Lamotrigine as an add-on treatment for depersonalization disorder: a retrospective study of 32 cases.
OBJECTIVE
Depersonalization disorder (DPD) is a chronic condition characterized by the persistent subjective experience of unreality and detachment from the self. To date, there is no known treatment. Lamotrigine as sole agent was not found to be effective in a previous small double-blind, randomized crossover trial. However, evidence from open trials suggests that it may be beneficial as an add-on medication with antidepressants.


METHODS
We report here an extended series of 32 patients with DPD in whom lamotrigine was prescribed as an augmenting medication. Most of the patients were receiving selective serotonin reuptake inhibitors.


RESULTS
Fifty-six percent (n = 18) of patients had a more than or equal to 30% reduction on the Cambridge Depersonalization Scale score at follow-up. Both maximum dose of lamotrigine used and before treatment Cambridge Depersonalization Scale scores showed positive correlations with the percentage of response.


CONCLUSIONS
The results of this trial suggest that a significant number of patients with DPD may respond to lamotrigine when combined with antidepressant medication. The results are sufficiently positive to prompt a larger controlled evaluation of lamotrigine as "add-on" treatment in DPD.
Sierra
Mauricio
M
Depersonalisation Research Unit, Psychological Medicine, Institute of Psychiatry, London, UK. M.Sierra-Siegert@iop.kcl.ac.uk
Baker
Dawn
D
Medford
Nicholas
N
Lawrence
Emma
E
Patel
Maxine
M
Phillips
Mary L
ML
David
Anthony S
AS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D015331:Cohort Studies; D003861:Depersonalization / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D011581:Psychological Tests; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000494:pharmacology; D016896:Treatment Outcome; D014227:Triazines / Q000627:therapeutic use*
D000927:Anticonvulsants; D000077213:Lamotrigine; D017367:Selective Serotonin Reuptake Inhibitors; D014227:Triazines