Hallucinogen-persisting perception disorder

Abstract

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. Previous treatment with antidepressants and risperidone failed to ameliorate these symptoms. Upon commencing drug therapy with lamotrigine, these complex visual disturbances receded almost completely. Based on its hypothesized neuroprotective and mood-stabilizing effects, the antiepileptic lamotrigine may offer a promising new approach in the treatment of HPPD.

Psychedelics

“…Another case study described a 33-year-old woman who developed HPPD after LSD use for a year. Although treatment with antidepressants and risperidone did not ameliorate her symptoms, treatment with the antiseizure drug lamotrigine almost completely abolished her visual disturbances (Hermle et al, 2012).…”

Ophthalmological assessment of cannabis-induced persisting perception disorder: Is there a direct retinal effect?

“…HPPD has been relatively well described for LSD [1,[10][11][12]34], but it is not clearly known, whether cannabis can also provoke it. Diagnosis of cannabis-induced HPPD may be considered in rare cases following a full diagnostic workup to exclude other disorders, such as temporal lobe epilepsy or cortical tumor, presence of systemic disorders with cerebral effects, such as systemic lupus erythematosus, head trauma, intraocular pathology, and multiple sclerosis, or the use/interruption of other concomitant drugs or toxic exposures (heavy metals, insecticides, other aerosolized hydrocarbons, arsenic, and bromism) [4][5][6]34].…”

Should Australian Psychology Consider Enhancing Psychotherapeutic Interventions with Psychedelic Drugs? A Call for Research

“…Oft‐mentioned risks of “flashbacks” in media and government communications have limited empirical support. While there have been occasional case studies highlighting the DSM‐5 diagnosis of hallucinogen persisting perception disorder (HPPD) (e.g., Espiard, Lecardeur, Abadie, Halbecq, & Dollfus, ; Hermle, Simon, Ruchsow, & Geppert, ), a review of 50 years of literature by Halpern and Pope () found that while some people re‐experienced transient perceptual changes associated with psychedelic use, cases that met the DSM criteria of persistence and creating psychological distress were extremely rare. More importantly, Halpern and Pope noted that HPPD was only associated anecdotally with the illicit use of psychedelics.…”