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Discussion Starter · #1 ·
http://www.medscape.com/viewarticle/468728_print

*This is on Medscape. You need to register informally to access the
full article.*

Medication-Associated Depersonalization Symptoms: Report of
Transient Depersonalization Symptoms Induced by Minocycline


Philip R. Cohen, MD
South Med J 97(1):70-73, 2004. ? 2004 Lippincott Williams &
Wilkins


Posted 03/10/2004
--------------------------------
Medications Associated with Depersonalization Symptoms
This table is at the end of the article, including a very detailed
bibliography.
(This includes both Rec drugs and Rx drugs. The article notes that
this induced DP is reversed when meds are discontinued. Obviously this
is not the case for everyone.)
Best,
D


"Alcohol
Antihistamines
Antipsychotics
Anxiolytics - (Anti-anxiety medications)
Benzodiazepines
Caffeine
Carbamazepine
Fluoxetine
Fluphenazine
Hallucinogens
Indomethacin
LSD
Marijuana
Meta-chlorophenylpiperazine
Minocycline (this article)
Nitrazepam
Sodium pentothal

-----------------

Abstract
Patients with depersonalization disorder experience episodes in which
they have a feeling of detachment from themselves. Symptoms of
depersonalization may occur in individuals who have other mental
disorders, or who have various medical conditions, or who have taken
certain medications.

A woman developed depersonalization symptoms after initiation of
minocycline therapy. Her symptoms ceased after treatment was stopped
and recurred when she restarted the drug. Medications that have been
associated with causing symptoms of depersonalization are presented and
the postulated pathogenesis by which some of these drugs induced
depersonalization symptoms is discussed. Medication-associated
depersonalization symptoms typically resolve once the inducing drug has
been withdrawn.

Introduction
Psychiatric syndromes that consist of disruptions of aspects of
consciousness, environmental awareness, identity, memory, or motor
behavior are classified as dissociative disorders.[1]

Depersonalization disorder is a dissociative disorder characterized by
persistent or recurrent episodes in which the individual has a feeling
of detachment or estrangement from one's self. Although their reality
testing remains intact, the person may feel like they are living in a
dream or like an automation.

Depersonalization disorder cannot be diagnosed if it is part of another psychiatric condition or if it is secondary to a medical disorder or if it is caused by a drug.[1-7]

In contrast, transient depersonalization symptoms may occur in
association with several mental disorders, medical conditions, or
medications.[1-42]


Minocycline is a semisynthetic tetracycline derivative that is well
absorbed after oral administration.[43-45] Since it penetrates well
into sebum, secondary to its high lipid solubility, it is commonly used
in the treatment of acne vulgaris.[46] The potential profile of
minocycline-associated adverse sequelae has been established.[43-51]

Central nervous system-related side effects that may occur in patients
treated with this medication include headaches, light-headedness,
pseudotumor cerebri (also referred to as benign intracranial
hypertension, which clinically presents with blurred vision and
headache), and vestibular disturbances (such as ataxia, vertigo, and
dizziness).[43-46,52-54]

A young woman with minocycline-induced transient depersonalization
symptoms is described. Her symptoms began after initiating treatment
with minocycline, ceased after stopping the medication, and recurred
after restarting the drug.

Other medications that have been associated with causing symptoms of depersonalization are summarized and some of the postulated mechanisms for the pathogenesis of these drug-related symptoms are discussed.

Conclusions
Individuals may develop depersonalization symptoms after medication
administration. Depersonalization symptoms appeared in a woman after
starting minocycline therapy and resolved once the drug was stopped;
subsequently, the symptoms promptly recurred when she rechallenged
herself with minocycline and permanently resolved after the medication
was discontinued.

The pathophysiology of minocycline-associated depersonalization
symptoms remains to be established. However, alternative mechanisms of pathogenesis?not necessarily mutually exclusive?have been hypothesized for some of the other medications associated with inducing
depersonalization symptoms: hypersensitivity of the serotonin system,
drug-related metabolic encephalopathy, panic disorder-related etiology,
and substance-induced temporal disintegration possibly secondary to
increased levels of brain activity.


Medication-associated depersonalization symptoms typically resolve
once the inducing drug has been withdrawn."
 

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Discussion Starter · #2 ·
From the article, the DSM-IV, the Merck Manual, and the ICD-9 ... is it 9 now? -- anyway

"Depersonalization disorder cannot be diagnosed if it is part of another psychiatric condition or if it is secondary to a medical disorder or if it is caused by a drug."

