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Anti-psychotics for derealization and time lapses?


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Hi,

I suffer from depersonalixation disorder and derealization since 2 years. Since my delivery. I never tried anti-p like Seroquel, because I was afraid of s/e and afraid that they wouldn't do much for the foggy feeling, time lapses, etc.

Since they all told me I wasn't having epilepsy, and I have GAD and depersonalization disorder, and depression, I wonder if it can help to ground myself, I mean, having the feeling to really live, be myself, and kind of happy. You know, being aware.

I have a lot of big dissociation moments (I feel like my mind is not there and I am afraid)

Thanks a lot, I need your opinions.

Dpmom

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Hello,

I had depersonalisation/derealization a few times when very depressed.  I'd go for Zyprexa.  This med kills psychosis like symptoms quickly and effectively - great first line med. But its long-term side effects profile kindov sucks.  You can also try Seroquel, that could help - I've been on it for years.  But if your body can't handle downers, Seroquel isn't really a good idea - it is very sedative.  You get to feel just like a lab rat when you're looking for the perfect med or med combo!!!  But hey, don't worry, you'll find something.

PBF

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Hello,

I had depersonalisation/derealization a few times when very depressed.  I'd go for Zyprexa.  This med kills psychosis like symptoms quickly and effectively - great first line med. But its long-term side effects profile kindov sucks.  You can also try Seroquel, that could help - I've been on it for years.  But if your body can't handle downers, Seroquel isn't really a good idea - it is very sedative.  You get to feel just like a lab rat when you're looking for the perfect med or med combo!!!  But hey, don't worry, you'll find something.

PBF

<{POST_SNAPBACK}>

Thanks A lot. I just wonder again. I see my psy tomorrow. and I don't know.... I have the choice. I could take 25 Seroquel and see..... or take Depakote. I don't know what could help for time lapses, kind-of absences, feelings of not beingme, not being there.... it's constant. I don't want to gain too much weight and have tardive dyskinesia.... but I want to heal and go to work!!!

Sorry for my complaints it's just that I am alone with this and it's been 2 years I try AD and benzo w/o great success. This fog never lift ;)

Thanks!!!!

Dpmom

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Hi dpmom!  'Member me?  I was the one who was so suspicious that your episodes were seizure-related, and even though your EEG came back clean, I'm still not convinced  ;) So from that corner, I'm curious to know if Depakote helps. So there's a vote in the other direction; sorry, not very helpful am I?!

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Thanks!!! for the replies.

Since you know meds a bit ;) Do you think it's safe to try Depakote AND klonopin AND Zopiclone (i.e. Lunesta) in the same day?

I asked many pharmacists, they say it's OK. But I read many things saying Klono and Depakote can cause absences. So I am still afraid.

What should I do? My psy thinks I can try it. I really asked, like, my neuro, a pharmacist, another pharmacist, and my psy asked 2 pharmacists :) hehe

thanks

DPmom

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Results from my favorite drug interaction checker, which you've probably already seen, says this:

"MONITOR: A single study has suggested that combination therapy with clonazepam and valproic acid may cause severe drowsiness and decreased seizure control. Other studies have not supported this finding.  Several case reports have suggested that the combination of clonazepam and valproic acid may precipitate absence status; however, this combination has had beneficial effects in the treatment refractory absence seizures. The mechanism and causality have not been determined.

MANAGEMENT: Monitoring for altered efficacy and safety is recommended if valproic acid (or its derivatives) and clonazepam are used together. Alternative therapy may be appropriate if significant side effects or loss of seizure control occur."

I couldn't find the single study they refer to, but I found some follow-up ones, including this one quoted below, and one finding the combination was effective against absence status and one finding it wasn't.  I don't know where to look for the case reports that talk about triggering it.

Valproate and clonazepam comedication in patients with intractable epilepsy.

Mireles R, Leppik IE.

The efficacy and the potential risk of inducing convulsive or nonconvulsive status epilepticus with the combination of valproate (VPA) and clonazepam (CZP), with or without other anticonvulsant drugs, in 55 patients with intractable epilepsy was evaluated. The patients were treated with VPA and CZP concomitantly for from 3 to 72 months (mean 21.7 months). Trough VPA serum levels ranged from 26 to 96 micrograms/ml). Trough CZP serum levels ranged from 5 to 63 ng/ml (mean 22.6 ng/ml). The treatment seizure frequency was compared with baseline values before combination treatment. Seizure improvement was obtained in 7 of 8 patients with absence seizures, 8 of 9 patients with myoclonic seizures, 19 of 39 patients with complex partial seizures, 3 of 14 patients with primary generalized tonic-clonic seizures, 8 of 23 patients with secondarily generalized tonic-clonic seizures, and 3 of 14 patients with atonic seizures. No single case of status epilepticus or exacerbation of seizures of any type was seen.

