Pharmacotherapy for dissociative disorders: A systematic review

Psychiatry Res. 2019 Nov:281:112529. doi: 10.1016/j.psychres.2019.112529. Epub 2019 Aug 23.


Background: Dissociative Disorder (DD) is a large group of disorders that shares common psychopathology. Psychopharmacological agents have sparse evidence in the treatment of DD in general. Multiple pharmacotherapy options have been used without conclusive evidence.

Methods: We conducted a systematic review of data in English language from 1967 to 2019 the protocol of which was registered under PROSPERO (Study ID CRD42019127235). Using PRISMA guidelines, 5 RCTs reporting data on 214 participants providing data on response to pharmacotherapy in dissociative disorder were included.

Results: The treatment response rate of pharmacotherapy group as measured in reduction in dissociative symptoms was 68.42% (n = 65/95), significantly higher than that of 39.49% (n = 47/119) in the control group. And, the pooled RR was 1.59 (95% CI, 0.76-3.30; P = 0.21). The overall effect estimates are favourable to pharmacotherapy group over placebo.

Conclusion: It would be apt to conclude that Paroxetine and Naloxone are the only pharmacological agents studied through RCTs and found to have modest evidence for controlling depersonalization symptoms and dissociative symptoms that are comorbid with PTSD and BPD. Results of this meta-analysis should be interpreted with caution in view of high heterogeneity and scanty literature on RCTs on various subtypes of DD.

Keywords: Dissociative disorders; Pharmacotherapy; Placebo; Systematic review.

Publication types

  • Systematic Review

MeSH terms

  • Dissociative Disorders / drug therapy*
  • Female
  • Humans
  • Male
  • Naloxone / therapeutic use*
  • Paroxetine / therapeutic use*
  • Psychotropic Drugs / therapeutic use*
  • Randomized Controlled Trials as Topic
  • Treatment Outcome


  • Psychotropic Drugs
  • Naloxone
  • Paroxetine