From the Research
For depersonalization disorder, Klonopin (clonazepam) is typically prescribed at a starting dose of 0.5 mg twice daily, which may be gradually increased to 1-2 mg per day divided into two doses, as suggested by the most recent and highest quality study available 1. The maximum recommended dose is usually 4 mg per day, though most patients respond to lower doses. Key points to consider when prescribing Klonopin for depersonalization disorder include:
- Treatment duration should be limited due to dependence risks, ideally not exceeding 2-3 months of continuous use.
- Klonopin works by enhancing GABA activity in the brain, which can help reduce anxiety that often underlies depersonalization symptoms.
- Side effects may include drowsiness, coordination problems, and cognitive impairment.
- Regular monitoring by a healthcare provider is essential, as is a slow taper when discontinuing to avoid withdrawal symptoms. This medication should be used as part of a comprehensive treatment plan that may include psychotherapy, particularly cognitive behavioral therapy, which has shown effectiveness for depersonalization disorder 1. Some studies suggest that opioid receptor antagonists such as naltrexone and naloxone are useful in at least a subgroup of patients 2, and clomipramine may be a promising pharmacologic treatment for primary depersonalization disorder 3. However, the quality and quantity of studies were generally low considering the high prevalence of DPD, and more high-quality research is needed 1.