Would you have tried Lamictal if it was free?
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In the British Journal of Psychiatry Sierra writes.
An initial study of lamotrigine monotherapy in four patients with primary depersonalisation found substantial benefits in all cases (Sierra et al, 2001), but a subsequent placebo-controlled cross-over study of nine patients found no significant benefits from the drug (Sierra et al, 2003). Nevertheless, our clinical experience suggests that lamotrigine does benefit some patients with primary depersonalisation, although this effect may be more reliable when the drug is given in conjunction with an SSRI (further details available from the authors on request).
(...)
When lamotrigine cannot be tolerated or is ineffective, clonazepam may be useful, although the usual caveats regarding prescription of benzodiazepines apply.
In the monotherapy study which they rebutted with their double blind study, but still believe in, it says:
" (...) subscale columns show assessment scores before lamotrigine was started and 1 month after the onset of treatment."
So although it may take time to exhaust the potential of Lamical, one could also get an effect rather soon after beginning treatment.
I have a lot of epilepsy in the family. Though I am not epileptic, it's still interesting to see that two epilepsy drugs are being used for depersonalization: Klonopin and Lamictal.
With Klonopin I guess any effect would come pretty instantaneously, whereas with Lamictal it would take time. But how much time, I dunno.
An initial study of lamotrigine monotherapy in four patients with primary depersonalisation found substantial benefits in all cases (Sierra et al, 2001), but a subsequent placebo-controlled cross-over study of nine patients found no significant benefits from the drug (Sierra et al, 2003). Nevertheless, our clinical experience suggests that lamotrigine does benefit some patients with primary depersonalisation, although this effect may be more reliable when the drug is given in conjunction with an SSRI (further details available from the authors on request).
(...)
When lamotrigine cannot be tolerated or is ineffective, clonazepam may be useful, although the usual caveats regarding prescription of benzodiazepines apply.
In the monotherapy study which they rebutted with their double blind study, but still believe in, it says:
" (...) subscale columns show assessment scores before lamotrigine was started and 1 month after the onset of treatment."
So although it may take time to exhaust the potential of Lamical, one could also get an effect rather soon after beginning treatment.
I have a lot of epilepsy in the family. Though I am not epileptic, it's still interesting to see that two epilepsy drugs are being used for depersonalization: Klonopin and Lamictal.
With Klonopin I guess any effect would come pretty instantaneously, whereas with Lamictal it would take time. But how much time, I dunno.
Tried both.
There is a good few threads on Lamotrigine you'd be best searching for, as many people have tried it. It doesn't seem to fair any better than anything else people have recovered with here. Having read i'd say most of the recovery stories, Time + AD that is working is top..add in a AS and i'd say that's the most common for treating symptoms.
"subsequent placebo-controlled cross-over study of nine patients found no significant benefits from the drug"...
yep sounds about right, that's from Kings College who people here have been to, search KCL, they don't even take this approach standardly anymore as far as I am aware, I remember because a member went and I thought they'd just be on the combo outlined in that trial (Clomipramine as the preferred AD and Lamotrigine).
These are free in the UK, I couldn't tolerate Lamotrigine. Know 4 others who have tried it and it wasn't the one for them either. Still open to it being helpful for some, as many recover using meds that can't pass a trial, some even get out using rather unique medications that work for them, eg someone recovered after many medications on a short course one of Adderall, which i've also tried, this for most DP people is the complete opposite to what they'd want, the more stimulation, the more anxiety.
There is a good few threads on Lamotrigine you'd be best searching for, as many people have tried it. It doesn't seem to fair any better than anything else people have recovered with here. Having read i'd say most of the recovery stories, Time + AD that is working is top..add in a AS and i'd say that's the most common for treating symptoms.
"subsequent placebo-controlled cross-over study of nine patients found no significant benefits from the drug"...
yep sounds about right, that's from Kings College who people here have been to, search KCL, they don't even take this approach standardly anymore as far as I am aware, I remember because a member went and I thought they'd just be on the combo outlined in that trial (Clomipramine as the preferred AD and Lamotrigine).
These are free in the UK, I couldn't tolerate Lamotrigine. Know 4 others who have tried it and it wasn't the one for them either. Still open to it being helpful for some, as many recover using meds that can't pass a trial, some even get out using rather unique medications that work for them, eg someone recovered after many medications on a short course one of Adderall, which i've also tried, this for most DP people is the complete opposite to what they'd want, the more stimulation, the more anxiety.
So ...
Sierra and the others did the open study.
Sierra and the others did the double blind study.
Sierra and the others wrote the BJP article where it says "Nevertheless, our clinical experience suggests that lamotrigine does benefit some patients with primary depersonalisation"
And now they don't recommend it anymore, WreckingHotelRooms?
Sierra and the others did the open study.
Sierra and the others did the double blind study.
