Living with HPPD: Causes, Challenges, and Coping Mechanisms FHE Health

The female patient, now 33 years old and an architect by profession, reported the recreational use of up to 30 doses of lysergic acid diethylamide (LSD; ‘tabs’) during a 1-year stay in the USA at the age of 18. Each single dose was probably limited to 100 µg and consumed in a peer group setting. She also used marijuana for relaxation and occasionally experimented with ecstasy, psilocybin mushrooms and ketamine. Imaging such as chest X-rays (CXR) of cardiopulmonary systems was performed to rule out underlying etiologies related to cardiopulmonary systems, such as infections (pneumonia). An electrocardiogram (ECG) was also performed to rule out cardiovascular etiologies.

However, changes were only permanent in 25% users and distressing in 4.2%. 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. It is important to note that HPPD hallucinations are always obvious as hallucinations to the individual experiencing them and don’t https://ecosoberhouse.com/article/performance-enhancing-drugs-what-are-the-risks/ override their reality. Despite that, HPPD can still cause significant distress and interfere with one’s work and social life. While these symptoms are reported, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) does not include them on the recognized list of symptoms. It is still unclear whether these symptoms are directly caused by the disorder.

What are flashbacks?

Results from brain magnetic resonance imaging scans, median nerve somatosensory evoked potentials, electroencephalograms and visual evoked potential tests were all normal. A MEDLINE literature search (1994–2011) with the keywords ‘Hallucinogen persisting perception disorder HPPD’ was conducted. Lauterbach et al. reported the unique case of HPPD induced by the atypical antipsychotic Risperidone 60. According to the literature, we found that the majority of HPPD cases have been induced by LSD or phencyclidine (PCP) (14 studies, 294 patients) 17,19,21,26,35,46,51,52,53,55,56,57,58,59.

• Hallucinogens are drugs that cause a person to perceive things that do not exist or are not present (hallucinations).
• As for her personality, the patient’s self esteem deteriorated even further during the 18-month observation period whereas obsessive–compulsive and anti-social traits receded.
• Such was the course of action in our patient’s management described above.
• In addition to medication, mental health professionals frequently recommend talk therapy as a treatment for HPPD.
• People may need to try different medications to find the one that works best for controlling symptoms or take more than one medication to get relief.

5. First-Line Medications

Psychiatrist Harry McConnell said a lot more research needed to be done into the basic mechanisms of how it occurred, who was at risk and treatments. “It’s been horrendous to watch how much this has affected his life,” she said. Jack initially experienced panic attacks that could last up to three hours.

The battle over prescribing psychedelic drugs

Although data is limited, research shows only 4% to 4.5% of people who take hallucinogenic drugs get it. A healthcare provider diagnoses HPPD based on assessment tools and by ruling out other health conditions. Research is limited regarding the best treatment but prescription medications and relaxation techniques, such as meditation, breathing, and yoga, may reduce symptoms or shorten episodes.

• The Perception Restoration Foundation (PRF) is an industry-funded 501 nonprofit.
• “If those things are going to help people with mental health conditions … I support that, but we need to do our due diligence,” she said.
• Some types of drugs that have delivered positive results include antipsychotics, some drugs used for treating PTSD, and naltrexone, which is used to treat opioid and alcohol dependency.
• The incidence of mental disorders in 200 Native Americans of the Navajo tribe after ritual use of mescaline was the subject of a recent study by Halpern Halpern, 2003.
• Your doctor may give you an electroencephalogram (EEG) test, to look at your brain’s electrical activity.

HPPD results in disturbed vision, where a sufferer may constantly see visual snow, haloes or trails. Psychedelic integration therapy can also help people with HPPD make sense, re-address and start to make sense of the experience that triggered their disorder. Many people with HPPD also experience anxiety and depression, and in some cases, suicidal thoughts. Because HPPD is relatively under-reported and under-researched, we still don’t know a huge deal about HPPD.

• Trying mindfulness, yoga, or meditation may help to reduce stress and anxiety.
• According to another study, it is hypothesized that the excitotoxic degradation of inhibitory interneurons with serotonergic and GABAergic receptors on their cell bodies and terminals may be the pathophysiological cause of HPPD symptoms 7.
• Hallucinogen-persisting perception disorder (HPPD) causes a person to keep reliving the visual element of an experience caused by hallucinogenic drugs.
• She’s also worried about the emerging use of psychedelic drugs to treat depression.
• While specific HPPD groups may be difficult to find, broader mental health or substance use forums may be helpful.

Another case reported a similar instance describing two LSD-abusing Drug rehabilitation schizophrenia patients who experienced brief episodes of transitory visual disturbances shortly after starting their risperidone treatment. These visual disturbances mirrored what individuals have previously reported as “flashbacks” from using LSD. It is a brief phase during treatment that ceases to exist within six months of the treatment with antipsychotics 8. A 33-year-old female patient developed a hallucinogen-persisting perception disorder (HPPD) after lysergic acid diethylamide (LSD) abuse for a year at the age of 18. Specifically, she reported after images, perception of movement in her peripheral visual fields, blurring of small patterns, halo effects, and macro- and micropsia.

Agomelatine, given its peculiar function on neurotrophic factors 74, could have some benefits on the syndrome, although no data are available until now. Some people experience these visual disturbances only once after using hallucinogenic drugs. For others, the disturbances may occur frequently but not be very bothersome. In addition to online therapy, numerous other resources are available to individuals with HPPD. Hallucination persisting perception disorder (HPPD) is a condition where people experience distressing, lingering changes to their perception after using drugs, commonly classical psychedelic drugs, such as LSD and psilocybin.

One study did not report differences in antipsychotic treatment response between SCZ and SCZ+HPPD patients 58. On the other hand, a more recent study has shown the ineffectiveness of antipsychotic medications in an SCZ+HPPD population 57. 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.

“Some people reckon it’s cool to be tripping every day, but it’s terrible. You want it to stop every day.” Working with a counsellor and therapist can also help people to adopt healthier thought patterns and behaviours to help manage any depressive or anxious comorbidities. Laboratory analysis completed to rule out underlying etiologies included urodynamic testing (UDS) and blood alcohol level (BAL), which were within normal limits.

As part of the initial psychiatric assessment, extensive neuropsychological profiling was undertaken (Table 1). Memory functions, attention span, visuo construction and frontal-executive functions were examined. No significant cognitive deficits were detected, except for underperformance in the test for phasic attention. With respect to her mental wellbeing, the patient’s self assessment indicated a light to medium depressive and anxiety disorder, most likely attributable to the chronic distress resulting from the abnormal perceptions.

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. The frequency of recurrence of perceptual distortions is lower for HPPD I than HPPD II 18. Prior substance users can voluntarily elicit or produce visual disturbances with or without known triggers 4,17,18. After HPPD II onset, hallucinogenic events tend to occur more frequently, and their duration and intensity increase. It’s important to understand that your doctor’s primary concern will be helping you address and treat your symptoms.

Other significant tests included a complete blood count (CBC) panel, an electrolyte panel, a lipid panel, a liver panel, a renal panel, a thyroid panel, a blood glucose level, and a d-dimer level, all within normal limits. Worrying about having an HPPD episode could actually make you more likely to experience one. Both PTSD flashbacks and pleasurable drug flashbacks are often all-encompassing. In other words, during these flashbacks, all of your sensory information tells you that you’re reliving the event or trip, even if you’re not. Because so few cases of HPPD are officially diagnosed, research is quite limited. That makes what doctors and researchers do know about the condition limited as well.