Pharmacotherapy of depersonalization/derealization disorder
- Daphne Simeon, MD
Daphne Simeon, MD
- Associate Clinical Professor
- Mount Sinai School of Medicine
Depersonalization/derealization disorder (DDD) is characterized by persistent or recurrent depersonalization and/or derealization that causes clinically significant distress, while reality testing remains intact .
DDD has a prevalence of approximately 2 percent and is associated with significant morbidity, but often goes undetected or misdiagnosed, leading to delays in treatment.
This topic discusses pharmacotherapy for DDD. The epidemiology, pathogenesis, clinical manifestations, course, and diagnosis of DDD are discussed separately. Psychotherapy for DDD is also discussed separately. (See "Depersonalization/derealization disorder: Epidemiology, pathogenesis, clinical manifestations, course, and diagnosis" and "Psychotherapy for depersonalization/derealization disorder".)
APPROACH TO TREATMENT
Our approach to selecting among treatments for depersonalization/derealization disorder, including the use of pharmacotherapy and psychotherapy, is discussed separately.
Depersonalization — Depersonalization is a persistent or recurrent feeling of detachment or estrangement from one’s self. An individual experiencing depersonalization may report feeling like an automaton or as if in a dream or as if watching himself or herself in a movie. Depersonalized individuals may report the sense of being an outside observer of their mental processes or their body. They often report feeling a loss of control over their thoughts, perceptions, and actions.
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- Jay EL, Nestler S, Sierra M, et al. Ventrolateral prefrontal cortex repetitive transcranial magnetic stimulation in the treatment of depersonalization disorder: A consecutive case series. Psychiatry Res 2016; 240:118.
- APPROACH TO TREATMENT
- OVERVIEW OF PHARMACOTHERAPY
- SEROTONIN REUPTAKE INHIBITORS
- Side effects
- Side effects
- ANTIPSYCHOTIC MEDICATIONS
- OTHER INTERVENTIONS
- SUMMARY AND RECOMMENDATIONS