Treatment of depersonalization disorder with clomipramine (Citations: 15)

Daphne Simeon, Dan J. Stein, Eric Hollander

Background: Although there is a dire paucity of data on the pharmacologic treatment of depersonalization
disorder, there have been a few reports in the literature suggesting that selective serotonin reuptake
inhibitors may be of therapeutic benefit. In this study, we undertook to evaluate the efficacy of the potent
serotonin reuptake inhibitor clomipramine in treating depersonalization.Methods: Eight subjects with
DSM-III-R depersonalization disorder were entered into a double-blind crossover trial consisting of 8
weeks desipramine and 8 weeks clomipramine. Due to the very small size of the trial findings are
presented descriptively.Results: Of 7 subjects who entered the clomipramine trial, two showed significant
improvement in depersonalization. Three subjects dropped out early, unable to tolerate adverse effects.
Of 6 subjects who entered the desipramine trial, 1 showed significant improvement in depersonalization.
One clomipramine responder was subsequently followed in open maintenance treatment with
clomipramine for 4 years, and her depersonalization symptoms remained in almost complete remission,
with relapses upon each attempt to taper off or switch medication.Conclusions: Clomipramine may be a
promising pharmacologic treatment for primary depersonalization disorder and warrants further
investigation.
Journal: Biological Psychiatry - BIOL PSYCHIAT , vol. 44, no. 4, pp. 302-303, 1998
DOI: 10.1016/S0006-3223(98)00023-7

Effect of naloxone therapy on depersonalization: a pilot study (Citations:

9)

Yuri L. Nuller, Marina G. Morozova, Olga N. Kushnir, Nikita Hamper

To test the hypothesis of the role for the opioid system in the pathogenesis of depersonalization, the
effect of naloxone (an opioid receptor blocker) on the symptoms and corticosteroids secretion was
studied in patients with depersonalization syndrome. Fourteen depersonalization patients were treated
with naloxone: 11 patients received single doses (1.6 or 4 mg i.v.) and three others received multiple
infusions, with the maximal dosage being 10 mg, and the effect of naloxone on symptom severity was
determined. In eight patients, the cortisol, cortisone and corticosterone content in the blood plasma was
determined prior to and after the 4 mg naloxone infusion. A reversed-phase microcolumn high-
performance liquid chromatography with ultraviolet detection was applied for assessment of
glucocorticoids. In three of 14 patients, depersonalization symptoms disappeared entirely and seven
patients showed a marked improvement. The therapeutic effect of naloxone provides evidence for the
role of the endogenous opioid system in the pathogenesis of depersonalization.
Journal: Journal of Psychopharmacology - J PSYCHOPHARMACOL , vol. 15, no. 2, pp.
93-95, 2001
DOI: 10.1177/026988110101500205