LSD

Hallucinogen Persisting Perception Disorder: Etiology, Clinical Features, and Therapeutic Perspectives

This paper provides a comprehensive review of 45 original studies on Hallucinogen Persisting Perception Disorder, synthesising current evidence on proposed aetiologies, the hallucinogens implicated, clinical features of HPPD types I and II, psychiatric comorbidities and available and potential treatments. It emphasises HPPD's rarity, its possible occurrence even after a single exposure, and the limited, heterogeneous evidence guiding therapeutic strategies.

Authors

  • Giovanni Martinotti

Published

Brain Sciences
meta Study

Abstract

Hallucinogen Persisting Perception Disorder (HPPD) is a rare, and therefore, poorly understood condition linked to hallucinogenic drugs consumption. The prevalence of this disorder is low; the condition is more often diagnosed in individuals with a history of previous psychological issues or substance misuse, but it can arise in anyone, even after a single exposure to triggering drugs. The aims of the present study are to review all the original studies about HPPD in order to evaluate the following: (1) the possible suggested etiologies; (2) the possible hallucinogens involved in HPPD induction; (3) the clinical features of both HPPD I and II; (4) the possible psychiatric comorbidities; and (5) the available and potential therapeutic strategies. We searched PubMed to identify original studies about psychedelics and Hallucinogen Persisting Perception Disorder (HPPD). Our research yielded a total of 45 papers, which have been analyzed and tabled to provide readers with the most updated and comprehensive literature review about the clinical features and treatment options for HPPD.

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Research Summary of 'Hallucinogen Persisting Perception Disorder: Etiology, Clinical Features, and Therapeutic Perspectives'

Introduction

Hallucinogens are a diverse group of natural and synthetic compounds that profoundly alter consciousness, cognition, emotion and perception, with visual distortions being the most prominent sensory effect. Their use spans millennia in ritual and healing contexts and re-emerged in Western medicine and culture in the 20th century, with LSD as the archetypal synthetic hallucinogen. Contemporary patterns of use include ceremonial contexts as well as recreational poly‑substance settings and novel psychoactive substances, and there is growing clinical concern about adverse psychiatric sequelae even in people without prior psychopathology. This paper by Martinotti and colleagues reviews original studies on Hallucinogen Persisting Perception Disorder (HPPD), a relatively rare condition in which perceptual disturbances experienced during acute intoxication recur after the drug has been cleared. The authors set out to summarise suggested etiologies, the range of substances implicated, clinical features of the two proposed subtypes (HPPD I and HPPD II), psychiatric comorbidities, and reported therapeutic strategies, aiming to provide a comprehensive qualitative synthesis of the original literature.

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Study Details

  • Study Type
    meta
  • Journal
  • Compound
  • Author
  • APA Citation

    Martinotti, G., Santacroce, R., Pettorruso, M., Montemitro, C., Spano, M., Lorusso, M., Di Giannantonio, M., & Lerner, A. (2018). Hallucinogen Persisting Perception Disorder: Etiology, Clinical Features, and Therapeutic Perspectives. Brain Sciences, 8(3), 47. https://doi.org/10.3390/brainsci8030047

References (7)

Papers cited by this study that are also in Blossom

The psychopharmacology of hallucinogens

Abraham, H. D., Aldridge, A. M., Gogia, P. · Neuropsychopharmacology (1996)

Clinical Applications of Hallucinogens: A Review

Garcia-Romeu, A., Kersgaard, B., Addy, P. H. · Experimental and Clinical Psychopharmacology (2016)

174 cited
Hallucinogen persisting perception disorder: what do we know after 50 years?

