Halluzinogen-induzierte Persistierende Wahrnehmungsstörung (HPPD) und Flashback-Phänomene – Differenzialdiagnose und Erklärungsmodelle

Hermle, Leopold; Ruchsow, Martin; Täschner, Karl-Ludwig

doi:10.1055/s-0035-1553717

Cited by 19 publications

(11 citation statements)

References 20 publications

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“…In clinical settings, recurrent drug effects after intake of hallucinogens have been reported in a study on the use of LSD in psychiatric treatments as early as the 1950s (Sandison et al 1954). Although these phenomena are therefore known for decades, they are still poorly described with little consensus on their cause (Halpern and Pope 2003;Hermle et al 2008Hermle et al , 2015Holland and Passie 2011;Lerner et al 2014b;Martinotti et al 2018). Reported incidences vary widely, with estimates between 15 and 75% of all users being affected (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…Reported incidences vary widely, with estimates between 15 and 75% of all users being affected (e.g. Hermle et al 2015;Stanton and Bardoni 1972). Most cases were reported after the use of LSD (Halpern and Pope 2003;Lerner et al 2014b), but flashbacks were also seen after the use of MDMA (Vizeli and Liechti 2017) as well as cannabis (Lerner et al 2011), amphetamines, tobacco, and alcohol (Lerner et al 2014b) and rarely after psilocybin (Hermle et al 2015).…”

Section: Introductionmentioning

confidence: 99%

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Flashback phenomena after administration of LSD and psilocybin in controlled studies with healthy participants

et al. 2022

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Background LSD and psilocybin are increasingly used in phase I trials and evaluated as therapeutic agents for mental disorders. The phenomenon of reoccurring drug-like experiences after the acute substance effects have worn off was described for both substances and especially attributed to LSD. According to the DSM-V, the persisting and distressing manifestation of these experiences is called hallucinogen-persisting perception disorder (HPPD). Data on both conditions is very limited. Objective This study aims to provide descriptive data on reoccurring drug-like experiences after the administration of LSD and psilocybin in controlled studies with healthy participants. Methods and materials Data from 142 healthy subjects enrolled in six double-blinded, placebo-controlled, randomized cross-over studies were analyzed. In total, 60 subjects received LSD; 27 subjects received LSD, MDMA, and d-amphetamine; 31 subjects received LSD and psilocybin; and 25 subjects received psilocybin and escitalopram. At the end-of-study visit (mean 39.8 days after last study session, SD 37.2), subjects were asked for any reoccurring drug effects since the initial substance effects had worn off. Those reporting reoccurring perception changes more than 24 h after administration were contacted for follow-up (mean follow-up duration: 31.2 months, SD 28.6). Results Thirteen out of 142 subjects reported reoccurring drug-like experiences (LSD: seven, psilocybin: two, both: four). The reported phenomena were predominantly mild and perceived as neutral to pleasant. Flashbacks were mostly of visual nature, lasted for seconds to minutes, and occurred within a week after the last drug administration. Two subjects reported distressing experiences that subsided spontaneously. One subject reported brief and pleasant visual perception changes which reoccurred for 7 months. None of the subjects reported impairment in their daily lives. None of the cases met DSM-V criteria for HPPD. Conclusion Reoccurring drug-like experiences after the administration of LSD and psilocybin are a common phenomenon occurring in up to 9.2% of healthy subjects (7.8% for LSD, 8.3% for psilocybin and 14.3% if both substances are administered). Additionally, our work suggests that flashback phenomena are not a clinically relevant problem in controlled studies with healthy participants.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Flashback phenomena after administration of LSD and psilocybin in controlled studies with healthy participants

et al. 2022

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“…Dabei können visuelle Störungen in Form von Mikro-oder Makropsie, visuellen Halos, gestörter Farbwahrnehmung, Augenrauschen und einer illusionären Palinopsie auftreten. Auslösende Drogen für ein HPPD sind u. a. LSD, 3,4-Methylenedioxyamphetamin (MDA), MDMA (3,4-Methylendioxy-methamphetamin, "Ecstasy"), Psilocybin, Diphenhydramin, Phencyclidin (PCP) und Cannabis [2,3,29].…”

