Faces of HPPD: Hallucinogen Persisting Perception Disorder Patient Survey Results and a Descriptive Analysis of Patient Demographics, Medical Background, Drug Use History, Symptoms, and Treatments

An internet survey of 26 individuals diagnosed with hallucinogen persisting perception disorder (HPPD), predominantly young white males from North America, found that all reported a history of preexisting mood disorders. Common prior hallucinogens included LSD, psilocybin, MDMA, and mescaline. Ongoing symptoms such as visual snow, floaters, trailing afterimages, and anxiety were reported by over 96% of participants, depersonalization by 92.3%, and suicidal ideation by over 69%. Current benzodiazepine use was 34.6%, with 78% of those users reporting dependency; 19% used marijuana, all claiming dependency. Treatments included benzodiazepines, anticonvulsants, neuroleptics, and counseling. The authors conclude that HPPD is understudied, with complex overlapping symptoms and high risks of suicide and drug dependency.

Study at a glance

Abstract

Objective: The purpose of the present study was to obtain patient information across a wide geography about medical history, drug use, symptoms, and treatments of individuals diagnosed with hallucinogen persisting perception disorder (HPPD). Methods: The study was an internet survey that yielded 26 HPPD patients from North America (81%), Europe (12%), and South America (almost 8%), predominantly male (73%), white (92%), with a median age of 24.5 (range, 18 to 63) years, who have been living with HPPD from a period of <1 year to well over 10 years. Results: History of preexisting mood disorders was reported (100%). Previous hallucinogen drugs used include lysergic acid diethylamide, psilocybin, 3,4-methylenedioxymethamphetamine, and mescaline in highest frequencies. There is a high percentage of current use of benzodiazepines (34.6%) and dependency (78% of those using). Current marijuana use is present for 19%, of which all claim dependency. All patients reported experiencing long-term and ongoing symptoms such as depersonalization (92.3%), visual snow, floaters, trailing afterimages and anxiety (96.2% for each factor). Suicide ideation was pronounced (over 69%). HPPD treatments included benzodiazepines (50%), neuroleptics (23%), anticonvulsants (35%), and receiving counseling (62%). Conclusions: HPPD is an understudied mental disorder that has a complex and unpredictable nature with overlapping psychiatric, psychological, and neurological symptoms. Controlled, evidence-based clinical studies are needed for improvements in diagnosing and treating HPPD. There is concern for patients' well-being, particularly concerning high reported suicide ideation and dependency on drugs currently used (even if they are prescribed). Improved education for health care professionals and patients is also needed.