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Hallucinogens Persisting Perception Disorder

What Is Hallucinogen Persisting Perception Disorder?

HPPD stands for hallucinogen persisting perception disorder. There are two different types of it, Type 1 is the generally less harmful prognosis in which the person only experiences short flashbacks where they feel like theyre under the influence of the drug again, similar to PTSD. In most cases Type 1 symptoms fully disappear with time and abstinence. Type 2 is a much more harmful prognosis that often causes the person extreme suffering because of the visual and often non-visual disturbances that can be seen and felt every waking second and appears to be permanent in most cases.

What causes HPPD?

It appears that pretty much all psychedelic and hallucinogenic drugs can cause HPPD, but the more common ones can be seen below. Theres also some indications that SSRIs and other antidepressants combined with the drugs mentioned below increase the risk of getting this disorder, potentially because they act on the same receptors in the brain. Theres even some cases were people seem to have gotten it from SSRIs alone, but its hard to know if that should be classified as HPPD or Visual snow syndrome since the people getting symptoms from antidepressants dont seem to get any of the visual hallucinations.

It is worth mentioning that HPPD can appear after a single exposure to a drug, and it may appear months or even years after the last dose consumed of various mind altering substances.

Like the Following:


* Psilocybin

* Muscimol



* Natural and synthetic cannabis

* 2CB

* Salvia

* Ketamine

   Note: Just because it is not listed does not mean it can not cause HPPD.

What symptoms can HPPD cause?

The DSM V, American Psychiatric Associations official archive of all conditions that are formally recognized as mental disorders, reports the following symptoms: Visual Hallucinations, usually walls breathing, seeing patterns, objects changing size, lights moving, texts vibrating/moving, ground or sky zooming out etc. Altered Motion Perception Flashes of Color Color Enhancement Trails or tracers Palinopsia/afterimages Halos Micropsia Macropsia


The DSM V does not report the following symptoms, but they have been reported by people who suffer from HPPD: Visual snow (the vast majority gets this nasty symptom) Distorted perception of distance Excessive blue field entoptic phenomena and floaters Ghosting (a form of double vision) Starbursts from light sources Glare and pattern glare Inability to focus on objects/stare; looks a bit out of focus Decreased ability to see in the distance

How common is HPPD?

Due to a lack of research, it is impossible to say how common HPPD is, however, Dr. Henry Abraham, who researched this for 40 years, estimated that around 4-6% gets it. This number should be taken with a grain of salt though, because there are many factors that could distort the number of cases of HPPD.

Is there any way to cure HPPD?

Currently, there is no widely accepted cure for HPPD. That being said, there are some treatments that have worked for some people:

The first thing one should do is to drop all recreational drugs, even caffeine and alcohol since these seem to worsen the symptoms for most people. For medicines, there are a few options.

The most effective medicine appears to be long lasting benzodiazepines. It is important to note that benzodiazepines come with their own risks and getting them can be very difficult.

Some anticonvulsant medicines have been shown to decrease the symptoms for some (not all). Medicines like Lamotrigine, Levetiracetam (keppra) and Valproic acid.

SSRIs have conflicting reports. Some people claim that it has worsened their symptoms and others claim it has helped. It appears that in most cases (and in literature) SRRIs only seem to lessen symptoms temporarily and then patients go back down to baseline within a few days.There is a case report were the patients symptoms went in to remission after 6 months on Zoloft, and theres some people that claim that they have been cured by Zoloft and the SNRI Duloxetine.

DO NOT take anti-psychotics. They ARE known to worsen symptoms


Many people can trip consistently for decades, sometimes with dosages into the milligrams, and never have any symptoms of HPPD. Some people can trip once on 150ug and get awful HPPD. Everyones risk tolerance is different, but its important to know the risks in order to make an educated decision on whether or not to trip.

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