Halpern, J. H., Pope Jr, H. G. · Drug and Alcohol Dependence (2003)

204 cited
Flashbacks and HPPD: A Clinical-oriented Concise Review

Lerner, A. G. · The Israel Journal of Psychiatry and Related Sciences; Jerusalem (2014)

Hallucinogen persisting perception disorder and the serotonergic system: A comprehensive review including new MDMA-related clinical cases

Litjens, R. P. W., Brunt, T. M., Alderliefste, G. et al. · European Neuropsychopharmacology (2014)

LSD-associated “Alice in Wonderland Syndrome”(AIWS): A Hallucinogen Persisting Perception Disorder (HPPD) Case Report

Lerner, A. G. · The Israel Journal of Psychiatry and Related Sciences; Jerusalem (2015)

Abnormal visual experiences in individuals with histories of hallucinogen use: A web-based questionnaire

Baggott, M. J., Coyle, J. R., Erowid, E. et al. · Drug and Alcohol Dependence (2011)

68 cited

Cited By (31)

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Safety pharmacology of acute psilocybin administration in healthy participants

Straumann, I., Holze, F., Becker, A. M. et al. · Neuroscience Applied (2024)

15 cited
Case analysis of long-term negative psychological responses to psychedelics

Bremler, R., Katati, N., Shergill, P. et al. · Scientific Reports (2023)

Preliminary evidence of links between ayahuasca use and the corpus callosum

Bouso, J. C., Simonsson, O., Kurth, F. et al. · Frontiers in Psychiatry (2022)

Hallucinogenic Persisting Perception Disorder: A Case Series and Review of the Literature

Van Der Walt, A., Ford, H., Fraser, C. L. et al. · Frontiers in Neurology (2022)

Hallucinogen persisting perceptual disorder: a scoping review covering frequency, risk factors, prevention and treatment

Doyle, M. A., Ling, S., Lui, L. M. W. et al. · Expert Opinion on Drug Safety (2022)

Show all 31 papers
Psychedelic Therapy's Transdiagnostic Effects: A Research Domain Criteria (RDoC) Perspective

Dursun, S. M., Kelly, J. R., Gillan, C. M. et al. · Frontiers in Psychiatry (2021)

Neuropsychological Functioning in Users of Serotonergic Psychedelics - A Systematic Review and Meta-Analysis

Basedow, L. A., Riemer, T. G., Reiche, S. et al. · Frontiers in Pharmacology (2021)

Do Psychedelics Change Beliefs?

McGovern, H., Leptourgos, P., Hutchinson, B. et al. · Psyarxiv (2021)

Safety pharmacology of acute LSD administration in healthy subjects

Holze, F., Caluori, T. V., Vizeli, P. et al. · Psychopharmacology (2021)

On Perception and Consciousness in HPPD: A Systematic Review

Ermentrout, G. B., Vis, P. J., Goudriaan, A. E. et al. · Frontiers in Neuroscience (2021)

Does psychedelic therapy have a transdiagnostic action and prophylactic potential?

Kočárová, C., Horacek, J., Carhart-Harris, R. L. · Frontiers in Psychiatry (2021)

73 cited
Migraine prevalence in visual snow with prior illicit drug use (Hallucinogen Persisting Perception Disorder) versus without

van Dongen, R. M., Alderliefste, G. J., Onderwater, G. L. J. et al. · European Journal of Neurology (2021)

22 cited
Symptom specificity of ayahuasca's effect on depressive symptoms

Gilbert, C. S., Earleywine, M., Mian, M. N. et al. · Journal of Psychedelic Studies (2021)

On the Relationship between Classic Psychedelics and Suicidality: A Systematic Review

Zeifman, R. J., Singhal, N., Breslow, L. et al. · ACS Pharmacology and Translational Science (2021)

The History of Psychedelics in Psychiatry

Nichols, D. E., Walter, H. · Pharmacopsychiatry (2020)

Psychedelic science in post-COVID-19 psychiatry

Kelly, J. R., Crockett, M. T., Alexander, L. et al. · Irish Journal of Psychological Medicine (2020)

A systematic study of microdosing psychedelics

Polito, V., Stevenson, R. J. · PLOS ONE (2019)

197 cited
Microdosing psychedelics: personality, mental health, and creativity differences in microdosers

Anderson, T., Petranker, R., Rosenbaum, D. et al. · Psychopharmacology (2019)

142 cited
Hallucinogen Persisting Perception Disorder After Ibogaine Treatment for Opioid Dependence

Knuijver, T., Belgers, M., Markus, W. et al. · Journal of Clinical Psychopharmacology (2018)

8 cited

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