Abilify, but I would say they are the exception not the rule.

But unfortunately, a lot of psychiatrists don't understand, or "hear" what is really being said. They misinterpret the description of some DP/DR symptoms ... and I've heard this over and over ... for "prodromal schizophrenia." DP/DR is NOT that at all.

I would get a second opinion or third opinon. This is your body, your mind.

But, as far as I'm concerned the top expert on DP/DR is Dr. Mauricio Sierra at the IoP in London. Have your doctor look at this page:

http://www.kcl.ac.uk/iop/depts/ps/research/neurobiologialmechanisms/depersonalisationresearchunit.aspx

Also, re: meds. It seems anticonvulsants for some reason help with DP/DR. Doesn't mean we have epilespy. I am on Klonopin and Lamictal. Life savers for me.

Here is a PubMed article on Lamictal for DP ....

http://www.ncbi.nlm.nih.gov/pubmed/16960469
*"Clin Neuropharmacol.*
2006 Sep-Oct;29(5):253-8.
Lamotrigine as an add-on treatment for depersonalization disorder: a retrospective study of 32 cases.

Sierra M, Baker D, Medford N, Lawrence E, Patel M, Phillips ML, David AS.
Source
Depersonalisation Research Unit, Psychological Medicine, Institute of Psychiatry, London, UK. [email protected]
Abstract

*OBJECTIVES:*
Depersonalization disorder (DPD) is a chronic condition characterized by the persistent subjective experience of unreality and detachment from the self. To date, there is no known treatment. Lamotrigine as sole agent was not found to be effective in a previous small double-blind, randomized crossover trial. However, evidence from open trials suggests that it may be beneficial as an add-on medication with antidepressants.

*METHODS:*
We report here an extended series of 32 patients with DPD in whom lamotrigine was prescribed as an augmenting medication. Most of the patients were receiving selective serotonin reuptake inhibitors.
RESULTS:
Fifty-six percent (n = 18) of patients had a more than or equal to 30% reduction on the Cambridge Depersonalization Scale score at follow-up. Both maximum dose of lamotrigine used and before treatment Cambridge Depersonalization Scale scores showed positive correlations with the percentage of response.

*CONCLUSIONS:*
The results of this trial suggest that a significant number of patients with DPD may respond to lamotrigine when combined with antidepressant medication. The results are sufficiently positive to prompt a larger controlled evaluation of lamotrigine as "add-on" treatment in DPD.
PMID:
16960469
[PubMed - indexed for MEDLINE]"

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Your doctor needs to become more informed. There was also another article my psychiatrist found ... more recent. I just did a quick search here. There is more and more evidence that Lamictal, Klonopin, and Neurontin, and even some other mood stabilizers can have an effect on DP. My sense is they have some anti-anxiety properties as well as other qualities we don't understand yet.

I'll try to find one great article, more recent.

Also, Dr. Sierra's Book, "Depersonalization: A New Look At A Neglected Syndrome" is THE book on DP/DR -- textbook published in 2009.

Your doctor is working for YOU. You must communicate.

Good luck.

D


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## Guest (Jun 23, 2013)

GroupHug said:


> I don't understand the reason you're on an anti-psychotic


A good number of psychiatrists and patients don't communicate very well re: DP/DR. Psychiatrists often think DP/DR is "prodromal schizoprhenia." It infuriates me. They have not been educated enough on DP/DR in med school. The irony is how I was diagnosed with DP/DR immediately in 1975. I was also given Klonopin in 1987 by a founding member of the ISSMPD at the time. He worked at Sheppard-Pratt -- a trauma and dissociative disorders facility. (He ultimately left CA to be there permanently). They had found THEN, that Klonopin was helping individuals who were inpatients with DP/DR.

That got lost along the way, when in the 1990s MPD and satanic ritual abuse was overdiagnosed. Doctors were sued, patients had to be "deprogrammed" people's lives were ruined ... "the road to Hell is paved with good intentions."

This damaged research into the dissociative disordes overall. It also led to calling MPD, DID. And the explosion of many alters went down significantly. The many, many alters were iatrogenic. Encouraged by the doctor, and produced by clients wanting to please their doctors.

Read: "Sybil Exposed" -- pretty terrifying.

All of that set back DP research about 50 years.


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## Guest (Jun 23, 2013)

The name of the MD who gave me Klonopin was Richard Loewenstein. Have your doctor contact him. Let me find a link for him.

http://www.sheppardpratt.org/sp_htmlcode/sp_clinicians/sp_clini_detail.aspx?DID=201&LID=41

Here is his contact information. And this is the website for Sheppard-Pratt.

http://www.healthgrades.com/physician/dr-richard-loewenstein-xmmf3

Another medical article by Sierra which also mentions Klonopin and indicates APs are not very effective. This has been my personal experience as well. There is still no clear understanding of dissociative disorders.

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


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