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Post Use Phenomena and Hallucinogen Persisting Perceptual Disorder

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Symptoms of HPPD may accompany or be worsened by symptoms of anxiety or depression. While prevalence estimates may be inaccurate, the first or type 1 (HPPD I) involves transient ‘flashbacks’ and is estimated to occur in about 5% of regular psychedelic users. The second or type 2 (HPPD II) involves chronic, intense, waxing and waning visual disturbances for months to years leading to significant distress or dysfunction. This form of HPPD has been estimated to occur in about 1 in 50,000 psychedelic users 1.

  • The psychedelic researcher Stanislav Grof believed HPPD occurs when suppressed material arises during a psychedelic experience and isn’t properly processed.
  • But they warn that the condition can be life-changing, and that people should know the risk before dabbling in hallucinogens.
  • Distinct substances, with completely different mechanisms of action, might lead or precipitate the genesis of HPPD, therefore suggesting a multifaceted etiology.
  • The most commonly prescribed medications for HPPD are antiseizure and antidepressant drugs.

Can the Effects Be Reversed?

HPPD symptom

HPPD patients appear to be sensitive to first-generation antipsychotics at low doses, requiring monitoring of extrapyramidal side effects. Haloperidol 69 and Trifluoperazine 70 were reported to be helpful. Perphenazine (4–8 mg/day) 17,23, Sulpiride (50–100 mg/day) 23, and Zuclopenthixol (2–10 mg/day) 17,23, at very low doses, are what is Oxford House well tolerated and may be an effective treatment. Some of the long-acting first-generation antipsychotics may still be useful in co-occurring Psychotic Spectrum Disorders and HPPD II 58.

How to Differentiate Between Bipolar Disorder and Hallucinogen Persisting Perception Disorder

This is important since one aspect that may cause significant distress is lack of education that post-use phenomenon can occur and temptation to pathologize unexpected changes to perception if they arise. It has been noted that no case meeting a diagnostic criterion for HPPD has been reported from a clinical trial to date 9, 10. The main group of symptoms reported are visual disturbances, which are more common than auditory disturbances. However, any perceptual symptom experienced during intoxication may re-occur following hallucinogen withdrawal.

HPPD symptom

Types Of Hallucinogen Persisting Perception Disorder

Getting an accurate count of HPPD cases is difficult because there haven’t been many population studies about it. In some cases, people experience HPPD after their very first use of a drug. Other people use these drugs for many HPPD symptom years before experiencing symptoms. Medications such as antipsychotics or antidepressants with activity at serotonergic neurons are characterized by mixed reports, with some cases showing improvements and other cases worsening with use. Particularly, the atypical antipsychotic risperidone has been flagged in several cases as worsening symptoms of HPPD and should be avoided. Several recent review articles have been published summarizing phenomenon reported by persons affected with HPPD and have observed several differences between symptoms listed in the DSM-5 and reported symptoms 2-4.