[TDX]

Proof:

 

[TDX]

Nothing ever happens in DP research so we might as well make wild conjectures based on the limited evidence we have. We're probably never going to have it better. Sad but true.

Yes, that what we have to do. But we should always not forget that they are "wild conjectures".

 

[TDX]

That's right, but the problem is the durability of the effect. Often TMS only works temporary and we don't know how long it works for DPD. If it's only temporary maintenance treatment is needed, which we'll most likely won't get, as one course is difficult enough to get. But both the TPJ-study and the angular gyrus-study adress this problem. Unfortunately we'll have to wait until end 2016 and 2019 until they are done.

 

[luctor et emergo]

TDX and King Elliott, thanks for teaming up and reading through all available researches.

Do you have acces to the restricted / members or otherwise shielded papers?

Anyway don't give up and definetely don't kill yourself!

I'm convinced that a combination of psychotherapy along with the right medications can get us back in reality, whatever that may be.

What I do know is when under the influence of cocaine, speed or xtc I still had dp, dr but I also did't care,

thus it was way less intense, there was more connection with myself and the surroundings.

Do you have any suggestions for an additional medication that goes with Brintellix (Vortioxetine).

I'm currently on 20 mg, no effect.

In 2007 I have used 200mg Lamotrigine, which is now known to be an insuffcient dosage, for about 5 to 6 weeks.

I took Lamotrigine (Lamicatal) in combination with 75mg Citaprolam for about 4 weeks. No effect.

Should I try Lamictal again, but now go up to 600mg in combination with Brintellix?

Also, my cortisol was measured with the dexamethason suppression test, outcame was 52 nmol / l

while < 27 nmol / l is considered normal. This high cortisol level could be due to Klonopin withdrawal,

Which makes dp, dr, the feeling of detachment more crippling than ever before.

Nath suggested Mifepristone, what's your opinion on this?

Keep up the good work guys!

 

[TDX]

I'm convinced that a combination of psychotherapy along with the right medications can get us back in reality, whatever that may be.

Medication: Yes. Psychotherapy: No. In the next few days I'll talk about this in the other thread.

In 2007 I have used 200mg Lamotrigine, which is now known to be an insuffcient dosage, for about 5 to 6 weeks.

I took Lamotrigine (Lamicatal) in combination with 75mg Citaprolam for about 4 weeks. No effect.

Should I try Lamictal again, but now go up to 600mg in combination with Brintellix?

This and maybe Keppra or Topiramate.

Nath suggested Mifepristone, what's your opinion on this?

Simeon mentioned it briefly in her book. She speculated that it might be useful "to the extent that the hypothalamus-pituitaryadrenal axis abnormalities in depersonalization might resemble those of depression" (pages 168-169). But I haven't checked this out, yet.

 

[luctor et emergo]

There are definitely some promising researches covering mifepristone and the regulation of cortisol levels.
But since I still consider myself recovering from Klonopin use and withdrawal (6 months out). I'm hesitant in taking more medications and risk poly drug use side effects on a recovering post benzo brain.

 

[TDX]

I'm having a bad day today but I'll read through your post properly tomorrow. I do have access to almost every paper listed on pubmed yeah. Hit me up if you want anything. It might take me a while to recover the login details to my uni's academic portal but I'm happy to sort it out. I'm on (hopefully temporary) leave from my masters right now but I still have academic access.

I dropped out of university, because of my disorder. But I can still get 99% of publications by using illegal sites (for example Libgen), using an open terminal at the library of medical school at my former university, interlending or contacting authors.

My TMS is scheduled for October so I'll let you know! I'm thrilled! I had a long chat with the doctor in charge today. She knows what she's doing and said she'll prescribe nalmefene if the TMS fails. I can also return in the future for maintenance treatment if it works. Things are finally looking up for me.

You a very lucky to have found such a doctor. I hope that it will work.

 

[luctor et emergo]

Thanks for your kind words! It makes me happy to know that we can help others. Something to live for.

You are very welcome! After all one school of thought is that people are here on earth to help other people. :smile:

I completely understand your reservations about medication after withdrawing from clonazepam. Benzos are a hell of a group of meds. Your doctor/psychiatric/whoever screwed you over when they agreed to let you use them long term. I've heard the horror stories about benzo dependence and withdrawal and I'm glad you made it through.

Believe me the horror stories, as you can read on benzobuddies.org are true.

When I wanted to quit the doctors only words were "you can do it" ... no tapering schedule, nothing!

rTMS is definitely something I am going to ask my new doctor next Thursday.

To give my suggestions body I will need all the current research, are there more than posted on this forum?

What are you (TDX, King Elliott) currently doing after dropping out of university, except scouring the web for dp, dr related information.

 

[TDX]

What are you (TDX, King Elliott) currently doing after dropping out of university, except scouring the web for dp, dr related information.

I'm doing nothing more than trying to kill time to make each day pass as fast as possible. Most of the time I'm watching videos (often Lets play videos) on youtube or kinox.to. At the moment I'm watching "Star Wars: The Clone Wars". It doesn't make fun, thanks to anhedonia. Rationally I know I should do something useful, but I'm suffering from avolition. I had many ideas of meaningful activities, but it's extremely hard to actually do them. At the same time I'm often agitated, which means I have the urge to walk around aimlessly without getting anything done. I can confirm that without his primitive drives the human being gets nothing done and has zero quality of life. Life feels like an endless desert. Cognitive problems and the blank mind cause further problems. I try to sleep as much as possible, to reduce my time and abuse Mirtazapine to do this. I'm serving my life-term in a maximum anhedonia prison.