Per this DSM-IV definition, if any of us experience other symptoms w/our DP, and it was CAUSED by a Rec/Rx [edit] drug, we do not have Depersonalization Disorder. This is "Primary" DP. It would seem few if any members of this board have Primary DP.

Dr. Sierra at the IoP is trying to research Primary DP in order to understand the basic mechanism, but finding actual individuals w/PRIMARY DP is difficult. These individuals apparently have tumors/lesions, etc. He has also gone back to study any literature on true Primary DP patients.

Go figure. This really confuses me.
Also, traisient DP is apparently very common in the population-at-large w/out any psychiatric diagnosis or disability. This transient DP is not disabling socially or occupationally.

Hmm.
D :roll:
I'm outta' here.....
 

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Well I know I keep banging on about it, but I had dp years before I had any other psychiatric problems. And I wasn't taking any drugs at the time it started. There seemed no reason for it whatsoever...so maybe I am one of these rare people with primary DP. Who Knows.

g
 

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Discussion Starter · #4 ·
Gavin when the DP first came on, you had no anxiety, no depression, no panic with it at all? You weren't an anxious person, etc? And now do you have anxiety, panic, etc. This is a sticky wicket.
Best,
D :shock:
 

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i had dp before i took meds so logically speaking i cant blame the meds....
thanks for the email btw dreamer,im back on track :wink:
 
G

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I got then well... Something after I smoked a joint 3 years ago!, I started taking meds, it helped, i smoked again, and used more meds. I am currently using Effexor XR 150mg + 100mg Xanax -- not 10mg 100mg! I am trying to get of it. So what do I have? The "tapering of the Xanax definately causes DP/DR. :roll:

So i assume i will fall under the categoray secondary DP?? For the side effects of Xanax? But what obout the joint i smoked? Is that then: substance-induced temporal disintegration.
:?:
 

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I guess I belong to the category of primary DP, as 15 years ago (1989) I first started feeling detached from my surroundings I didn't use any drugs, not even alcohol. Also I didn't have anxiety, depression or other psychological symptoms, only this feeling of being like asleep while awake or being behind an invisible icy wall, which separates me from my surroundings. I was 14-yr-old when I started feeling like this and now am 29 yrs... I was surprised to hear that primary DP is a rare phenomenon, as it must be the case with me. :shock: Any others?
 

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100mg of Xanax ? A day ? Really ? That's the equivalent of, er, well, a LOT of Valium. At least 1000mg a day....that can't be right. 1000mg of Valium a day would knock out a horse, several horses !!
 

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I'm with you Ninnu, I've been on this board for nearly a year and it's taken me this long to realise that people who had DP before any other problems are rare as a lottery winning unicorn.

Yes Dreamer, I had no probs whatsoever before DP came. It was the most stress free time of my life. I'd graduated from uni the year before and I was building up my portfolio at my own pace (i wanted and still do, to become an illustrator) but there was no pressure on me financially. I was enjoying life.

I know the exact date the switch went in my brain...March 8th 2000. I was just sitting in a pub half way down my first pint of guiness (that night) when all of a sudden it felt like the world had become distanced and flat, like I was somewhere else, or like I was half asleep and half awake. Of course this bothered me, but eventually as the days went on I tried just to get on with my life and hope it would go away. But IT never did, instead my life and my motivation slipped away and I guess that's what created my panic disorder, when things gradually built up and up and I realised this thing might stop me from doing all the things I'd dreamed of doing. Now, that seems to be under control with Efexor, but the DP is there as always.

gav
 

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Hi Gavin, I'm in the same boat. I remember I used to read lots of biological etc. literature when I was under 14-yr-old, also I used to draw every day. But since I started feeling DP/DR, those things that had interested me lost some of their meaning, as I couldn't feel much enthusiasm anymore. Nowadays I'm not much into natural sciences during my spare time, as I need to read the stuff for exams - but I draw & plan my scifi comic when I have free time. The only thing is that I have to press me to draw - never having natural inspiration for anything. *sigh* I only hope I would feel it though, someday...so I keep trying. At least I have learned never to wait for the inspiration, cuz then you have to wait forever and will never draw anything... :wink:
 

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I also have primary DP. My first experience with it was when I was six. No drugs, no alchohol, nothing. I was sitting in the car with my family thinking about God when it happened. Ninnu I like your quote. :)
 