Sierra and the others wrote the BJP article where it says "Nevertheless, our clinical experience suggests that lamotrigine does benefit some patients with primary depersonalisation"
And now they don't recommend it anymore, WreckingHotelRooms?
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I tried this, was recommended it by Sierra himself who write a letter to my GP. Considering he is a consultant Psychiatrist he saw me at short notice, for free, for 2 hours and wrote a letter to my GP recommending Lamotrigine, Escitalipram and modafinil. My original GP refused modafinil but my new one did prescribe it, which I really hoped would help. But unfortunately it did nothing for me but give my the shits and insomnia. I have enough issues falling asleep without that causing issues
I digress, lamotrigine did absolutely nothing for me, took it for a couple of months I think. It is relatively safe but can cause a life threatening rash which is rare but to be kept an eye on. This one supposedly calms glutamate and increases GABA, but for me I felt nothing whatsoever, nothing changed. Felt like a sugar pill unfortunately and did nothing for me
I digress, lamotrigine did absolutely nothing for me, took it for a couple of months I think. It is relatively safe but can cause a life threatening rash which is rare but to be kept an eye on. This one supposedly calms glutamate and increases GABA, but for me I felt nothing whatsoever, nothing changed. Felt like a sugar pill unfortunately and did nothing for me
Thanks for sharing!
I am on modafinil, and it really gave me energy to focus. Lately I've been having more trouble concentrating, and I am not sure if it's due to daily modafinil and caffine use (low dose, but every day), or due to the fact that there has been extreme stress in my life lately.
I am on modafinil, and it really gave me energy to focus. Lately I've been having more trouble concentrating, and I am not sure if it's due to daily modafinil and caffine use (low dose, but every day), or due to the fact that there has been extreme stress in my life lately.
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Low dose modafinil or caffeine? I was thinking of trying modafinil again at some point and take a lower dose and work my way up.
It could be stress, goes without saying its always good to eliminate as much as possible for DP. Sleep is the biggest issue usually
It could be stress, goes without saying its always good to eliminate as much as possible for DP. Sleep is the biggest issue usually
Low dose of both modafinil (prescribed two tablets a day, but I took 1/2 when waking up) and caffine (1 tbsp of regular coffee, 2 tbsp of decaf when waking up).
I am going to do one more day of naloxone, then that's done, and then klonopin next week, if I get a prescription.
I'll prolly do two full weeks without modafinil or caffine, just to see what happens.
I am going to do one more day of naloxone, then that's done, and then klonopin next week, if I get a prescription.
I'll prolly do two full weeks without modafinil or caffine, just to see what happens.
Does any of them, any in the team, do private consultations? Such a letter would perhaps give me access to Lamotrigine.
No, there are in reality no "Depersonalisation research Unit"anymore. Their latest publication was in 2016 and likely written in 2015. Anthony David is at another university, so is E. Hunter, Nick Medford, M. Sierra. I asked them for a private consultation with a employed in 2004 and was told that they only took patient under the NHS scheme. You have to go to a psychiatrist to get such prescriptions. A normal GB would not give to most people. I was in correspondence with Nick Medford around that periode to ask him of the combinations they used and the dose of lamotrigine people responded in and it was in the range of 200-300.mg but they had tried doses as high as 500.mg. I have tried 500.mg
Lamotrigine was chosen because a trial found it could block the dissociative effect of ketamine in a trial done at Yale. Not, because it is antiepileptic. I think that trial cannot be replicated and that is why it don´t work in most. There are some very hyperactive areas in the brain in depersonalisation and it might reduce this activity in some. It could also be placebo though the placebo effect should be more reduced in depersonalisation compered with other groups.
I'm on 200 mg/day now, together with Clomipramine. Though it is sort of expensive (even in EU) research suggests Lamotrigine is a promising drug against obsessive thinking and intrusive thoughts, which is I think a primary reason DPDR (when it's secondary to anxiety/OCD that is) seems to be improved via this combination of meds.
Lamictal is supposed to work after about 6 weeks, my psychiatrist said, so it takes time.
Lamictal is supposed to work after about 6 weeks, my psychiatrist said, so it takes time.
Much appreciated, Cedric! Much appreciated!
Out of the blue I got some OCD like symptoms a while back. Never had it before, but bang, there it was. So perhaps with Lamotrigine I could "feed two birds with one scone", so to say.
No problem, we're all here to get better and to help others get better.
Now, don't expect miracles. The effects of most drugs I tried have all been subtle (except Clomipramine which after 6 weeks had a huge effect for me) so sometimes it's hard to say what helps.
Still, these meds can be of help to make you not ruminate on the DPDR as much, which I think is the key to recovery for most of us.
Agree!
My OCD like symptoms weren't related to DPDR in that way, they were rather political, and the only thing that has suppressed them so far is alimemazine, which does a half good job at it.
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