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Discussion Starter · #1 ·
I know there seems to be a strong debate over atypical antipsychs, but I had a good, albeit temporary (2 months) string on Abilify. High energy, great as an anti-depressant and drastically lowered my DR. However, as with Klonopin (experiencing benefit there as well), I pooped out on it.

This lamictal thing has got me thinking. Currently on SSRI, TCA + klonopin (no way I'm ready for the klonopoison withdrawal from 1.5 mg/day).

Paolo
 

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Paolo,

What's TCA? Also, sad to hear the Abilify pooped out on you.

Fosheez, how long have you been on the abilify?

-Nate
 
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Hi.

If you add Lamictal, you'll have the same combination that has brought me close to complete relief. Also, check out Dreamer's posts; she uses the same structure. Her results have apparently been less dramatic, but well worth knowing about. Lamictal + SSRI + TCA (tricyclic antidepressant) + Klonopin.

My numbers are 300 mg Lamictal; 25 mg. Zoloft; 10 mg Tofranil; and 3-4 mg. Klonopin. (I've been told that Tofranil potentiates Zoloft -- maybe that's why such a low dose works. But this is totally my own speculation.) My only problem is an ongoing struggle to adjust to the sedating effects of Klonopin. I keep cutting the dose, but for me, below a certain level it's just plain sedating, with no anti-DP effects.

Marjorie
 

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Marjorie,

What made you go as high as 300mg Lamictal? Did you notice a benefit by increasing dosage till you reached that level? Also, what benefit do you perceive the TCA gives you?

I'm currently taking 200mg Lamictal, 20mg Lexapro, .5mg Risperdal, 25mg Topamax

I just started taking the Topamax and even at the small dose, I'm noticing some improvement. Before the topamax, however, other than improved mood and better outlook, there was basically no improvement in my DR.

-Nate
 

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How does a tricyclic antidepressant (TCA) differ from a regular antidepressant?

Is topomax a TCA? I was prescribed that once along with seroquel, but when I took the seroquel the effects freaked me out so I didn't even try the topamax and got a new shrink.

Which brings me to my next question... is Risperdal like Seroquel?? My prozac/klonopin combo is no longer working and I'm trying to figure out what route to go next.

And what is Lamactil? Sorry... Why have doctors not explained all this crap to me.
 
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According to London institute of psychiatry - one of the only places that has conducted DP treatment studies in any significant numbers recommends a lamictal + SSRI (or SRI) combo - they say they have helped 40% of patients with these combos. The lamictal is in the anti-convulsant category category (also acts as mood stabilizer) and of course the SSRI's and SRI's treat anxiety and/or depression. DO a google on London Institute of Psychiatry and Depersonalisation unit and you can find the results of their studies. Good luck and beware of rare but sever rashes with Lamictal (report anything to a Dr. because the rashes although 1 in 1000 can be fatal).
 

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There realy is no "regular" anitdepressant. But the most prescribed ADs are SSRIs (selective serotonin reuptake inhibitors) which include Zoloft, Lexapro, Prozac, etc. I think Effexor and Wellbutrin are up there, too.

Here is the AD breakdown. ADs can work by increasing the amounts of at least one of three neurotransmitters: serotonin, norepinephrine, and dopamine. SSRIs increase the amount of serotonin. Effexor increases serotonin and norepinephrine. Wellbutrin increases dopamine and norepinephrine. Depending on which neurotransmitters an AD affects can determine some of the side effects.

TCAs mainly increase serotonin and norepinephrine. The "tricyclic" part I think just refers to the molecular structure of the AD's active ingredient. TCAs are old antidepressants and are notorious for bad side effects and can cause death when taken in overdose. Nick Drake, the 70s British folk singer, killed himself by overdosing on a TCA. i think you really have to take a buttload, though. That was probably more info than you needed to know.

Anway, TCAs are used as a second-line of treatment, when people fail to respond to the newer ADs, which are safer and have less side effects. TCAs can be very effective, though.
 
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Abstract (Article Summary)

There is evidence to support the view that glutamate hyperactivity might be relevant to the neurobiology of depersonalization. We tested the efficacy of lamotrigine, which reduces glutamate release, as a treatment for patients with depersonalization disorder. A double-blind, placebo-controlled, cross-over design was used to evaluate 12 weeks of treatment of lamotrigine. Subjects comprised nine patients with DSM-IV depersonalization disorder. Changes on the Cambridge Depersonalization Scale and the Present State Examination depersonalization/derealization items were compared across the two cross-over periods. Lamotrigine was not significantly superior to placebo. None of the nine patients was deemed a responder to the lamotrigine arm of the cross-over. Lamotrigine does not seem to be useful as a sole medication in the treatment of depersonalization disorder.
 

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I have to point out that the study quoted above is relevant to lamotrigine/lamictal as the SOLE treatment for depersonalization. The good results gotten in London resulted from a combination treatment of lamotrigine/lamictal WITH an SSRI. One drug can potentiate the other in ways that are not fully understood.

If you think of all the endless combinations and dosages of drugs that are out there, the relatively short amount of time that we've collectively been trying different combos, and the dearth of scientific studies on this condition, it stands to reason that there's still plenty of things to try and still lots of hope for recovery to be had.
 
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Nate said:
I have to point out that the study quoted above is relevant to lamotrigine/lamictal as the SOLE treatment for depersonalization. The good results gotten in London resulted from a combination treatment of lamotrigine/lamictal WITH an SSRI. One drug can potentiate the other in ways that are not fully understood.

If you think of all the endless combinations and dosages of drugs that are out there, the relatively short amount of time that we've collectively been trying different combos, and the dearth of scientific studies on this condition, it stands to reason that there's still plenty of things to try and still lots of hope for recovery to be had.
Succinctly and well put.

Its a shame that a research unit can't conduct a bigger trial than 50 or so people. Which leads me to wonder - does anyone know how many of us are out there (dp/DR)? Also - has anyone ever petitioned the National Institute of Health (govt. researcher in the USA) or another governmental psychiatric organization anywhere in the world. I live in DC and would be willing to investigate the red tape and the potential possibilities. There has got to be a better way than to sit back and wait while a couple very small and underfunded research units do their best. What if we could rise up like a tide and demand more attention? Has anyone made such an attempt? I guess I'm asking everyone if there have been such efforts to quantify us move us from the margins of psychiatry to a share of the main stage? If not, does anyone have any ideas on how we might be able to petition governments and/or non-profit organizations for more attention/research?

Otherwise I fear we will be taking shots in the dark with our meds for the foreseeable future. I'm no activist but this frustrating condition could lead me to become one. What about you guys? :?:
 

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murman said:
Nate said:
does anyone know how many of us are out there (dp/DR)?:
I really wonder too, what percenrage of the population it affects and if it's all around the world...
Imagine having DR in downtown Tokyo ! Damn !

It;s somtimes weird 'caus all doctors doenst seem to know about this condition or they totally ignore it and at some other places they have a departement studying this...

Just for fun...any of you ever met someone with DP/DR ?

Damn I need a DP'ed girlfriend =) that would be the solution ! hehe !
 
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Inflammed,
I don't think it should be the best for you, because you would think of DP all the time, with a DP friend :)

Maybe the best is to have normal friends :) Just to feel normal too. :)

About DP and doctors, my psychiatrist is very open, but he didn't care about DP/DR, he cared about the underlying condition : anxiety and depression. But, when I ask him about trying meds for DP/DR, like maybe Lamictal, Anafranil, etc., he agrees.

Cynthia xxx
 
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