Epilepsia. 1985 Mar-Apr;26(2):122-6.

Pubmed abstract

From my limited knowledge, I guess I agree with the professionals you've already canvassed ... those three are probably safe together.  Now whether or not it's a good idea to start them all at the same time ... I don't know.  Is that what's happening?  Or are you already on Klonopin and Lunesta?

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The pdoc doesn't know, and I am very serious on that. :)   The pharmacists doesn't see why I shouldn't take them together. But inside, I don't want to, I am still scared. ;)   And I want to throw up in the day, not in the night (remember Lamictal made me very ill). So I would like to try it in the AM, and to sleep take the klono AND zopiclone.

I really have trouble to sleep, even with zopiclone. I often talke 2 zopi, one in the day to ease my derealization because klono doesn't help, and another in the night, and I still wake up early. On top I take Klono because of my anxiety, but in fact I only take it because I am addicted to it :P damned it. Even 1,5 mg of Klono doesn't help for derealization and time lapses, it just makes me more tired, and depressed.

I really hope that Depakote will help my anxiety. If not, will try that Seroquel and will pray. :ninja:

Dpmom

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I have trouble with this as well.  Nobody seems to know a lot about it, but one article I read cited success with MAO-Is and/or lamcitl (sp?) for depersonalization.  I've been on tegretol for the past while for this.  I'm inside my own head more than before but I'm so fuzzy that I might as well not be.

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Hey, DPmom, I'm glad your EEG was normal (though it probably would've been a relief to be able to pinpoint a treatable, organic source of trouble...).  My EEG results were normal, too. 

I wish I had some meds advice for you...maybe an MAOI (as VE suggested)?  Hope you find something that helps.

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Dpmom...I''m taking seroquel and it is helping just a little bit with the time lapsing and unreality, though it takes a pretty high dose to help with that. At a lower dose (100mg) I take it nightly to help me sleep

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Juat took my first Seroquel. I feel less myself, I type slowly and I feel not there at all. It's a strange sensation. I hope I'll sleep tonight.

I HAD the choice between this and Depakote... I choosed this because of klono issues with Depakote, but again, I don't know it there was any probs with Depakote AND klono. Damned pills.

I feel like a zombie now. Duh.

Dpmom

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I hATE it form the bottom of my heart. I felt immedialtey drugged to the point that I had to go to sleep NOW, at 8 PM. I was dizzy, and I drank all the night, because I needed so much water!!! I had nightmares and felt like if I had fever. I felt MORE depersonalized, not there at all. My dissociation was wayyyyy worse. I woke up and just want this feeling to end. It's horrible. I also have back pain.

I think AC are better for me.

;)

Dpmom

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Yikes!  Talk to your pdoc - this could be a tough one at startup (anyone else know?) that mellows after a few days.  As I understand it, a low dose functions as a powerful sleep aid but the higher doses are where the AP effects kick in, and it's less sedating.  If you're going to give it a real try, I think you should take it at bedtime and try to stick it out for a few days.  But talk to your pdoc, definitely!  I'm sorry that night was so awful  ;)

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  • 1 month later...

Wow - depersonalization and derealization disorder. I think this is what I have had going on for almost a year now. I think it got worse almost when I started to take Seroquel and messed around with my dosages because I dont' like it.

But it also started around the time I started Lamictal, which didn't work out for me.

I think something else is going on sometimes. I told my pdoc that I feel like my mind is going to slip off deep into my pillow somewhere at night sometimes. I have other feelings like my mind is going somehwere outside of itself and it isn't comfortable.

Mostly these things happen at night but sometimes during the day.

APs are not really helping this.

I am a little worried that I might have something wrong with my brain and at times have felt like I was developing a siezure that never really happened.

I am going to seek out help for organic causes first but it could just be all the stress I've been under for so long and I've been sick with other things for a few years too involving chronic pain. Maybe it has something to do with Fibromyalgia for all I know and chronic fatigue. Just need to get it check out. It's disturbing and not going away.

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