[leminaseri]

Recently I went into a frenzy of cure-seeking research and found myself re-reading the wikipedia pages about depersonalization and dpdr. To my surprise i found them totally re-done with some information like rTMS removed (thank god) and some added. The added information in question was about treatment efficacy of naloxone and lamotrigine. So I'm asking: anybody here has had any experience with those two substances? I will very likely try naloxone (and maybe you could to the same) since:
1) It's very cheap
2) Has almost no side effects and is as safe as it can be
3) I already have experience with intramuscular injection drugs
And will report back. I'm not very sure about Lamotrigine (though I will try to talk about it to my psychiatrist) since it's potentially very dangerous.

on this forum are already 74357632566 reports that naloxone didnt work

 

[leminaseri]

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. The opiate system likely plays a role but not the whole explanation of it. When studies are so small in size, with almost no follow up, no placebo controlled and no replication by others,- you can not conclude much either for or against. There will always be a placebo response of 30-40% felt reduction in some when the trial is active and some weeks after.

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? and do you still think that the anancasm of one person with dpdr is a factor that the symptoms persist?

 

[leminaseri]

difficult to say if those who recover is more recent, have a more anxiety related condition that depersonalization is just a response too. There are some recent German structural brain scans that point towards that the condition becomes more "imprinted" into the brain with more white mater indicating som abnormal networks. Over and underachieve parts of the brain also changes in size like a muscle is over or under used. They also point some networks related to obsessive-compulsive thinking. Some more psychoanalytical models finds this obsessive feeling of "incompleteness" to be precent prior to the outset. In their model the brain makes a "solution" with depersonalization that becomes destructive instead of a brake,- and the brain starts to obsess about depersonalization instead of incompleteness.

The medial prefrontal cortex is found overactive in some studies with depersonalization. It is a location too deep to stimulate with normal rTMS but after 2015 a deep coil was developed and the medial prefrontal cortex have been tried in research in depression. 1/3 with depression respond to it, many with OCD and PTSD also see a response. A Recent trial with functional brain scan in depression found that those with depression who responded also had new connections between the medial prefrontal cortex and precuneus. These two locations are also the two central hubs in the default mode network and is related to the feeling of the self. So, those who respond gets a more integrated default more network. The precuneus is also found as abnormal in many brain scans studies. A location that can only be stimulated with a deep coil. So, there are some locations never tried in depersonalization but I would say the medial prefrontal cortex is strong candidate as it is related to both obsession and the default mode network.

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?

my second episode of dpdr was triggered by major depression and anxiety (obsession about becoming psychotic). i took antidepressants, which eliminated my anxiety but the dpdr was still there. im taking the medication for 20 months now and im tapering slowly because i dont like the side effects. i hope that my anxiety comes back because this seems the only way how i can hope for a recover, EVEN if my outset is quite recent. sure my very first bout of dpdr was triggered 11 years ago but my symptoms were very different. i dont think that both episodes came from the same issue