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Hallucinogen persisting perception disorder: A literature review and three case reports

Valentin Yurievich Skryabin, М.а. Винникова, A. Yu. Nenastieva, Vladislav Vladimirovich Alekseyuk

Journal of Addictive Diseases October 2, 2018 DOI: 10.1080/10550887.2019.1673655 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Case series Case report Peer reviewed
Sample size 3
Population Patients with hallucinogen persisting perception disorder
Interventions tofisopam lamotrigine sertraline
Topics Cannabis MDMA Psilocybin
Keywords Hallucinogen Visual hallucination Kava
Citations 27
Key findings HPPD can occur after use of psilocybin mushrooms and cannabis (type I) or after ecstasy use (type II), and treatment may reduce but not eliminate symptoms.

Abstract

The paper describes diagnostic criteria, clinical presentation and types of hallucinogen persisting perception disorder (HPPD), as well as current approaches to the treatment of this phenomenon using available scientific sources. Three case reports are also presented to demonstrate different types of this disorder. The first case report describes a 23-year old patient with a previous history of cannabis consumption who reported HPDD type I after the use of psilocybin mushrooms with small amounts of alcohol and hash. A month later, after cannabis use, the same visual and auditory distortions appeared again. During the following year, hallucinations recurred with the consumption of natural cannabinoids but not with alcohol intake. The symptoms have reduced within a year. Surprisingly, both other cases belonging to HPDD type II appeared in patients who consumed ecstasy, although MDMA is generally not considered a hallucinogen and hallucinations are not frequently reported after MDMA consumption. In both cases of HPPD type II after the use of ecstasy, the condition was very stressful and frightening. Both patients sought medical help and received tofisopam, lamotrigine and sertraline. After that, in both cases visual impairments have smoothed, but have not passed completely. Scientific sources suggest that HPPD may affect more than 50% of hallucinogen users and this disorder is often underdiagnosed. Therefore, patients suffering from HPPD can present in various clinical settings, and clinicians should be aware of this condition.

Comparable studies

Other case reports and case series on cannabis, most cited first.

Study Year Design Participants
Psychotic Reactions Following Cannabis Use in East Indians Patients at an Indian drug addiction clinic who developed acute cannabis-related psychosis 1974 Descriptive report (case series of clinical observations) n = 200
Psychiatric effects of cannabis use Swedish cases of cannabis psychosis 1985 Case series n = 70
Forty-Six Cases of Psychosis in Cannabis Abusers Gunila Bernhardson Habitual cannabis users treated for psychosis at Swedish psychiatric clinics and mental... 1972 Case series (retrospective survey of psychiatric records) n = 46
Hallucinogen persisting perception disorder after psilocybin consumption: a case study 18-year-old man with HPPD after mixed psilocybin and cannabis intoxication 2005 Case study n = 1
Cannabis‐induced Koro in Americans American men aged 22-26 with years of cannabis experience who reported negative... 2001 Case series n = 3

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Cannabis MDMA Psilocybin Addiction