Hallucinogen-persisting perception disorder (HPPD) is rare in adolescents. A 16-year-old male with major depressive disorder and polysubstance use (LSD, MDMA, psilocybin, cannabis, benzodiazepines) experienced auditory hallucinations and heightened hearing between MDMA use for eight months, plus auditory and visual hallucinations during a five-day inpatient admission. Treatment with aripiprazole 5 mg led to gradual improvement but not complete resolution. First-line treatments include clonidine and benzodiazepines; second-generation antipsychotics are generally less effective except aripiprazole. The diagnosis was complicated by polysubstance use, requiring distinction from non-substance-induced psychotic disorders.
Hallucinogen-Persisting Perception Disorder (HPPD) is rare in adolescents. A 16-year-old male with major depressive disorder and polysubstance use (LSD, MDMA, psilocybin, cannabis, benzodiazepines) experienced auditory hallucinations and heightened hearing between MDMA use for eight months, plus auditory and visual hallucinations during a five-day inpatient stay. Treatment with aripiprazole 5 mg led to gradual symptom improvement, though symptoms did not fully resolve. Literature review indicates first-line treatments include clonidine and benzodiazepines; second-generation antipsychotics are generally less effective except aripiprazole. Diagnosis was complicated by polysubstance use, requiring distinction from non-substance-induced psychotic disorders.