Frontiers in Neuroscience
August 11, 2021
Pieter J. Vis, Anneke E. Goudriaan, Bastiaan C. Ter Meulen et al.
40 citations
Hallucinogen-persisting perception disorder (HPPD) involves perceptual symptoms and flashbacks after psychedelic use, but its phenomenology is poorly understood. A systematic review of 66 case reports and series covering 97 people identified 64 unique symptoms. Of these, 76% were characteristic of Alice in Wonderland syndrome, over 50% were non-visual, and 38% were not clearly linked to prior intoxication, contrasting with DSM-5 criteria. Fewer than half of patients had a protracted course over a year, and a third achieved remission. Co-occurring depression with or without anxiety was associated with longer symptom persistence and more negative treatment outcomes. HPPD involves changes in the content of consciousness and an attentional shift from external to internal phenomena, rather than the altered states seen in acute intoxication. The authors recommend expanding diagnostic criteria.
Harv Rev Psychiatry
September 9, 2025
Arjen Neven, Jan Dirk Blom
3 citations
Hallucinogen persisting perception disorder (HPPD) involves lingering or recurring perceptual phenomena after substance use, which can be mild or severely burdensome. A systematic review of 31 medication studies covering 87 participants found that clonidine, clonazepam, and levetiracetam produced substantial symptom reduction in three observational studies. Among those receiving benzodiazepines, antiepileptics, antidepressants, or alpha agonists, 28% achieved full recovery and 61% partial recovery within a year. Benzodiazepines were ineffective when HPPD was triggered by lysergic acid diethylamide, and risperidone aggravated symptoms. The authors suggest these medications can treat HPPD effectively but call for randomized controlled trials and epidemiological studies.
Transcultural psychiatry
December 1, 2015
Jan Dirk Blom, Igmar T Poulina, Trevor L Van Gellecum et al.
Brua, an Afro-Caribbean religion and healing tradition from the southern former Netherlands Antilles, shapes how individuals experience and express disorders that Western psychiatry considers mental illness. A systematic review of 35 texts—including three peer-reviewed papers and eight theses—found Brua to be a holistic patchwork of creolized beliefs and practices seen as both cause and remedy for ailments. Tension between Brua and Western psychiatric practice is significant, but adherence does not seem to cause much patient delay in help-seeking. However, belief in Brua as a source of complaints and patients' use of practices including hallucinogens may affect diagnosis and treatment of mental disorders.