Dissociative Identity Disorder (DID), formerly known as Multiple Personality Disorder, is a complex and deeply rooted psychological condition primarily treated through psychotherapy, not medication. However, pharmacological treatments can play a supportive role, especially when managing co-occurring symptoms such as depression, anxiety, PTSD, or sleep disturbances.
1.
No Medications Specifically Target DID Itself
There are no FDA-approved medications that directly treat DID. Medications are used off-label to manage comorbid symptoms, which often overlap with DID presentations.
2.
Medications for Comorbid Conditions
People with DID frequently experience symptoms that may be addressed with the following classes of medications:
a.
Antidepressants (SSRIs, SNRIs)
Used to treat:
- Depression
- Anxiety
- PTSD symptoms
Examples:
- Sertraline (Zoloft)
- Fluoxetine (Prozac)
- Venlafaxine (Effexor XR)
b.
Anxiolytics
Used with caution to manage severe anxiety or panic symptoms.
Examples:
- Buspirone
- Benzodiazepines (e.g., lorazepam) – short-term use only due to risk of dependence and possible worsening of dissociation
c.
Atypical Antipsychotics
Sometimes prescribed for:
- Severe mood swings
- Impulse dyscontrol
- Intrusive voices (not psychotic in origin, but ego-alien internal voices)
Examples:
- Quetiapine (Seroquel)
- Olanzapine (Zyprexa)
- Risperidone (Risperdal)
d.
Mood Stabilizers
If there are symptoms resembling mood dysregulation (e.g., from bipolar spectrum or trauma-related affective instability).
Examples:
- Lamotrigine (Lamictal)
- Valproate (Depakote)
3.
Trauma-Informed Caution
Many individuals with DID are highly sensitive to medication side effects. This sensitivity may reflect:
- Somatic memories of trauma
- Alter identities reacting differently to pharmacologic agents
- Fear of losing control
Thus, medication changes must be made slowly and collaboratively, with informed consent from the system, when possible.
4.
Adjunctive Use of Medication
Medication should never be used as the sole treatment for DID. Instead, it is used to stabilize symptoms enough to allow psychotherapeutic work to proceed—especially trauma integration, identity negotiation, and safety planning.
5.
Therapeutic Integration
- Phase-oriented trauma therapy (e.g., as proposed by ISSTD guidelines)
- Attachment-based or psychodynamic therapy
- EMDR (with caution and training)
- Internal Family Systems (IFS)
If you’d like, I can also provide:
- A flowchart of medication considerations in DID
- A comparison of DID and borderline personality disorder pharmacotherapy
- The ISSTD treatment guideline summary for DID
Would you like one of those?
