[Peter]

on this forum are already 74357632566 reports that naloxone didnt work

To be fair, people usually do not get naloxone by infusion as in the Nuller trial, but intramuscular or they snort it. This might explain why it hasn't been working that well.

 

[Peter]

It has to be given I.V and it have a short half-life of close to an hour. That also makes it unusable for a treatment.

Still some people on the Nuller trial had a response lasting more than 24 hours. Even if it worked only briefly, it might give an indication that other drugs working on the opioid system (Naltrexone, nalmefene, buprenorphine) might be worth a try.

One on this site, one called "huggybear" from Schizerland who have had all his posts and profile deleted wrote some years ago that he had his insurance to paid a serval infusions at a hospital for several hours in the highest dose as in the Fuller study,- felt nothing.

...and the owner of the former site repersonalization.com responded to naloxone. However lamotrigine worked for him as well, so he sticked with that.

 

[Peter]

got a question for you. do you think the dpdr from which people can recover in a few years is fundamentally (maybe biologically) the same „illness“ as someone who got this for 20 years?

Not necessarily, since other mental disorders can also be both episodic and permanent (like depression or psychosis) and I am not aware of evidence that this indicates a fundamental difference. There is evidence that depression and psychosis can become more severe with each episode and the likelihood of the symptoms becoming permanent rises with each subsequent episode. This might also hold up for depersonalization disorder, where the course patterns "permanent" and "initially episodic, but later permanent" are the most common courses.

Have tried nalmefene and naltrexone myself. I could not tolerante such high doses need because the affinity to kappa it very low. Felt nothing. I think Joe Perkins could tolerante a very high dose for a long time without effect. One with a heroin addiction here was shifted from metadone to buprenorphine and felt a 20% reduction.

Someone on Longecity was cured while taking buprenorphine. Currently only combining buprenorphine with naltrexone (similar to ALKS-5461) might be the safest and most cost effective way to block the kappa-opioid-receptors.

but then we have some people (even if its limited) who recovers also after 10+ years without a specific treatment. just with things like meditation or lifestyle changes. do you think they reach a shift in their brain what makes that possible or it is a psychological thing?

They exist, but they are not as common as many people want to believe and in most cases it is difficult to draw conclusions from their recovery stories, especially regarding the direction of causality between the things they did and their recovery. Maybe their symptoms got better by themselves and this made them change their lifestyle?

 

[Peter]

Yeah, just like rTMS, it's a shot in the dark since studies about it are very limited.

I would say we have to work with what we have, of course not without taking notice of the associated problems.

Regarding use, i guess it can actually be usable for treatment because it can either be administered intramuscularly and snorted.

I might not work if you do not get by IV.

Having them utterly destroyed by rTMS taught me this lesson already.

What effect did TMS have on you? Which area was targeted?

 

[Peter]

By the way, my dear friend leminaseri. In Germany there is an opportunity for you to try naloxone infusions:
rTMS + Ketamin und tDCS + Ketamin | Depressionsbehandlung mit rTMS-Neuromodulation Praxis Dr. Tamme (wege-aus-der-depression.de)

The only catch: You have to pay for them yourself.

 

[Peter]

There is a recent Chinese evaluation of possible targets for rTMS in depersonalization. It is partly based on all brain scans . They point towards the medial prefrontal cortex as the strongest candidate .

Since several studies suggest that topiramate dampens prefrontal activity I wonder whether it could be used to treat depersonalization disorder.

 

[Peter]

I told a neurologist about the doses I had tried in topiramate and he was surprise I could tolerate it. But I lost of lot of weight.

So you did not have cognitive problems, like difficulties finding words? This could mean that topirmate did not dampen your prefrontal cortex. Some people who take topiramate react with increased prefrontal activation, possibly due to a compensatory effect.

I responded by accident with 30% to clonazepam and my psychiatrist and I knew that it was only a matter of time before tolerance would become a problem. So, we tried anti-epileptics that worked on the GABA system like to topiramate or gabapetine.

Clonazepam might have a special mechanism of action regarding depersonalization other than GABA, since other benzos often do not have the same effect. Apart from that Gabapentin doesn't seem to affect the GABA system directly.