Narcan for dissociation treatment

bellbird

Sponsor
I experience pretty significant dissociation as part of my PTSD; I'm pretty sure my diagnosis has the dissociative subtype.

I had an MDT a couple of weeks ago with my GP and T, and they briefly discussed some options for my dissociation. One that I can remember was low dose Narcan.

I think they're in the process of finding a pdoc with experience with this, which in little NZ isn't the easiest. So nothing is certain yet.

Just wondering if anyone has tried this? And if so what your experience was?
 

joeylittle

Administrator
This sounded interesting to me, so I just went down the rabbit hole of google for a bit...I doubt anyone in the US would ever have this suggested, though I'm super-interested to hear if they have.

For anyone who doesn't know - Narcan was developed to reverse opioid overdose. When administered in time, it will (essentially) stop the overdose, save someone's life.

It is also used to stop/reverse septic shock.

In the US, the big debate around Narcan is whether or not it's alright to prescribe it to people for at-home (non-MD administered) use. Apparently, many doctors are in favor of this, but it's not really common practice. The concern is that it takes medical training to know how/when to administer the drug. The counter-argument is that it's not actually that difficult to use in it's intranasal form, and it's extremely low-risk: if you take it when you don't need it, nothing bad happens, you just stop feeling the opioid effect.

So, @bellbird - as a layperson, I can see where Narcan would make sense for dissociation, based on its mechanism of action. It's also interesting that it's used as part of a strategy to reverse a septic shock state. And it doesn't seem to have much risk; there are a few side effects, but the six or seven pieces I read were all pretty clear about how minimal those were. I think you do need to make sure you ask your docs about the various interactions, if you are on any other medications. If you are taking anything that interacts with the opioid receptors (and some psych meds do), they should be able to explain to you if using the Narcan prn (as-needed) could temporarily alter the effectiveness of those other meds.

Really interested to know how it goes, if you decide to try it.
 

Sweetleaf

MyPTSD Pro
My pdoc had me on naltrexone for dissociation, mainly dr/dp.

It worked wonders for me! Miracle drug tier.

I was on 12.5mg at first, then 25, then 50, then 25 again. Every few weeks I needed to take a 2-4 day break for it to regain it's normal efficacy.

Naltrexone is another opioid antagonist like narcan.

But yeah, anyway - I highly recommend naltrexone. I believe there are some studies on its use on depersonalization, if your doc wants to look stuff up.

It let me do a lot of trauma work, EMDR, etc - I was dissociating too much to do trauma work or much of anything. Now I'm at a point where I dont dissociate very often, and for now I dont feel like I need naltrexone anymore.
 

Sweetleaf

MyPTSD Pro
@bellbird I'm glad to see people talking about opioid receptor antagonists for dissociation - if you wanna try one, ask your doc if you can try naltrexone!

Takes like 2-7 days to figure out if it works for you, in my experience. On the first day I already felt a noticeable decrease in dissociation, and it just got better from there.
 

bellbird

Sponsor
Yeah.....that's all I got. :facepalm:
You manage to keep this place running smoothly, all whilst having PTSD yourself... you're doing fab @joeylittle :hug: ?

Thanks, @Sweetleaf ! Once we find a pdoc with experience in opioid receptor antagonists (which will probably involve at least a couple month wait and possibly for my T and I to head out of city for an appointment), I'll be sure to ask them about Narcan v naltrexone :)
 

Sweetleaf

MyPTSD Pro
Yeah.....that's all I got. :facepalm:
I'm just recommending the drug I tried. The exclamation point was out of enthusiasm, not in a condemning-narcan way.

I brought up narcan with my pdoc and she suggested naltrexone instead, and it worked. Kinda funny - the day I came in wanting to talk about trying narcan, she was already planning on suggesting naltrexone to me lol.

I wanted to use naltrexone as a PRN and she said it would probably be better to use daily, just to help prevent dissociation in the first place. Not sure what would be better with narcan.

Naltrexone has alternative uses as a weight loss drug (outside the US IIRC), and as an aid in quitting alcohol (it lowers the enjoyment of drinking, sucks out a lot of the fun, the euphoria). If you dont wanna be an alcoholic and want to lose weight, those are benefits, though from my experience the weight loss and alcohol-ruining effects diminish over time as your body gets used to those side effects.

If I remember right, it is easier to get it prescribed in the first place, because of how much it is used in helping people quit drinking - so, regularly prescribed to people for use on a daily basis. I imagine a lot of insurance companies will cover it, too. I could be wrong on all that of course. It is also readily available in pill form, easy to take.

Either drug is worth a shot, I doesn't matter which one people want to try. But it's nice to know there are other options.

I'd be totally interested in what people have to say about narcan for dissociation.
 

joeylittle

Administrator
Naltrexone has alternative uses as a weight loss drug (outside the US IIRC), and as an aid in quitting alcohol (it lowers the enjoyment of drinking, sucks out a lot of the fun, the euphoria).
Oh yes, that's right. I had it suggested to me by my psych. Maybe that's why my brain is latching onto it strangely. I do think it's used for addiction recovery in the US.
I'm just recommending the drug I tried.
Truly, no worries. Your post just made me vaguely remember some study I was reading. :) Wasn't meaning to contradict your recommendation.
 

Sharon7788

Learning
I started Naltrexone about a month ago and it 100% keeps me from dissociating so far. It was a little hard for me at first because I felt like I had abandoned my parts but it is very helpful. I’m able to do EMDR with the dissociation under control. It’s been a miracle drug for me.
 
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