Hallucinogen Persisting Perception Disorder: Etiology, Clinical Features, and Therapeutic Perspectives

The effectiveness of drug therapy can vary from person to person. Every person who has visual disturbances as a result of HPPD experiences them slightly differently. The effects of taking larger doses of hallucinogens should wear off over the course of six to 15 hours. HPPD symptoms, however, persist long after the normal active life of the drug and can be either episodic or mostly continuous. These symptoms can last for weeks, months, and sometimes even years. In some cases, the condition becomes chronic, while in other instances, people can suppress the feelings and function normally.

Drugs that Cause HPPD

In the International Classification of Diseases, 10th revision (ICD-10), such hallucinogen-induced echo psychoses are listed under F16.70 Dilling et al. 1991; Pechnik and Ungerleider, 2004. At variance with DSM-IV-R, ICD-10 recognizes hallucinogen-induced visual disturbances as lasting only seconds to minutes. Hallucinogen persisting perception disorder (HPPD) is a rare medical condition that can cause visual disturbances (sometimes called flashbacks) if you’ve taken hallucinogenic drugs in the past.

Hallucinogen persisting perception disorder

• Researchers and doctors do not yet have a solid understanding of who develops HPPD and why.
• However, there are examples of people experiencing HPPD symptoms over a number of years.
• Worrying about having an HPPD episode could actually make you more likely to experience one.
• In Type 2, the experience is more disturbing and persistent, and an individual may experience consistent changes in vision.

The mechanisms behind HPPD are still not well understood, and there is a lack of clear explanation regarding its causes. One of the current hypotheses suggests that anxiety may not only amplify existing visual disturbances but could also potentially trigger these visual phenomena. Many individuals with HPPD report that their visual distortions become more pronounced or even emerge during periods of heightened anxiety or stress. This indicates hppd symptoms that anxiety may play a role in both the onset and intensification of these symptoms, making them more noticeable or cognitively magnifying the perception of such disturbances. With a multitude of potential etiologies, it may not be possible to put forward a unified pathophysiological model of HPPD.

Health Conditions

These medications may also be helpful when visual disturbances are accompanied by co-occurring mood swings and mood disorders. According to DSM-5, Hallucinogen Persisting Perception Disorder is the recurrence of perceptive disturbances that firstly develop during intoxication. The contents of the perception and visual imagery range extensively 17,19. DSM-5 and previous DSM editions report a list of the most common symptoms experienced by HPPD patients, but only a few symptoms have been described in the professional literature. The main group of symptoms reported by Criterion A of the DSM-5 are visual disturbances.

• After that, in both cases visual impairments have smoothed, but have not passed completely.
• However, the presence of psychiatric and neurological comorbidities could represent a valid criterion to address the choice.
• The hallucinations are typically long, and can come and go over the course of months or years.
• In some cases, the condition becomes chronic, while in other instances, people can suppress the feelings and function normally.

HPPD can affect mental health and cause ongoing stress and concern. Importantly, other etiologies of this distress such as alcohol rehab post-traumatic stress disorder, depersonalization, derealization, etc. must be excluded. Other causes of visual disturbances such as anatomical lesions, epilepsy, and schizophrenia must also be ruled out.

• Following informed consent, a trial of the antiepileptic lamotrigine was initiated to combat the unrelenting visual disturbances of the patient.
• The only effect of the flashback you’ll experience is the visual disruption.
• Your doctor may give you an electroencephalogram (EEG) test, to look at your brain’s electrical activity.
• Lofexidine (0.2–0.8 mg/day) is a sympatholytic centrally acting α2 presynaptic adrenergic agonist that showed similar efficacy in some cases 23,65,66.
• Naltrexone has been usually used, alone or with other medications, in chronic patients with continuous visual imagery that previously did not respond to other medications 17,18.