Hallucinogen Persisting Perception Disorder

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**Hallucinogen Persisting Perception Disorder (HPPD)** is defined as a long-lasting condition characterized by spontaneous recurrence of visual disturbances reminiscent of acute hallucinogen intoxication. In contrast to psychotic disorders, individuals with HPPD recognize the unreal nature of their visual disturbances, which qualifies them as pseudohallucinations.

## Signs & Symptoms

Individuals who experience visual disturbances caused by HPPD often experience one or more of the following symptoms:

* Intensified colors.
* Flashes of color.
* Color confusion.
* Size confusion.
* Halos around objects.
* Travers and trailers.
* Seeing geometric patterns.
* Seeing images within images.
* Difficulty reading.
* Feeling uneasy.

Individuals re-experience the same hallucinations they had on a past psychedelic trip. It's not clear how or why HPPD flashbacks occur, so one can happen at any time.

It's common for individuals with HPPD to experience:

* Anxiety disorders.
* Panic disorder.
* Symptoms of depersonalization and derealization.
* Suicidal thoughts.

These symptoms can last for weeks, months and sometimes years. In some cases, the condition becomes chronic, while others can suppress the feelings and function regularly.

## Causes

Researchers and doctors do not yet have a solid understanding of who develops HPPD and why. It's also unclear what causes HPPD in the first place. The strongest connection points to a history of hallucinogenic drug use, but it's not clear how the type of drug or the frequency of drug use may affect who develops HPPD.

In some cases, individuals experience HPPD after their first use of the drug. Others use these drugs for many years before experiencing symptoms.

What does not cause HPPD is better known. HPPD is not the result of:

* Brain injury.
* A neurological condition like epilepsy.
* Another psychiatric condition.
* Lingering symptoms are not the result of a bad trip.
* These symptoms are not the result of the drug being stored in the body and then released later. This is a common myth, but it is not true.
* HPPD also is not the result of current intoxication. Many individuals experience symptoms of HPPD days, weeks, or months after drug use.

### Hallucinogens

Visual disturbances are the result of hallucinogenic drugs, primarily LSD. Some hallucinogens appear in nature, such as psilocybin, chemically synthesized hallucinogens include ketamine, PCP, dizocilpine, and MDMA. The psychedelic trip is likely caused by the way psychotropic compounds bind with 5-HT2A serotonin receptors; however, more research is needed to understand exactly how hallucinogens work.

## References

Hermle L, Simon M, Ruchsow M, Geppert M. Hallucinogen-persisting perception disorder. Ther Adv Psychopharmacol. 2012 Oct;2(5):199-205. doi: 10.1177/2045125312451270. PMID: 23983976; PMCID: PMC3736944.

https://www.healthline.com/health/hppd

https://www.psychologytoday.com/us/conditions/hallucinogen-persisting-perception-disorder