HPPD: Symptoms, causes, and treatment

Episodes of HPPD I and II may appear spontaneously or they may be triggered by identified and non-identified precipitators 18. With regards to this point, neither HPPD I nor HPPD II can really be considered as persisting in a narrow sense of the word. Additionally, their differential diagnosis can only be proposed in terms of prognosis rather than clinical presentation.

Psychological treatments

Clinical experience and an extensive and comprehensive knowledge of these phenomena are vital for successful treatment outcomes. A latent period may antecede the onset of returning visual occurrences. This latent period may last from minutes, hours, or days up to years, and re-emerge as either HPPD I or II with or without any recognized or perceived precipitator 17,19.

What flashbacks feel like

• However, you should keep in mind that these studies feature small sample sizes and can be prone to sampling bias.
• Anti-seizure and epilepsy medicines like Klonopin (clonazepam) and Lamictal (lamotrigine) have been used in the treatment of HPPD, however, there is no recognized medical treatment for flashbacks.
• If a history of psychedelic drug use is known, HPPD may be diagnosed correctly.
• A representative, but not exhaustive, list of reported visual disturbances.

You’ll be aware of the effects of the disturbances, but you likely will not enjoy the other effects of reliving a trip. As the flashbacks become more common, they can become frustrating, even overwhelming. Type 1 HPPD is typically experienced as brief, random “flashbacks.” On the other hand, type Substance abuse 2 HPPD is generally long term, disturbing, and pervasive.

• It is also important to note that several drugs were tried and found to be ineffective in the treatment of hallucinogen persisting perception disorder, including benzodiazepines.
• Often, these are negative events that feel intrusive, unwanted, and unpleasant.
• Planning self-care coping skills that can reduce your fight, flight, or freeze response and calm anxiety quickly can be helpful.
• Studies show LSD (also called acid) is the most common hallucinogenic drug that can cause HPPD.
• In the clinical trial, 16 HPPD patients were treated with a Clonazepam dosage of 2 mg/day 51.

Living With Hallucinogen Persisting Perception Disorder

According to studies, the amount of a substance you took doesn’t seem to make a difference in your risk of getting HPPD. HPPD can occur in combination with other mental disorders, such as panic disorder, alcohol use disorder, and depression, according to the DSM-5. Some types of therapy used to treat those conditions may be helpful in managing HPPD symptoms as well. The effects of taking larger doses of hallucinogens should wear off over the course of six to 15 hours.

• In addition, visual problems can be caused by brain infections or lesions, epilepsy, and a number of mental disorders (e.g., anxiety, delirium, dementia, schizophrenia, Parkinson’s disease).
• A healthcare provider diagnoses HPPD based on assessment tools and by ruling out other health conditions.
• Being prepared as much as possible for how you’ll respond to HPPD symptoms could be helpful, especially with more intense episodes.
• Dr. Henry Abraham suggested in 2001 that half of people who saw him clinically recovered from HPPD within five years.

• These medications can be useful as a short-term solution for those with severe, debilitating cases.
• Or you may continue to see an object even after it’s gone from your vision (an “after image”).
• While this condition may be misunderstood, there is still a lot of valuable information about it that should be highlighted.

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. If a doctor is not sympathetic to a person’s symptoms or does not want to explore HPPD as a diagnosis, then it is a good idea to speak to a different doctor. HPPD flashbacks are not usually pleasurable, and they can become annoying if they occur frequently or last for a long time. These individuals do not relive any other aspects of the feeling of being on drugs.

There is little evidence that an individual’s chances of developing HPPD increase with their frequency of drug use; the disorder can also occur in people who have had little experience with hallucinogens. HPPD is divided into two types, according to the kinds of hallucinations the person experiences. In Type 2, the experience is more disturbing and persistent, and an individual may experience consistent changes in vision.

If appropriate steps are taken, then visuals tend to reduce by themselves over time. In cases where distress is not reported, an alternative label can be used, such as post-drug perceptual changes (PDPCs) or post-psychedelic perceptual changes (PPPCs). While not distressing for everyone, these perceptual changes can cause a high degree of distress for some people. It’s when people are seriously bothered by the symptoms that they may be diagnosed with HPPD.

The alterations in brain activity may be due to shifts in levels of the brain chemical gamma-aminobutyric acid or GABA. Secondly, HPPD seems to be more likely following the abuse of psychedelics, frequently occurring in a recreational context. In contrast, participants in clinical trials only take two doses of a psychedelic, given a week apart. Based on his clinical work, Abraham suggested the HPPD population falls into three groups, possibly due to genetic differences.

In the clinical trial, 16 HPPD patients were treated with a Clonazepam dosage of 2 mg/day 51. Their symptoms improved significantly after treatment initiation and the improvement persisted during a 6-month follow-up after treatment discontinuation 51. The same author reported two cases of cannabis-induced visual disturbances and correlated anxiety features. More recently, Clonazepam (6 mg/day) has been proved to be effective in improving cannabis-induced HPPD symptoms 50. On the other hand, the intrinsic abuse potential of benzodiazepines might be inconvenient in certain individuals with a past history of substance use 17,18. Given the benign nature of HPPD I, the use of benzodiazepines should be proposed only for severe cases, in the acute phase, and for the short term.

The exact cause of Hallucinogen Persisting Perception Disorder is not yet fully understood. However, research suggests that the prolonged effects of hallucinogens on the brain’s visual processing centers may contribute to the development of this disorder. Hallucinogens, such as LSD and psilocybin, interact with serotonin receptors in the brain, leading to alterations in neural activity. Some hypotheses propose that HPPD may arise due to alterations in the serotonin system or the disruption of neural pathways responsible for visual processing. However, modern research into HPPD highlights the distinction between these previously named “flashbacks” and Hallucinogen Persisting Perception Disorder (HPPD) itself. While flashbacks are temporary and transient experiences, HPPD is a lifelong condition that sufferers live with continuously.