Section: Hallucinogen Persisting Perception Disorder (Hppd)unclassified

Das Visual-Snow-Syndrom: Symptome und ophthalmologische Befunde

Tegetmeyer

2016

Klin Monatsbl Augenheilkd

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The symptom "visual snow" describes the continuous perception of tiny flickering dots within the whole visual field of both eyes. The diagnosis of a visual snow syndrome requires the appearance of typical additional visual symptoms and the exclusion of ophthalmological or neurological causes, or pharmacological influences. Three male and four female subjects between 13 and 36 years of age referred with visual snow were investigated and asked about their symptoms. A complete ophthalmological investigation, including binocular fundoscopy, was performed in all patients. Furthermore, best corrected visual acuity, perimetry, binocular functions, colour vision (D15-test), full-field ERG, pattern-reversal VEP and SD-OCT images of macula and optic nerve (RNFL) were analysed. Visual acuity of at least 1.0 and normal findings for all further investigations were observed in all patients. The following additional visual symptoms were identified: illusionary palinopsia (n = 6), disturbance of night vision (n = 5), positive light phenomena (n = 7). A history of migraine with aura was reported in five patients. The intake of hallucinogenic drugs or centrally active pharmaceuticals was denied by all patients. The findings of available or initiated neurological investigations were normal. The visual snow syndrome has to be regarded as a diagnosis of exclusion. Visual function parameters are not impaired. Apart from eye diseases, a persistent migraine aura as well as neurological diseases or the intake of hallucinogenic drugs must be excluded as possible causes of visual snow and palinopsia.

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“…Zumal Drogenwirkungen zunächst flüchtig sind, wird in Kreisen erfahrener Konsumenten davor gewarnt, etwa während einer gemeinsamen MDMA-Erfahrung oder gar während der Einwirkung von Halluzinogenen längerfristig angelegte (z. B. Heirats-)Versprechungen zu machen [31]. Auch wenn es nicht explizit untersucht wurde, sprechen unsere Ergebnisse dafür, dass Drogen wie Meth-/Amphetamin, Kokain, Ecstasy, Poppers eine erhebliche Libidosteigerung und damit auch ein Dosis-abhängiges "Unsafe Sex"-Risiko [1-8] bedingen, wohingegen Drogen mit eher nicht erhöhter Libido, wie etwa LSD oder andere Halluzinogene, eher weniger zu (vollendetem) Sex und damit auch mit etwas geringerer Wahrscheinlichkeit zu "Unsafe Sex" führen.…”

Section: Ergebnisse ▼unclassified

Wirkungen psychoaktiver Substanzen auf das Bedürfnis nach Liebe, Zärtlichkeit und Sex sowie auf die sexuelle Performance – Ergebnisse einer Umfragestudie bei 1 616 Personen mit überwiegend multipler Drogenkonsumerfahrung

Eul¹,

Verres

2016

Suchttherapie

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Zusammenfassung Es wurden 1?616 drogenerfahrene Personen mittels anonymer Frageb?gen ?ber Ver?nderungen (A) im Bed?rfnis nach Liebe und Z?rtlichkeit, (B) im Bed?rfnis nach Sex sowie (C) in der F?higkeit zur Ausf?hrung von Sex nach Konsum 9 verschiedener, standardm??ig erfasster und 25 weiterer Drogen im Vergleich zum n?chternen Normalzustand befragt. Die gr??te Steigerung des Bed?rfnisses nach Liebe, verbunden mit einer deutlich angehobenen Libido, wurde dem Konsum von Ecstasy (3,4-Methylendioxy-Methamphetamin, MDMA) und nachfolgend von Cannabis zugeschrieben. Kokain war mit der h?chsten Libido und der intensivsten sexuellen Performance assoziiert, allerdings bei kaum erh?hten Liebesgef?hlen. Auch die Droge Poppers wurde ? wie Kokain ? besonders h?ufig intentional zur Steigerung sexueller Lust konsumiert, belegte aber in Bezug auf das Bed?rfnis nach Liebe und Z?rtlichkeit nur den vorletzten Platz im Drogenvergleich. Als vergleichsweise weniger bedeutsam f?r die Sexualit?t wurden Alkohol, Psilocybinpilze, Speed, LSD und Heroin eingestuft. H?here Dosierungen erwiesen sich (au?er bei Ecstasy/MDMA) im Vergleich zu m??iger Dosierung als eher hemmend bez?glich der 3 untersuchten Parameter. Betrachtet man die Einnahme der hier untersuchten psychoaktiven Substanzen als Selbstmedikation, wird die Hypothese plausibel, dass ein verbessertes Wissen ?ber die Vorz?ge einer m??igen Dosierung zu befriedigenderen sexuellen Erfahrungen unter Drogeneinfluss und dadurch auch zu einem achtsameren Umgang mit psychoaktiven Substanzen beitragen kann.

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Halluzinogen-induzierte Persistierende Wahrnehmungsstörung (HPPD) und Flashback-Phänomene – Differenzialdiagnose und Erklärungsmodelle

Cited by 19 publications

References 20 publications

Flashback phenomena after administration of LSD and psilocybin in controlled studies with healthy participants

Flashback phenomena after administration of LSD and psilocybin in controlled studies with healthy participants

Das Visual-Snow-Syndrom: Symptome und ophthalmologische Befunde

Wirkungen psychoaktiver Substanzen auf das Bedürfnis nach Liebe, Zärtlichkeit und Sex sowie auf die sexuelle Performance – Ergebnisse einer Umfragestudie bei 1 616 Personen mit überwiegend multipler Drogenkonsumerfahrung

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