Can Naloxone / Naltrexone Cure Derealization (DPDR)? There is some evidence for dysregulation of endogenous opioid systems in depersonalization, and a few studies have suggested that opioid antagonists may have efficacy in the treatment of dissociation and depersonalization symptoms.
During my DPDR recovery I did not take any pharmaceuticals, neither am I a doctor, nevertheless one of the first questions I had during my DPDR was “Is there a pill that can cure me?”. Thus, I contacted a pharmacist to write this article about Naltrexone and Naloxone for me.
Keep on reading to gain insights into Naltrexone and Naloxone and its effects on DPDR.
Naltrexone and Naloxone
Naltrexone and naloxone are opioid antagonists primarily used in treatment of opioid overdose such as morphine etc. But do you know that they may help with the treatment of depersonalization/derealization as well?
Naloxone and Naltrexone are opioid antagonists that have shown some efficacy in treating DPDR.
There is some evidence for dysregulation of endogenous opioid system in the brain suffering from depersonalization, and a few studies suggested that opioid antagonists may have efficacy in the treatment of dissociation and depersonalization symptoms.
Studies suggested that blocking opioid receptors in the brain leads to a decline in opiate-modulated dissociative states. That means taking Naltrexone or Naloxone can lead to experiencing less of dissociative states such as depersonalization, derealization, and their various symptoms.
Stress can be accompanied by secretion of endogeneous opioids, mostly beta-endorphins. These observations led us to suggest that disturbance in the opioid system such as the increased endorphin secretion and/or a change in the sensitivity of opioid receptors play an important role in the pathogenesis of depersonalization.
There are few neurochemical and neurohormonal studies of chronic depersonalization, and they have suggested possible dysregulation of several systems including the hypothalamic-pituitary-adrenal axis, noradrenergic, serotonergic, glutamatergic, and endogenous opioids. The endogenous opioid system is well known to mediate stress-induced analgesia. 0pioid antagonists have been reported to reduce symptoms of dissociation and depersonalization in a few preliminary studies.
In one study of subjects with borderline personality disorder, decrease in dissociation was reported using high dose naltrexone.
Specifically in DPDR, one study reported a marked decline in chronic depersonalization in subjects treated intravenously with naloxone, although the duration of the response was not clearly explicated. Of note, naloxone, naltrexone, and nalmefene are all nonspecific opioid antagonists, whereas selective k opioid antagonists have not yet been developed for human use.
Open Tratment trial
In the open treatment trial, described by Daphne Simeon in the “Journal of Clinical Psychopharmacology”, 14 subjects were recruited and treated with Naltrexone for 6 weeks to a maximum dose of 100 mg/d (first 7 subjects) or 10 weeks to a maximum dose of 250 mg/d (next 7 subjects). The rationale for the use of high dose naltrexone , as well as the increase in naltrexone dosing halfway through the trial , is that naltrexone is a non-specific opioid antagonist which blocks “mu” receptors at low doses but requires high doses to block other opioid receptors such as the “kappa” receptors. Mean naltrexone dose was 120 mg/d.
There was an average 30% reduction of symptoms with treatment, as measured by 3 validated dissociation scales.
Three out of fourteen patients who were administered naltrexone were found to be free of depersonalization symptoms, whereas seven showed marked improvement.
Adverse effects reported by the 14 trial participants were, sedation/fatigue (N=70), nausea (N=5), depression (N=3), diarrhea (N=1), tingling (N=1), and nightmares (N=1). Two subjects reported no side effects
Conclusion
There is some evidence for dysregulation of endogenous opioid systems in depersonalization, and a few studies have suggested that opioid antagonists may have efficacy in the treatment of dissociation and depersonalization symptoms.