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The British Journal of Psychiatry (2004) 185: 31-36
© 2004 The Royal College of Psychiatrists

Fluoxetine therapy in depersonalisation disorder: randomised controlled trial

Daphne Simeon, MD, Orna Guralnik, PsyD, James Schmeidler, PhD and Margaret Knutelska, MPh

Department of Psychiatry, Mount Sinai School of Medicine, New York, New York, USA

Correspondence: Dr Daphne Simeon, Psychiatry, Box 1230, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA. Tel: +01 (212) 241 7477; fax: +01 (212) 427 6929; e-mail: daphne.simeon{at}mssm.edu

Declaration of interest None.

Background Despite anecdotal reports that serotonin reuptake inhibitors may improve depersonalisation, there is no proven efficacious treatment for depersonalisation disorder.

Aims To investigate the efficacy of fluoxetine in the treatment of depersonalisation disorder.

Method Fifty-four people who met DSM–IV criteria for depersonalisation disorder were recruited through newspaper advertisements, and 50 were randomised to a 10-week, double-blind trial of fluoxetine 10–60 mg/day or placebo. Primary outcome measures were the Dissociative Experiences Scale – Depersonalisation Factor, the Depersonalization Severity Scale and the Clinical Global Impression – Improvement (CGI–I) scale.

Results Intention-to-treat analysis revealed that fluoxetine (mean dosage 48 mg/day) was not superior to placebo except for a clinically minimal but statistically significantly greater improvement in CGI–I score in the fluoxetine group prior to covarying for anxiety and depression (2.9 v. 3.6). Depersonalisation was significantly more likely to improve if comorbid anxiety disorder improved.

Conclusions Fluoxetine was not efficacious in treating depersonalisation disorder, despite the commonly reported clinical use of serotonin reuptake inhibitors for this condition.


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