Sierra Mauricio, Baker Dawn, Medford Nicholas, Lawrence Emma, Patel Maxine, Phillips Mary L, David Anthony S
Depersonalisation Research Unit, Psychological Medicine, Institute of Psychiatry, London, UK.
Clin Neuropharmacol. 2006 Sep-Oct;29(5):253-8. doi: 10.1097/01.WNF.0000228368.17970.DA.
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.
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.
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.
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.
人格解体障碍（DPD）是一种慢性疾病，其特征为持续存在的主观虚幻感和自我分离感。迄今为止，尚无已知的治疗方法。在之前一项小型双盲随机交叉试验中，未发现拉莫三嗪作为单一药物有效。然而，开放试验的证据表明，作为抗抑郁药的附加药物可能有益。
我们在此报告一组扩大的32例人格解体障碍患者，他们使用拉莫三嗪作为增效药物。大多数患者正在接受选择性5-羟色胺再摄取抑制剂治疗。
56%（n = 18）的患者在随访时剑桥人格解体量表评分降低了30%或更多。使用的拉莫三嗪最大剂量和治疗前剑桥人格解体量表评分均与反应百分比呈正相关。
该试验结果表明，相当数量的人格解体障碍患者在与抗抑郁药物联合使用时可能对拉莫三嗪有反应。结果足够积极，促使对拉莫三嗪作为人格解体障碍“附加”治疗进行更大规模的对照评估。