 

[luctor et emergo]

I'm serving my life-term in a maximum anhedonia prison.

You will not. The situation you are currently may seem hopeless. However when you look back on the year 2015 in let's say 5 years,

there will be significant changes in your life. And you will have experienced emotions, because in time you are going to socialize.

It's nearly impossible to not feel anything when around other humans, mainly because most are stupid, shallow and superficial.

 

[TDX]

It's nearly impossible to not feel anything when around other humans

Trust me: It's possible.

And you will have experienced emotions, because in time you are going to socialize.

I socialized the shit out of me when I spent 3 months in a psychiatric clinic and I did not experience emotions. My brain is broken and I can only hope that medication or neuromodulation might fix it. I am just realistic. I don't belong to the delusional "We will all recover"-crowd.

 

[inferentialpolice]

TDX, on 20 Jul 2015 - 5:20 PM, said:

Medication: Yes. Psychotherapy: No. In the next few days I'll talk about this in the other thread.

I look forward to this debate.

Is this happening soon? What thread?

 

[didep]

You're not being too optimistic about ALKS-5461? In trials of this drug you can not know whether it works or not for dp / dr?

 

[didep]

Hopefully then that is as soon as possible on the market.

 

[TDX]

I'm waiting for TDX to make the first move by explaining his perspective on the successful CBT trial. I don't personally believe the "therapy is useless" line is tenable.

It's a bit complex, because I am seeing both flaws in their theory and in their study, which in my opinion was not so succesful. In my opinion only a small subgroup might benefit from this therapy. At the moment I'm reading again their book "Overcoming Depersonalization Disorder", because it clarifies some parts of their theory, particulary how they handle "negative symptoms" like emotional numbness, which in my opinion is an important weakness of their approach.

I can see where you're coming from but unless our current understanding of the neurotransmitter systems involved in DP is completely wrong, ALKS-5461 will perform at least as well as naloxone.

I share the opinion that ALKS-5461 might be very helpful, but you should be careful to draw too much conclusions from a small uncontrolled trial. While it's true that there is a low placebo effect in DPD you should not oversee the problem of patient selection. For example in the 1990s it seemed like SSRI were the cure for DPD, because Hollander et al published a case series where SSRI put DPD in remission for 7 of 9 patients. There were also other case reports which comfirmed this view. But Simeon et al showed in a proper trial that SSRI don't work in most cases. Hollander might have had a high response rate, because of a non-representive sample, because Hollander seems to be an OCD-expert. The same might be a problem in Nullers study.

I don't want to say, that ALKS-5461 is not promising. It might not only work for DPD, but also for depression (which it is mean for), anxiety, addiction, PTSD, Borderline and even for some cases in psychosis. But we should not praise it before we have it (which fortunately might be next year).

 

[TDX]

Fortunately, unlike the case of SSRIs, we've yet to see a shred of research that contradicts the indication of KOR antagonists

And I hope we will never see such a thing, but rather the opposite.

What I find infuriating is that there still hasn't been a larger, placebo-controlled trial of naloxone after 14 years. The field of psychiatry gives not a single fuck about us.

That's the problem. Theoretically it's possible by using a port catheter so that the patients whose symptoms stay away to 12 to 24 hours could get an infusion everyday. This could be done at the same centers where methadone is handed out. In my time at the clinic someone told me that he got naloxone infusions everyday, because of his addiction. But I don't know what the longterm effects of naloxone might be...

But as ALKS-5461 is on the horizon they probably won't do another trial with naloxone and also not with nalmefene.

 

[TDX]

Naloxone was clearly never going to be practical for mass use

Well, theoretically I could have been used therapeutically, just like they could have used the Buprenorphine-Naltrexone-combo to treat depression and other disorders.

 

[eddy1886]

Fair play to you guys...This is the first time ive read this post and im very impressed!

Having suffered with DP for over 20 years I would love a drug that would alleviate my symptoms...

Just as a side note an anti psychotic called Dolmatil (Sulpiride) has really helped me over the years...Ive been on it since day one and it has helped me live a somewhat reasonable life...

The other things i would like to point out is that years of therapy never did anything for my DP...Exercise made it worse and various different healthy eating regimes didnt do squat for it either....

I believe at the heart of this disorder is a chemical imbalance which only medicine can treat (Unfortunately we havent discovered the medicine yet)

On a side note have you noticed that many of the "Complete" recovery stories on here seem to mention a medication..This leads me to believe there are no 100% recovery stories from DP yet....Just people who feel alot better???????

 

[LostTheRealness]

No. There are 100% recovery stories. DP can get completely away. you feel it.

 

[TDX]

This is true but that doesn't mean there's nothing psychological going on or that psychology is irrelevant. Everything is ultimately chemical imbalances but they merely form part of a chain of causation.

The relevance of psychotherapy depends on the mental disorder. While psychotherapy is the first-line treatment for anxiety disorder, OCD, mild to moderate depression, addiction and most personality disorders it only plays the second fiddle in the treatment of organic psychosyndromes, psychosis and bipolar disorder.

I can understand it when someone who's had negative experiences with medication becomes wary of it but there's a large contingent of people who haven't even tried medication and have absolutely no understanding of how it works preaching its axiomatic inferiority to noble suffering in the service of an abstract and uncertain "long term".

I think this might be more because of mentality than intelligence. While psychoanalysis is shunned by most psychiatrists it's still in the head of most ordinary people in the sense that they think in mental disorders that there is "something underlying" in themselves they have to correct. It's a bit like to astone for one's sins and might be partly a remnant of christianity.