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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
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
“Hallucinations” Following Acute Cannabis Dosing: A Case Report and Comparison to Other Hallucinogenic Drugs Healthy 30-year-old male 2018 Case study n = 1
Cannabis Psychosis in Young Psychiatric Inpatients Consecutive psychiatric hospital admissions of patients aged 35 and under 1986 Case study n = 25
Light microscopy can reveal the consumption of a mixture of psychotropic plant and fungal material in suspicious death. Deceased young man who participated in an ayahuasca ceremony 2015 Case study n = 1

Citations in the library

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Cannabis MDMA Psilocybin Addiction