A question that I often get asked is, “What are some of the medications that are currently available for treating depersonalization disorder (DPD)?” While I tell my clients that there is no medication available for treating DPD specifically, there are some that may alleviate certain symptoms of the illness. In this article, I hope to cover some of the medication available for dealing with DPD and its symptoms.
Before We Proceed
I’m not a medical doctor nor a licensed therapist. Please do your own research and always be sure to consult with a psychiatrist or a medical doctor before consuming any medication.
With that being said, let me reiterate this fact: so far, there has not been any medication developed to specifically treat depersonalization & derealization disorder.
Psychopharmacological medication usually doesn’t deal directly with the root cause of mental illness. Most modern-day medications are aimed at reducing the severity of the symptoms and do not treat the underlying imbalance. Most of the time, these imbalances can be psychological, resulting from years of abuse, trauma from other sources, or sometimes even spontaneous occurrences (spiritual emergencies).
One also needs to be aware of the potential side effects of using medication for treating a mental illness. These side effects can range anywhere from mild nausea and upset stomach, to having suicidal thoughts and ideation.
Medication may also prevent the patient from developing their inner strength, courage, and resilience to go through the motions of an illness. In most cases, people who come through a difficult illness, such as depersonalization, without the help of medication are LESS afraid when the symptoms return.
In my opinion, medication should not be the first resort of a patient dealing with depersonalization, derealization, anxiety, or panic disorder.
Nonetheless, it is my belief that taking medication for mental illness is fine, as long as one is aware of the above caveats. In some cases, when the severity of the illness is very strong, there is nothing more helpful than having some relief from the mental agony with the help of a prescription pill.
Now that we got that out of the way, let’s dive in and see what medications are available for the treatment of depersonalization (DP) and derealization (DR), and their symptoms.
Naloxone and Naltrexone
You may have heard about Naloxone and Naltrexone in the news being used in case of opioid overdoses, but do you know that they may help with the treatment of depersonalization/derealization as well? Naloxone and Naltrexone are opioid antagonists that have shown some efficacy in treating DPD.
It has been hypothesized that blocking opioid receptors in the brain leads to a decline in opiate-modulated dissociative states. That means taking Naltrexone or Naloxone can lead to experiencing less of dissociative states such as depersonalization, derealization, and their various symptoms.
In one study conducted, three of the fourteen patients who were administered Naloxone were found to be free of depersonalization symptoms, whereas seven showed marked improvement.
In another study, fourteen subjects were treated with Naltrexone and it was found that there was an average of 30% reduction in symptoms.
Both these studies are promising, but it should also be noted that in both cases, the effect was only temporary. When consumption of Naloxone or Naltrexone stops, the symptoms and the illness may return. Currently, no pharmaceutical company is developing a naloxone/naltrexone-based drug exclusively for the treatment of DPD.
Lamotrigine is an anticonvulsant and a mood stabilizer. It has been observed that Lamotrigine blocks the release of the neurotransmitter glutamate. Neurotransmitters are chemical messengers that transmit signals between nerve cells or neurons. Glutamate release is known to cause dissociative symptoms, such as depersonalization and derealization.
In the two studies conducted with Lamotrigine for treating DPD, one concluded that Lamotrigine showed some treatment efficacy (meaning, it worked), while in the other, the same result was NOT observed.
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs, such as Prozac, Celexa, Paxil, and Zoloft, are a class of compounds that work on the serotonergic system of the brain (and to some extent the gut, where serotonin receptors are also found). The serotonergic system is thought to play a key role in regulating mood and in mood disorders, such as depression.
For people with DPD, SSRIs have been found to be effective at treating the depression that people often experience along with their depersonalization. This can be helpful because at least now the person may find the motivation to get out of bed and engage with their life. Doing so greatly increases their chances of recovery from DPD.
Whether SSRIs reduce the underlying dissociation is still up for debate. Currently, there aren’t any studies available to show conclusive evidence to support that notion. The only evidence available is anecdotal (coming from someone’s experience). People in various DP/DR forums and groups sometimes claim that SSRIs have been able to alleviate some or all of their dissociation.
In one study, Fluoxetine (also known as Prozac), an SSRI, showed some treatment efficacy in people with depersonalization disorder who also have an anxiety disorder.
Sometimes called “benzos,” these are a class of compounds that are part of the tranquilizer family. Benzodiazepines work with the GABA receptors in the brain, resulting in a sedative, anxiolytic (anti-anxiety), muscle-relaxant effect. Common drugs belonging to this class are Xanax, Klonopin, Librium, Valium, and Ativan.
These compounds are often prescribed for anxiety, panic disorders, and obsessive-compulsive disorders.
It has been found that having high levels of anxiety sometimes results in depersonalization, and a person with DPD does experience bouts of anxiety. Because of this link, people taking benzos for DPD do sometimes experience some relief from it. Whether or not these compounds alleviate the underlying dissociation is still in question.
Depersonalization can also bring about panic attacks and obsessive-compulsive thinking, which benzos might work to mitigate. It must be noted that the effects of medication vary widely with patients. While it may help to alleviate a symptom in one person, it does not do anything for the other, or worse, it can exacerbate the symptom for someone else.
Obsessive thinking and having intrusive thoughts or imagery is a common symptom of DPD. Anafranil is a drug that has been shown in some studies to help alleviate these kinds of thoughts. This is a compound that belongs to the tricyclics, which are anti-depressants that are older than SSRIs and have more side effects. As in the previous case, Anafranil does not seem to have any effect on dissociation itself.
At this time, there isn’t any psychopharmacological medication that can treat DPD specifically and effectively. All of the above medications may relieve one or more symptoms of depersonalization, but not the underlying illness itself.
In the future, there might be a drug available that can treat DP/DR effectively, although I am skeptical. DPD, like any other mental illness, is not just a result of chemical imbalances in the brain that can be fixed with some pills. It is a complex phenomenon that may arise due to, but not limited to, chemical imbalances, psychological factors, environmental circumstances, and maybe even a spiritual crisis. Taking all of these into account, it is wise not to rely on medication alone for the treatment of DPD. Various forms of therapy often outperform medication when it comes to effectiveness.
I’m curious to know if there has been any medication that has helped you with DPD or its symptoms. Please leave a comment below letting me know what medication has been helpful and how it has helped you. Thanks.