Halluzinogen-induzierte psychische Störungen

Hermle, Leopold; Kovar, Karl‐Artur; Hewer, Walter; Ruchsow, Martin

doi:10.1055/s-2008-1038191

Cited by 20 publications

(8 citation statements)

References 23 publications

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“…The actual incidence of HPPD is not known and depends on the prevalence of use in different countries, but epidemiologic information is scarce. Hermle et al (2008) reviewed MEDLINE data for 1997-2007, searching for reports of hallucinogen-induced psychosis, flashbacks, and HPPD. The authors reported that adolescent intoxication with psychedelic drugs rarely produced acute psychotic syndromes, further stating that "The clinical relevance of flashback phenomena as a posthallucinogenic psychiatric disorder has to be disputed.…”

Section: Hallucinogen Persisting Perception Disordermentioning

confidence: 99%

Psychedelics

2016

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Section: Hallucinogen Persisting Perception Disordermentioning

confidence: 99%

Psychedelics

2016

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“…Our patient, now 36 years old and currently in an apprenticeship in a tree nursery, had been experiencing persistent visual disturbances from the age of 18 onwards following a year long recreational use of LSD, cannabis, alcohol and cocaine. These disturbances manifested themselves variously as photopsia (included small intensely coloured, flickering, geometric shapes within the entire visual field), afterimages personality disorder, mental trauma in childhood/adolescence) may constitute such variables [7,8]. In this context it is noteworthy that a whole range of non-hallucinogenic psychotropic drugs are also known to elicit complex visual perception disorders.…”

Section: Discussionmentioning

confidence: 99%

“…Pharmacological approaches to HPPD are currently based on a few uncontrolled single case observations with sometimes contradictory recommendations as to the clinical usefulness of clonidine, SSRIs, benzodiazepines, risperidone, olanzapine and naltrexone (Table 2). Thus, no sound clinical guidelines exist for a rational pharmacological treatment of HPPD [3,7,37,38]. Moreover, it remains unclear whether the "successful" treatments listed in Table 2 are the result of actual therapeutic efficacy or spontaneous remissions.…”

Section: Treatmentmentioning

confidence: 99%

“…He reported the subsequent development of 16 persistent visual disturbances in these individuals [5]. The clinical relevance of these findings and their distinction from "flashbacks" and "HPPD", however, remains unclear and awaits further clarification [3][4][5][6][7]. Current knowledge with regard to risk factors, etiology and therapeutic options is thus limited and must be interpreted with caution [3,8].…”

Section: Introductionmentioning

confidence: 99%

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Hallucinogen Persisting Perception Disorder (HPPD) and Flashback-are they Identical?

Melanie¹

2013

J Alcoholism Drug Depend

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Background: Despite a multitude of etiological and therapeutic approaches, the exact pathophysiological mechanisms underlying Hallucinogen persisting perception disorder (HPPD) remain elusive. Rather, in each individual case, specific risk factors and different vulnerabilities form part of a multifactorial origin of this rare but highly debilitating psychiatric disorder. Case: The following case report describes the history of a 36 year old male who has been suffering from a visual perception disorder for the last 18 years. At the age of 17 he used LSD for the first time, having consumed cannabis and alcohol on a regular basis during the preceding year. Descriptions: After one particular LSD trip at age 18, the patient suddenly developed persistent visual disturbances including small-sized, colour-intensive, flickering, geometrical patterns; intermittent after images of objects in the visual fields, and trailing phenomena of moving objects. Results from the Early Trauma Inventory (ETI) questionnaire indicated significant mental trauma in childhood and adolescence. Brain MRI and electrophysiological investigations revealed a few disseminated subcortical lesions. Conclusion: Upon experimental treatment with lamotrigine, the patient experienced partial to complete remission of the various visual disturbances. With its potentially neuroprotective and mood-stabilising properties, lamotrigine may offer a promising new therapeutic approach for the treatment of HPPD.

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“…The prevalence of both symptom types is unknown but thought to be low [41; 42]. However, there is a history of claiming that psychedelic-use can be directly causal of their emergence [42]. Here, we define 'psychedelics' as "LSD, psilocybin/magic mushrooms/truffles, DMT, ayahuasca, 5-MeO-DMT, mescaline (synthetic or plant derived), or the psychedelic-like drug MDMA/ecstasy".…”

Section: Introductionmentioning

confidence: 99%

Focusing on the negative: cases of long-term negative psychological responses to psychedelics

Bremler¹,

Katati²,

Shergill³

et al. 2023

Preprint

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Background: Recent controversies have arisen regarding claims of uncritical positive regard and hype surrounding psychedelic drugs and their therapeutic potential. Criticisms have included that study designs and reporting styles bias positive over negative outcomes.Aim: The present study was motivated by a desire to address this alleged bias by intentionally focusing exclusively on negative outcomes, defined as self-perceived ‘negative’ psychological responses lasting for at least 72 hours after psychedelic use. A strong justification for this selective focus was that it might improve our ability to capture otherwise missed cases of negative response, enabling us to validate their existence and better examine their nature, as well as possible causes, which could inspire risk-mitigation strategies. Methods: Via advertisements posted on social media, individuals were recruited who reported experiencing negative psychological responses to psychedelics (defined as classic psychedelics plus MDMA) lasting for greater than 72 hrs since using. Volunteers were directed to an online questionnaire. These data were analysed using quantitative methods. A key second phase of this study involved reviewing all of the submitted cases, identifying the most severe – e.g., where new psychiatric diagnoses were made or pre-existing symptoms made worse post psychedelic-use – and inviting these individuals to participate in a semi-structured interview with two members of our research team, where relevant experiences and backgrounds were examined in greater depth. Based on the content of these interviews, a brief summary of each case was compiled, and an explorative thematic analysis was used to identify salient and consistent themes and infer common causes. Results: Thirty-two individuals fully completed an onboarding questionnaire (56% male, 53% < age 25). 37.5% of completers had a psychiatric diagnosis that emerged after their psychedelic experience, and anxiety symptoms arose or worsened in 87%. Twenty of the seemingly severer cases were invited to be interviewed; of these, 15 accepted an in-depth interview that lasted on average 60 minutes. This sample was 40% male, mean age = 31±7. Five of the fifteen (i.e., 33%) reported receiving new psychiatric diagnoses after psychedelic-use and all fifteen reported the occurrence or worsening of psychiatric symptoms post use, with a predominance of anxiety symptoms (93%). Distilling the content of the interviews suggested the following potential causal factors: unsafe or complex environments during or surrounding the experience, unpleasant acute experiences (classic psychedelics), prior psychological vulnerabilities, high- or unknown drug quantities and young age.Conclusion: The current exploratory findings corroborate the reality of mental health iatrogenesis via psychedelic-use but due to design limitations and sample size, cannot be used to infer on its prevalence. Based on interview reports, we can infer a common, albeit multifaceted, causal mechanism, namely the combining of a potent pro-plasticity drug (often ‘over-dosed’) with adverse contextual conditions and/or special psychological vulnerability - either by young age or significant psychiatric history. Results should be interpreted with caution due to the small sample size and selective nature of the recruitment approach.

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Halluzinogen-induzierte psychische Störungen

Cited by 20 publications

References 23 publications

Psychedelics

Psychedelics

Hallucinogen Persisting Perception Disorder (HPPD) and Flashback-are they Identical?

Focusing on the negative: cases of long-term negative psychological responses to psychedelics

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