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I've been suffering a lot of derealization/depersonalization recently.  Lot of stress and anxiety all at once over the last year has hit me.  Basically my life has been thrown into chaos alongside medication problems ....

Do you guys find any medications that will work well?  Can you get rid of it with anti-anxiety meds?

I've considered benzos but I'm concerned it will only worsen the condition...Seroquel seems to help a bit.

Edited by BrianOCD

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I don't know about derealization and medication but for OCD, the SSRIs are usually the go to meds for OCD. If that doesn't work, you could try the old "gold standard" antidepressant for OCD clomipramine or low dose resperidal I've read can help. 

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Some of the things I've read that may help:

  • As @CeremonyNewOrder stated, clomipramine, a tricyclic antidepressant
  • Lamotrigine, an anticonvulsant, which reduces the amount of glutamate released
  • Opioid antagonists, like naltrexone
  • The combination of an SSRI and a eugeroic like modafinil (though I guess an SNRI could work too)

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2 hours ago, mikl_pls said:

Some of the things I've read that may help:

  • As @CeremonyNewOrder stated, clomipramine, a tricyclic antidepressant
  • Lamotrigine, an anticonvulsant, which reduces the amount of glutamate released
  • Opioid antagonists, like naltrexone
  • The combination of an SSRI and a eugeroic like modafinil (though I guess an SNRI could work too)

Is attacking the anxiety enough to get out of derealization/depersonalization?

Like somebody taking benzos over a few months, would that inevitably mean it couldn't exist, or is it known to persist through these?

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9 hours ago, BrianOCD said:

Is attacking the anxiety enough to get out of derealization/depersonalization?

Like somebody taking benzos over a few months, would that inevitably mean it couldn't exist, or is it known to persist through these?

My answer to your question is a complete reach in the dark...

Chronic stress/anxiety causes dysregulation of the HPA axis and causes a rise in cortisol, which in turn causes further dysregulation of the HPA axis, causing a further dysregulation of the HPA-axis... etc... causing a negative feedback loop, causing anxiety and stress to worsen (due to lack of your physically being able to cope with it). It's known that long-term exposure to anxiety/stress can cause depersonalization/derealization, so this worsening of anxiety could cause worsening of the derealization and depersonalization.

Antidepressants can regulate the HPA axis, and I suppose benzos too since they all lower cortisol to some extent or another (oxazepam (Serax) I believe does so in particular, but my pdoc said they all do). So I would imagine taking a benzo over a period of time would "re-regulate" your HPA axis and get your physical coping mechanisms back in line so that you can hopefully start feeling better, at least a little bit.

As far as oxazepam (Serax) goes, it's a short-acting benzo, which, were it to be taken regularly, it would need to be dosed 3-4 times per day (according to Epocrates... see attached picture...) Personally, I love it, and it's pretty much the only benzo that works for me anymore.

But anyway, like I said, this is ENTIRELY just my speculation, and I'm NOT an expert.

unnamed.jpg

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On 2/7/2018 at 11:22 AM, mikl_pls said:

My answer to your question is a complete reach in the dark...

Chronic stress/anxiety causes dysregulation of the HPA axis and causes a rise in cortisol, which in turn causes further dysregulation of the HPA axis, causing a further dysregulation of the HPA-axis... etc... causing a negative feedback loop, causing anxiety and stress to worsen (due to lack of your physically being able to cope with it). It's known that long-term exposure to anxiety/stress can cause depersonalization/derealization, so this worsening of anxiety could cause worsening of the derealization and depersonalization.

Antidepressants can regulate the HPA axis, and I suppose benzos too since they all lower cortisol to some extent or another (oxazepam (Serax) I believe does so in particular, but my pdoc said they all do). So I would imagine taking a benzo over a period of time would "re-regulate" your HPA axis and get your physical coping mechanisms back in line so that you can hopefully start feeling better, at least a little bit.

As far as oxazepam (Serax) goes, it's a short-acting benzo, which, were it to be taken regularly, it would need to be dosed 3-4 times per day (according to Epocrates... see attached picture...) Personally, I love it, and it's pretty much the only benzo that works for me anymore.

But anyway, like I said, this is ENTIRELY just my speculation, and I'm NOT an expert.

unnamed.jpg

You always sound like an expert though Mikl =P

I think you're right, and the benzo use has been helping me somewhat to feel better, although I'm pretty far gone from my old self now....I hope I can reconnect.

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