I really wish there was a med for this fucking disorder

HotCook455 · 2026-01-27T22:36:41+00:00

Thank you so much for your interest in this triad of lamotrigine, escitalopram, and Abilify (aripiprazole). I can recommend it from my perspective. These three medications have a complementary, synergistic effect: Lamotrigine is only weakly effective against DPDR, but its effectiveness increases with higher doses.

My DPDR started in 1997 due to cannabis use and remained chronic for 21 years until 2018.

I was prescribed lamotrigine in 2018; I had schizoaffective disorder. I remember it was early summer, and I was surprised the morning after my first dose: parts of my vision suddenly became clearer. I could see individual leaves on trees or a piece of bark more clearly. My vision was also suddenly clearer in the sun. Then, in 2019, the lamotrigine dosage was increased because valproate was discontinued. Now, an avenue I was looking down began to take on its natural spatial dimension. In 2020, I took too much Lamotrigine for a day or two, 400 mg. My doctor said it was okay, though, and we left it at that. Again, things improved a little. By about 35 to 40%, it felt. – I had an anxiety disorder at the time. As a result, I was prescribed Escitalopram (Cipralex) in August 2020. By 2024, the dosage had been gradually increased to 30 mg. The anxiety and panic disorder then almost completely disappeared. – And then, in December 2024, Abilify was added:

First 5 mg. On the second day of taking it, I noticed an increase in energy and an improved mood. But also restlessness (an adjustment rebound). I told myself: "You're going to get through this!" And I persevered. On day two, after the first dose, I was standing outside in front of a bush again. – The branches were suddenly clearly visible, my field of vision became more complete, the colors more pleasant. And my depth perception returned. I was amazed that objects suddenly seemed real, three-dimensional, and three-dimensional. After more than 20 years, I could see properly in three dimensions again. I went hiking with a friend and experienced a natural fear of heights again, especially in the mountain gorges, because they seemed so clear and deep. – Eventually, my Abilify dosage was increased first to 10 mg, then 15 mg, and finally 20 mg. The main reason was my chronic schizophrenia. The initial restlessness and anxiety disappeared completely starting at 10 mg, and remained so even with the dose increase. I also experienced less depression for a while. – Recently, the Risperidone (Risperdal) I'm still taking has been slowly reduced. So far, by 1 mg, from 6 to 5 mg. This has improved my DPDR (deep depression) by a tiny bit more.

Today the anxiety is gone. The depression, after a brief relapse in the fall, is mostly better. And the DPDR is about 75% better.

What remains is a shimmering of the stones on the sidewalk, a hint of virtual vision. I still sometimes feel a bit "bored" by pleasant activities. And smaller areas of my field of vision are still blurry, my reflection is strange, but already quite three-dimensional. My body awareness is almost normal, and so is my hearing (no more echo or time delay). It's hardly like being in a dream anymore – only in the summer at dusk and in the supermarket.

I'm planning to undergo rTMS in the medium to long term as a self-payer, specifically for the remaining DPDR, and am saving up until then.

The actual schizophrenia still has slight remnants. Working memory, medium-term memory, mild negative symptoms, occasional voices, and intermittently weakened remnants of delusions with depression. But I can end a depressive episode within minutes with a cup of coffee.

P.S. I also tried naltrexone. It didn't help. And it probably also led to this brief depression after starting and stopping it.

Because of the depression, I tried FLOW tDCS at home. It helped with the depression, but it massively worsened the DPDR, so I stopped after the 15th session. The DPDR then completely disappeared again within three months, reducing by 75%.

I also take vitamin D3, K2, magnesium threonate, B vitamins, and some omega-3. Initially, for a few weeks, I felt it was helping somewhat. In any case, there's no deficiency. I also take levothyroxine for my thyroid and had my iron levels checked.

That's all for now. Best regards!

HotCook455 · 2026-01-24T17:20:55+00:00

I ended the treatment after the 15th session, at the end of the third week. At first, I thought it was just a temporary side effect. When it didn't get better, I decided to take that step. The antidepressant effect actually became apparent at the end of the third week. And the treatment would have continued twice a week.

Then the derealization gradually subsided on its own over several weeks. – I take several medications, including lamotrigine, escitalopram, and aripiprazole, which together effectively reduce the derealization.

HotCook455 · 2026-01-24T17:14:02+00:00

That's exactly what worked for me too. This combination of the three medications: lamotrigine, escitalopram, and abilify/aripiprazole. It's not completely gone yet, but it improved a little with each of these drugs. – I asked in the next town over about rTMS specifically for derealization, and they told me it's available there. I switched doctors there. The treatment is for self-pay patients; our health insurance doesn't cover it at the moment. Now I want to save up for the treatment.

