Fluoxetine therapy in depersonalisation disorder: randomised controlled trial.
BACKGROUND
Despite anecdotal reports that serotonin reuptake inhibitors may improve depersonalisation, there is no proven efficacious treatment for depersonalisation disorder.


OBJECTIVE
To investigate the efficacy of fluoxetine in the treatment of depersonalisation disorder.


METHODS
Fifty-four people who met DSM-IV criteria for depersonalisation disorder were recruited through newspaper advertisements, and 50 were randomised to a 10-week, double-blind trial of fluoxetine 10-60 mg/day or placebo. Primary outcome measures were the Dissociative Experiences Scale-Depersonalisation Factor, the Depersonalization Severity Scale and the Clinical Global Impression-Improvement (CGI-I) scale.


RESULTS
Intention-to-treat analysis revealed that fluoxetine (mean dosage 48 mg/day) was not superior to placebo except for a clinically minimal but statistically significantly greater improvement in CGI-I score in the fluoxetine group prior to covarying for anxiety and depression (2.9 v. 3.6). Depersonalisation was significantly more likely to improve if comorbid anxiety disorder improved.


CONCLUSIONS
Fluoxetine was not efficacious in treating depersonalisation disorder, despite the commonly reported clinical use of serotonin reuptake inhibitors for this condition.
Simeon
Daphne
D
Department of Psychiatry, Mount Sinai School of Medicine, New York, New York 10029, USA. daphne.simeon@mssm.edu
Guralnik
Orna
O
Schmeidler
James
J
Knutelska
Margaret
M
D000328:Adult; D003861:Depersonalization / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D005473:Fluoxetine / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors