Hallucinogen Persisting Perception Disorder in a Young Adult Case Report.
Sonali Notani, Vikas Srinivasa, Serena Chaudhry, Ashley Weiss
Case Reports in Psychiatry September 3, 2026 DOI: 10.1155/crps/6605265 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case report Longitudinal Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A 24-year-old college student (WA) with HPPD II, comorbid bipolar I disorder, and generalized anxiety disorder |
| Interventions | Olanzapine Clonidine Clonazepam |
| Topics | LSD |
| Keywords | Psychosis Case report Bipolar |
| Key findings | The authors report that a 24-year-old man with HPPD II, bipolar I disorder, and generalized anxiety disorder improved in mood and psychosis with olanzapine, but his perceptual disturbances and "visual snow" persisted despite trials of clonidine and clonazepam, fluctuating in severity without fully resolving. They argue the case illustrates the difficulty of distinguishing HPPD from psychosis and the limited effectiveness and knowledge of HPPD treatments, and they call for longitudinal assessment. |
Abstract
Hallucinogen persisting perception disorder (HPPD) is a rare psychiatric diagnosis encompassing a range of perceptual disturbances caused by the lingering effects of hallucinogens. There are two major subtypes of the disorder: HPPD I and II. HPPD II is considered a more severe form that is generally longer-term, distressing, and requiring more intense treatment. In the limited available literature, many of the affected patients have multiple psychiatric comorbidities. The following case describes a 24-year-old college student, WA, who was diagnosed with HPPD II along with comorbid bipolar I disorder and generalized anxiety disorder. WA presented with an escalation of manic symptoms, psychosis, and two lysergic acid diethylamide (LSD) uses prior to hospitalization. He was treated with olanzapine, leading to mood stabilization and remission of psychosis. Post treatment, WA continued to experience perceptual disturbances and "visual snow." Medications clonidine and clonazepam were trialed for HPPD. While symptoms fluctuated in severity, they never fully resolved. Despite this, WA achieved acceptance of his symptoms, mood stability, and a functional recovery. WA's case is an example of the clinical complexity in accurate diagnosis and treatment of HPPD, including the distinction of the symptoms from psychosis. As LSD-assisted therapies continue to be investigated for conditions such as anxiety and depression, recognition and management of persistent adverse effects such as HPPD are becoming increasingly important in both psychiatric and general medical practice. This case demonstrates the limited effectiveness and lack of knowledge on HPPD treatments as well as the need for longitudinal assessments in management.
Comparable studies
Other case reports and case series on LSD, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Lasting Neuropsychiatric Sequelae of (??)Methylenedioxymethamphetamine (???Ecstasy???) in Recreational Users Persons who ingested large doses of MDMA | 1991 | Case study | n = 2 |
| Further Studies in the Therapeutic Value of Lysergic Acid Diethylamide in Mental Illness Patients with mental illness | 1957 | Case series | |
| Coma, Hyperthermia, and Bleeding Associated with Massive LSD Overdose a Report of Eight Cases People who self-administered large amounts of pure LSD powder intranasally | 1975 | Case series | n = 8 |
| Using a MDMA- and LSD-Group Therapy Model in Clinical Practice in Switzerland and Highlighting the Treatment of Trauma-Related Disorders Patients with chronic complex post-traumatic stress disorder (c-PTSD), dissociative,... | 2022 | Case series | |
| Persistent Palinopsia Following Ingestion of Lysergic Acid Diethylamide (LSD) Patients who developed persistent palinopsia after LSD ingestion | 1996 | Case series | n = 3 |
Citations in the library
Cites 7
- Lysergic Acid Diethylamide-Assisted Therapy in Patients With Anxiety With and Without a Life-Threatening Illness: A Randomized, Double-Blind, Placebo-Controlled Phase II Study. Biological Psychiatry February 1, 2023
- The neural basis of psychedelic action. Nature Neuroscience October 24, 2022
- Hallucinogen Persisting Perception Disorder: Etiology, Clinical Features, and Therapeutic Perspectives Brain Sciences March 16, 2018
- The “Endless Trip” among the NPS Users: Psychopathology and Psychopharmacology in the Hallucinogen-Persisting Perception Disorder. A Systematic Review Frontiers in Psychiatry November 20, 2017
- Psychological effects of psychedelics in adolescents. Front Child Adolesc Psychiatry June 7, 2024
and 2 more in the library