Treatment of depersonalization disorder with fluoxetine: a case report

Background

One small prospective series and two single case reports had described successful treatment of primary depersonalization disorder in a number of patients treated with fluoxetine [1–3]. But then, one recent randomized, double masked, placebo-controlled trial failed to show efficacy [4]. We present the case of depersonalization disorder that responded favorably to fluoxetine treatment.

Materials and methods

A 23-year old single man had a 1-year history of primary depersonalization disorder. He described feeling “detached from my body, as if I was observing myself from the outside, cut off from emotions and feelings, feeling as if I had completely lost my self and feeling like I was in a dream”. He felt far removed from everything. The patient was treated with fluoxetine 10 mg/day, which was slowly raised to 40 mg/day.

Results

Eight weeks after beginning fluoxetine, the patient had a remarkable improvement. Following complete resolution of the depersonalization symptoms, the patient began to socialize, entertain and work. This is continued for 12 months of follow up.

Conclusions

Fluoxetine may be a promising pharmacological treatment for primary depersonalization disorder.