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Thanks Peacedove - I do not remember anymore where I found the quote, but I have been using it with a couple of years. It is nice to meet other people with primary DP too, in that way I don't feel so much out of place here. This forum is great, though it seems I stay sometimes too much time online, when I have spare time. :oops:
 
G

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The first time it happened to me was when I was about 17 and just watched a scary movie at a friends. I came home and my house I had grown up in just didn't seem familiar anymore. I kept petting my cat and was totally freeked out. I was up all night. When my parents woke up I told them what was going on. They asked me if I'd ever taken LSD and I admitted I had. They called some therapist on the phone and she told them I was having an acid flashback and that it might go away soon or may last forever, you just never know. This REALLY freaked me out! It was gone by that evening.

I also got it from smoking pot and thinking it was laced. It was last for a couple days.

I also got it once when I was 18. I was in Job Corp. When I got up and went outside it was wierd because the place was quite and I didn't know where everyone was. Then I noticed police dogs on the football field. I wasn't aftaid this time. I just felt like I was in a dream and I couldn't wake up.

I wonder then, If this is my primary problem as well. Hmmmmm....

Carla
 

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I don't mean to start an all out "No, you don't mean ME" war here, but I personally believe that since this illness is considered psychobiological, that the chemical part of the illness, is VERY crucial to the onset, induction, or root cause of DP/DR in general. The brain, though well studied, is not greatly understood by the concepts of science, and potential of it. I think of everything chemically. Even those who say "Well I had DP before taking drugs." DID you? Were you ever anaesthitized for a common childhood mishap, surgery, illness? Tonsils being taken out, wisdom teeth being removed. Chemical, common for causing DP/DR I've read. What about pregnant women? Drugs used for pain of labor? etc.

Not to mention the non-foreign-body substances that make us see what we see, do what we do. We are only the product of our bodies make-up. That means to me, synapses firing. I don't find it at all unusual that those things could become damaged and muddled up. (Perhaps it was learning about the nervous system in adv. 4th grade, and how if 2 neurons touched one could die, or have stroke). Anyways, trauma victims, the removal of the psyche, ego, superego, ID. It seems to me, that EVEN if you believe in a "higher" power, don't you think there's an all inclusive answer that...well even if that's the case, in this existence, these are the bodies we've been given, and unfortunately they've malfunctioned...

Gives rise to the idea that one might be handicapped, or some such, and many different issues raised, that lead back to a chemcial disorder, that gives rise to a psychological disorder that gives reciprocation (through anxiety) to a bigger chemical disorder, and so on and so on, in reciprocal.

That is, and just always has been my contention, from Cannabis-induced souls who HATE the sound of Jimi Hendrix now, to blokes on a bicycle ride who suddenly had the sun just become "too bright" for them. Psycho-BIOLOGICAL.

Thanks for all the really good info dreamer.

(Benzodiazepams work for me...Klonopin...so, maybe it's not all inclusive...since at the time, that was what was working for everyone, circa...00'/01' right?)

Cheers!

Doug / Sixtiessoul (that70sboy/ dj)
 

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I don't mean to start an all out "No, you don't mean ME" war here, but I personally believe that since this illness is considered psychobiological, that the chemical part of the illness, is VERY crucial to the onset, induction, or root cause of DP/DR in general. The brain, though well studied, is not greatly understood by the concepts of science, and potential of it. I think of everything chemically. Even those who say "Well I had DP before taking drugs." DID you? Were you ever anaesthitized for a common childhood mishap, surgery, illness? Tonsils being taken out, wisdom teeth being removed. Chemical, common for causing DP/DR I've read. What about pregnant women? Drugs used for pain of labor? etc.

Not to mention the non-foreign-body substances that make us see what we see, do what we do. We are only the product of our bodies make-up. That means to me, synapses firing. I don't find it at all unusual that those things could become damaged and muddled up. (Perhaps it was learning about the nervous system in adv. 4th grade, and how if 2 neurons touched one could die, or have stroke). Anyways, trauma victims, the removal of the psyche, ego, superego, ID. It seems to me, that EVEN if you believe in a "higher" power, don't you think there's an all inclusive answer that...well even if that's the case, in this existence, these are the bodies we've been given, and unfortunately they've malfunctioned...

