From the Research
For mild depersonalization, selective serotonin reuptake inhibitors (SSRIs) like sertraline (50-200 mg daily), fluoxetine (20-80 mg daily), or escitalopram (10-20 mg daily) are commonly used as first-line treatments. These medications work by regulating neurotransmitters like serotonin, which help normalize brain function in areas responsible for self-perception and emotional processing 1. However, a study found that fluoxetine was not efficacious in treating depersonalization disorder, despite the commonly reported clinical use of serotonin reuptake inhibitors for this condition 2. Other treatment options include clomipramine, which may be beneficial for some patients 3, and lamotrigine, an anticonvulsant, which may be added at 25-200 mg daily in cases that don't respond adequately to SSRIs 4. Clonazepam, a benzodiazepine, can be prescribed at 0.5-2 mg daily for short-term relief of acute symptoms, but should be used cautiously due to dependency risks 5. Some key points to consider when treating mild depersonalization include:
- Treatment typically continues for at least 6-12 months after symptom improvement
- Psychotherapy, particularly cognitive behavioral therapy, is often recommended alongside medication for better outcomes
- Patients should maintain regular follow-ups with their healthcare provider to monitor effectiveness and adjust dosages as needed
- Opioid receptor antagonists such as naltrexone and naloxone may be useful in at least a subgroup of patients 5.