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Re: Journal of Clinical Psychiatry » jazzdog

Posted by Cam W. on December 13, 2001, at 17:27:43

In reply to Re: Journal of Clinical Psychiatry » Cam W., posted by jazzdog on December 7, 2001, at 12:29:52

Jane - Sorry, I almost forgot about this post.

"Lamotrigine in the Treatment of Depersonalization Disorder" is a letter to the editor by a group from King's College in London, England (M Sierra, ML Phillips, MV Lambert, C Senior, AS David) and JH Crystal from Yale in New Haven, USA. •Paid for by Glaxo Wellcome•. In J Clin Psychiatry, Oct. 2001; pp 826-827.

Lamictal has been reported to inhibit glutamate release and depersonalization symptoms may be due to excess excitatory amino acids.

Eleven treatment-resistant patients with chronic depersonalization disorder (for 2 to 15yrs) given lamotrigine as an add-on therapy to SSRIs (1 patient was taking no meds) Six of eleven responded (2 parox; 1 fluox; 1 sert; 1 cita + lith; monotherapy in 1) with a 40% to 80% improvement on a "subjective" improvement scale. Only the results of the responders is shown. The lamotrigine dose raised gradually over 3 weeks to 200mg or 250mg/day (in responders).

Study limitations (as per Cam): 1) open label; 2) short term (3 weeks); 3) no placebo; 4) small size; 5) rating scale only out of 4 and is subjectively, not objectively, measured - never heard of scale, so not sure if it has been validated; 6) glutamate is only one excitatory amino acid; 7) most important - drug company sponsored.

Therefore, and the researchers even mention this, "caution is needed at this early stage before ascribing the improvement seen in our patients to a specific antidepersonalization effect".

- Cam




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