Gives rise to the idea that one might be handicapped, or some such, and many different issues raised, that lead back to a chemcial disorder, that gives rise to a psychological disorder that gives reciprocation (through anxiety) to a bigger chemical disorder, and so on and so on, in reciprocal.

That is, and just always has been my contention, from Cannabis-induced souls who HATE the sound of Jimi Hendrix now, to blokes on a bicycle ride who suddenly had the sun just become "too bright" for them. Psycho-BIOLOGICAL.

Thanks for all the really good info dreamer.

(Benzodiazepams work for me...Klonopin...so, maybe it's not all inclusive...since at the time, that was what was working for everyone, circa...00'/01' right?)

Cheers!

Doug / Sixtiessoul (that70sboy/ dj)
 

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that was indeed a very inetersting read...

i had an allergic reaction to Venlafaxine...i only took two 75mg (on seperate days)...it was for anxiety and depression...

and i had major symptoms....skin burning...throat closed...could not breathe...loosing sight...numbness...pins and needles...thumping racing heart....hot cold sweats....disorientation...dizziness tot he point of collapsing....pains all over...the whole lot on the leaflet...

it think it is safe to say it was the scariest moment of my life... :shock: :(

it was the first time i had experienced dp/dr...

and since i have not been the same...

my anxiety has been much worse since then...

and i am sure it was the trigger to my dp/dr...despite when the tablets had left my system i think i was ok...shortly after....

but that was not doubt due to the relief of getting the chemicals out of my body...

so now i am petrified to go on any meds...

i panic if i have to take a pain killer! :roll:

but if meds caused it....i am trying to find a non-med solution to solve my dp/dr problem.

my doctors and therapists just keep telling me that it could not have been the trigger as i was experiencing unreality symptoms before i took them...

but at least before those tablets i did not check out my heart rate all the time or check my breathing or felt completely detached from myself and my surroundings!

sorry...a simple post has turned into a rant :? :roll:

i hope i can find a solution without meds...
 

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that was indeed a very inetersting read...

i had an allergic reaction to Venlafaxine...i only took two 75mg (on seperate days)...it was for anxiety and depression...

and i had major symptoms....skin burning...throat closed...could not breathe...loosing sight...numbness...pins and needles...thumping racing heart....hot cold sweats....disorientation...dizziness tot he point of collapsing....pains all over...the whole lot on the leaflet...

it think it is safe to say it was the scariest moment of my life... :shock: :(

it was the first time i had experienced dp/dr...

and since i have not been the same...

my anxiety has been much worse since then...

and i am sure it was the trigger to my dp/dr...despite when the tablets had left my system i think i was ok...shortly after....

but that was not doubt due to the relief of getting the chemicals out of my body...

so now i am petrified to go on any meds...

i panic if i have to take a pain killer! :roll:

but if meds caused it....i am trying to find a non-med solution to solve my dp/dr problem.

my doctors and therapists just keep telling me that it could not have been the trigger as i was experiencing unreality symptoms before i took them...

but at least before those tablets i did not check out my heart rate all the time or check my breathing or felt completely detached from myself and my surroundings!

sorry...a simple post has turned into a rant :? :roll:

i hope i can find a solution without meds...
 

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i also belive a have got dp through meds. i went to the gps with a pain in my head, which i now think was tension, iwas given carmazapine 100mg 2 times a day, they knocked me out totally, i only took 6 tabs, and that was 11 months ago. the gps reckon that the dp would be short term will the meds left my system, i think they were wrong, i use to enjoy life, icould come and go as i pleased, take my kids out, socialize, but now i hate been in, i cant go out on my own, isuffer from chronic anxiety, depression and panic attacks, hopefully the meds i am now on will help, and the community mental health team are trying to help me get some confidence, but its a long slow process, heres hoping we are all better soon and able to live life to the full once again.
 

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i also belive a have got dp through meds. i went to the gps with a pain in my head, which i now think was tension, iwas given carmazapine 100mg 2 times a day, they knocked me out totally, i only took 6 tabs, and that was 11 months ago. the gps reckon that the dp would be short term will the meds left my system, i think they were wrong, i use to enjoy life, icould come and go as i pleased, take my kids out, socialize, but now i hate been in, i cant go out on my own, isuffer from chronic anxiety, depression and panic attacks, hopefully the meds i am now on will help, and the community mental health team are trying to help me get some confidence, but its a long slow process, heres hoping we are all better soon and able to live life to the full once again.
 
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