A Review of Hallucinogen Persisting Perception Disorder (HPPD) and an Exploratory Study of Subjects Claiming Symptoms of HPPD.
Hallucinogen persisting perception disorder (HPPD) is rarely encountered in clinical settings. It is described as a re-experiencing of some perceptual distortions induced while intoxicated and suggested to subsequently cause functional impairment or anxiety. Two forms exist: Type 1, which are brief "flashbacks," and Type 2 claimed to be chronic, waxing, and waning over months to years. A review of HPPD is presented. In addition, data from a comprehensive survey of 20 subjects reporting Type-2 HPPD-like symptoms are presented and evaluated. Dissociative Symptoms are consistently associated with HPPD. Results of the survey suggest that HPPD is in most cases due to a subtle over-activation of predominantly neural visual pathways that worsens anxiety after ingestion of arousal-altering drugs, including non-hallucinogenic substances. Individual or family histories of anxiety and pre-drug use complaints of tinnitus, eye floaters, and concentration problems may predict vulnerability for HPPD. Future research should take a broader outlook as many perceptual symptoms reported were not first experienced while intoxicated and are partially associated with pre-existing psychiatric comorbidity.
Laboratory for Integrative Psychiatry, Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Oaks Building, Belmont, MA, 02478-1064, USA. john_halpern@gmail.com.|Department of Psychiatry, Harvard Medical School, Boston, MA, USA. john_halpern@gmail.com.
John H
JH
Halpern
Lev Hasharon Mental Health Center, Pardesya, Israel.|Sackler Medical School, Tel Aviv University, Tel Aviv, Israel.
Arturo G
AG
Lerner
Laboratory for Integrative Psychiatry, Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Oaks Building, Belmont, MA, 02478-1064, USA.|Department of Psychiatry, Harvard Medical School, Boston, MA, USA.|Senckenberg Institute for History and Ethics in Medicine, Goethe-University Frankfurt/Main, Frankfurt, Germany.
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D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006212:Hallucinations / Q000139:chemically induced / Q000523:psychology; D006213:Hallucinogens / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010468:Perceptual Disorders / Q000139:chemically induced* / Q000453:epidemiology / Q000523:psychology*; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
D006213:Hallucinogens
Dissociation; Drug-induced flashback; Flashback; Hallucinogen Persisting Perceptual Disorder (HPPD); Hallucinogens; LSD; Posttraumatic Stress Disorder (PTSD)