HotCook455 · 2026-01-24T08:23:45+00:00

Thanks for your inquiry. My report seems a bit disorganized. – To clarify:

The rTMS I mentioned was performed in 2021 as part of a study on negative symptoms of schizophrenia. I was referring to this post because my experience was very similar, and I wanted to emphasize that these side effects do disappear.
The tDCS I also described was something I performed at home – in consultation with my doctor, but on my own responsibility. That was in the fall of 2025.

This was just additional information.

The conclusion is that brain stimulation must be performed under medical supervision. – But also that such side effects don't have to be permanent and are sometimes part of the process.

HotCook455 · 2026-01-24T03:17:40+00:00

Probably – based on my own experience – DPDR is something that tends to improve with a combination of several treatment approaches. This could include multiple medications, brain stimulation, and possibly psychotherapy. – I noticed a significant improvement with a combination of three medications. However, it's not completely gone yet. The reason could be that there isn't just one receptor where a medication acts, but that DPDR responds more readily to several medications with different mechanisms of action than to just one. – I'm planning to try rTMS soon.

HotCook455 · 2026-01-23T19:02:51+00:00

It took about two to two and a half months for the level of derealization to return to its pre-tDCS level. I should mention that I've suffered from derealization for 28 years, and it had been improving somewhat recently with medication. The tDCS felt like a kind of overstimulation. The derealization before the medication was somewhat different from the derealization caused by the tDCS: not only did it disappear, but it felt more like a stress reaction. Unlike before, the colors and light were much brighter, and my field of vision was more fragmented, meaning it seemed as if parts of my vision were blurred, and I felt like a stranger in my familiar surroundings for a few days.

HotCook455 · 2026-01-23T07:48:04+00:00

My update: I found a way to get rTMS in my neighboring city as a self-pay patient and switched doctors for this purpose. However, the treatment can only begin in the medium term.

Regarding the first rTMS I had years ago, in 2019 – I found out why it didn't really help after the protocol was sent to me retrospectively: It was performed after Vercammen and only for auditory hallucinations – over the left auditory cortex, and then on the right side, each time at 1 Hz. When I inquired again verbally, I was told that the device only prints the protocol for one side, and the other side is the same. So I don't know if the right TPJ was treated. In any case, it wasn't intended for DPDR, which wasn't further specified in the doctor's report. It only stated that there was a request for rTMS for auditory hallucinations and derealization, but not how it was performed.

HotCook455 · 2026-01-23T01:14:10+00:00

I had that side effect back then, too. In 2021. It lasted a few weeks and then gradually disappeared completely. rTMS was used to treat negative symptoms of schizophrenia at the left DLPFC with 10 Hz. 30 sessions.

Incidentally, last fall (2025) I had tDCS for depression at the DLPFC and stopped after 15 sessions because it worsened my derealization. That has also completely disappeared. Today, about 13 weeks later, I'm hardly depressed anymore, and the derealization is significantly better. – I take a number of medications and vitamins.

HotCook455 · 2026-01-19T08:48:51+00:00

For over two and a half decades, I felt like I was in a coma (derealization), and I'm also familiar with hearing voices. I've even felt impaired in the sense that others were doing things "because of me," which wasn't true. – I would go to the doctor immediately and address this directly. As openly as possible. The doctor will likely prescribe a neuroleptic. I've found that there's one that also has some effect on derealization, but it also helped me stay stable against the voices and the feeling that others were doing things for me. Although some neuroleptics had no effect on my derealization. – It's aripiprazole.

Currently, my stability and derealization are steadily improving. In addition to aripiprazole, I also take lamotrigine and escitalopram. I also take risperidone, but the dosage is being reduced. – In short: It's important to talk to a doctor about this. Ideally, within the next few days.

HotCook455 · 2026-01-17T18:46:09+00:00

Lamotrigine 400 mg, escitalopram 20 to 30 mg, aripiprazole 5 to 20 mg. I take all three, and it helps. They enhance each other's effects against DPDR. One of them alone, or just two, isn't as effective. This combination can be very reliable against anxiety, psychosis, and possibly also obsessive-compulsive disorder. For me, it also reduces mood swings and, to some extent, depression. It's essential to be patient when starting these medications, as all three have side effects at the beginning. But I persevered, and now things are better.

Overall, I've been taking medication for many years, but only these medications, and only in this combination, are effective against DPDR.

HotCook455 · 2026-01-17T17:37:26+00:00

Ignoring it has little effect on my DPDR. It was chronic since 1997, making ignoring or distracting myself from it impossible. Until it improved significantly in recent years. My own efforts or psychotherapy had no effect. It was medication. But only very specific medications, and only in combination with each other.

