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I dont understand the posts reference to wiki. Wiki says that rTMS trails shows the rTMS at the right TPJ might be helpfull to 50%. It really don't point towards naloxone or naltrexone as being a treatment.

In medicin 50% of findings or cures can not be replicated. There is a reason to 50% can't now as fraud, to small samples, high placebo effect, biases among researchers and patients. Research in depersonalization might have a replication crisis much higher than 50% because research in it is very underfunded. It is very difficult to get money for research and one donor stopping making contributions might close down research totally as it happened with the depersonalization research unit. So, everthing is small in size, no placebo group no follow up. So, it is close to claims.
The Fuller "trail" is very small 12. patients. It is a pilot study to test the idea that the opiopate system is involved in depersonalization. It is not a trail for a treatment, there is no follow up as if was a trail. It is a pilot study to see if the opiopate system plays a role. It have not be replicated by others to show it findings is false or correct. People read it as a "trail" for a treatment as they also think a trail is a "free treatment" and a "research unit" is a "treatment center"- the narratives says it has to be like that so they think that.

Naloxone is an antagonist at the opiapate system given to accute overdoses to opioids. It is used to stop people form going into a respiratory crises and sleep to death from an overdose.

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.

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.

 

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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.

 

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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.

 

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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 . It is a location never tried, as all research is done prior to 2015 where a coil that could stimulate this area was developed. This coil is approved to clinal use last year for magventure machines . One can see the diffrent locations in the article and I expect that 80% would be non-responsive. There is a need for a better understanding of networks involved. Many locations have to be tested and people be scan before and after to see changes. There likely is variations in locations people will respond to. It is seen in other conditions like depression and obsessive compulsive disorder. Potential Targets for Noninvasive Brain Stimulation on ... - MDPIhttps://www.mdpi.com › pdf

 

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No. I have tried topiramate in very high doses prior to its was known I had depersonalization. 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. 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.

There is overactivity/overregulation in the prefrontal cortex in almost all depressions and obsessive compulsive disorder. You don't use anti-epileptics to normalize that as it don't work.