Three Cases of Depersonalization/Derealization Disorder Related to the Use of Classic Psychedelics
SUCHT - Zeitschrift für Wissenschaft und Praxis / Journal of Addiction Research and Practice December 1, 2025 Dario Jalilzadeh Masah, Derin Marbin, Tomislav Majić 1 citation
Symptoms of depersonalization and derealization are common during the acute effects of classic psychedelics and can persist, leading to depersonalization-derealization disorder (DDD) with distress and help-seeking behavior. Three cases of DDD after use of LSD, psilocybin, and 5-methoxy-dimethyltryptamine are presented, all treated at an outpatient clinic for post-psychedelic complications. Symptoms emerged shortly after exposure and lasted months. Psychotherapeutic interventions were helpful, while initial misdiagnoses delayed treatment in some cases. Psychotherapy should be prioritized for psychedelic-related DDD, with pharmacological treatment as a second-line option. Exploring the acute drug experience may validate patients and strengthen the therapeutic relationship, while revealing psychodynamic factors underlying individual pathologies.