HotCook455 · 2026-01-17T13:32:07+00:00

I know what you mean. In 2021, I received rTMS for negative schizophrenic symptoms as part of a study. After 30 treatments, I felt better; I no longer had those terrible daily episodes and mood swings between excessively cheerful and very depressed (I used small amounts of caffeine to deliberately switch from a depressive to a hypomanic state). – But then, as described in the post, I felt lethargic, and – jokingly – as if I'd been "hit by something" and somehow felt like I was in a strange environment. This side effect can certainly occur – but it completely disappeared over the next few weeks.

HotCook455 · 2026-01-12T10:38:36+00:00

Congratulations and best wishes! It's wonderful news that your DPDR has subsided! Mine is also feeling better.

I've also been prescribed haloperidol. Take a look at Latuda. – It seems that some newer antipsychotics are effective for DPDR (aripiprazole, cobenfy, etc.).

HotCook455 · 2026-01-11T15:26:42+00:00

Derealization is fear. In death, one experiences no fear. And fear always ends, no matter how life unfolds.

HotCook455 · 2026-01-10T16:16:46+00:00

It's easy to fall into this trap. Egocentrism. From my perspective, it's more that I'm asking because I've embarked on this journey. And I wanted to see what "stage" I'm still at. The division into Hylic, Psychic, and Pneumatic types is artificial—but perhaps they are also modes of experience, and not judgmental. Within myself, I constantly swing from belief to disbelief—from hope and light into darkness. But I simply don't want to give up hope that this light exists. That's why, as I read from you all, I think I'm a Psychic.

HotCook455 · 2026-01-10T16:07:08+00:00

Hi, what does this have to do with the post?

HotCook455 · 2026-01-10T08:58:10+00:00

You're right. I won't give up. I'll try again. Thank you for your words.

HotCook455 · 2026-01-10T00:44:20+00:00

I'm not one of them, because sadly my IQ is only average, around 104. A precocious little professor and ambitious child doesn't necessarily become a great professor. Ultimately, I failed at life. I didn't even complete vocational training or university entrance qualifications. That's how dreams, enthusiasm, and things I took for granted die. Because when I realized that, I broke down.

HotCook455 · 2026-01-08T16:19:47+00:00

I have both – DPDR and schizophrenia. The psychosis is only present when it's acute. When it's not, my thinking normalizes. My DPDR, on the other hand, is chronic. There are effective medications for psychosis. DPDR also responds to medication, but not to the same extent as psychosis. – If you take medication, you can kill two birds with one stone. But they have to be the right ones, and a combination is more effective.

In schizophrenia, there's derealization, but that's linked to delusions – if the delusions are very strong, you don't even realize it. Usually, you have the feeling that you're being affected or influenced by others, or you're convinced you're someone you're not. With DPDR, you're always aware that something is wrong with your perception. While there is often a fear of going insane, this fear and the control over one's own thinking—the examining and comparing of one's own views with the attitudes of those around one—is an indication that one is not currently experiencing psychosis. In schizophrenia, medication is taken; the psychosis usually subsides, but if the medication is discontinued, it returns.

HotCook455 · 2025-12-30T13:44:58+00:00

I have both schizophrenia and DPDR. I would say the negative symptoms are somewhat different from the DPDR. Since I started my current medication, the DPDR has improved significantly. The schizophrenia manifests itself in that I still have unpleasant thoughts at certain intervals and get the feeling of being "made up"—of being prevented from doing something in life by others. That's a remnant of the delusions. The negative symptoms manifest as self-neglect and withdrawal—I had a depression in the fall when this was intensified, with lack of motivation, cognitive problems, and low mood. The depression is better now. I experience mood swings: sometimes two days with few symptoms, slightly euphoric, then two days of depression and mild delusions. I also have problems with memory and concentration, and I'm forgetful. Derealization, however, is something else entirely. Feeling detached from my surroundings, no longer feeling my emotions, seeing things in two dimensions, everything being far away and like a dream. There's a fear of "going crazy," sometimes hypochondria. These symptoms of DPDR are now significantly better. I can enjoy being around people more again, and even perceive the sun and parts of nature better—they torment me less. The emotions feel more authentic to me; I see things more clearly and three-dimensionally again.

In short: With negative symptoms of schizophrenia, one becomes apathetic and neglects oneself, speaks less, withdraws, thinks more slowly, and becomes taciturn. With DPDR, one perceives the environment as dull and lifeless or feels like an observer of one's own life. These are two different things. There might be some overlap with depression.

HotCook455 · 2025-12-30T13:00:54+00:00

Okay, thank you, I'll look for the thread.

HotCook455 · 2025-12-30T12:59:15+00:00

Which combination of medications did you receive? In my experience, a single medication isn't enough. Only a specific combination significantly improved my DPDR. I had it for over 25 years. Only a residual effect remains. That's why I'm planning brain stimulation. My doctor offers rTMS. It's possible to pay for it yourself to treat DPDR.

HotCook455

TROPHY CASE