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Pharmacotherapy of depersonalization/derealization disorder

Daphne Simeon, MD
Section Editor
David Spiegel, MD
Deputy Editor
Richard Hermann, MD


Depersonalization/derealization disorder (DDD) is characterized by persistent or recurrent depersonalization and/or derealization that causes clinically significant distress, while reality testing remains intact [1].

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 of depersonalization/derealization disorder".)


Our approach to selecting among treatments for depersonalization/derealization disorder, including the use of pharmacotherapy and psychotherapy, is discussed separately. (See "Approach to treating depersonalization/derealization disorder".)


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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Literature review current through: Nov 2017. | This topic last updated: Jul 06, 2017.
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