Hallucinogen Persisting Perception Disorder
Hallucinogen Persisting Perception Disorder (HPPD) is a rare clinical condition in which patients who have had previous exposure to a hallucinogenic substance continue to experience perceptual distortions months to years after complete cessation of the initial substance use.
Currently, there is no standardized treatment for HPPD. However, some interventions show promise, including lamotrigine, benzodiazepines, and non-invasive brain stimulation. Research on these treatments is limited due to the rarity of the condition and the variability of its symptoms.
Prevalence
HPPD is considered an uncommon outcome of psychedelic use. One study estimates the prevalence at about 4.2% among hallucinogen users, specifically referencing data from the American Psychiatric Association[1][2].
Risk Factors
HPPD has been observed more frequently in:
- adolescents who use psychedelics[3]
- females[4]
- people taking LSD
- people with a history of psychological disorders or substance misuse.
Clinical Features and Impact
- HPPD symptoms are mainly visual (e.g., afterimages, halos, visual trails), but non-visual symptoms can also occur.
- The disorder can persist for months or years and may cause significant distress or impairment in daily life, though a substantial number of cases remit over time.
- The burden and impact of HPPD symptoms do not appear to differ significantly between those exposed to hallucinogens and those who have not, suggesting that other factors contribute to the severity and persistence of symptoms.
Conclusion
HPPD is a genuine but rare complication of psychedelic use, affecting a small minority of users—about 4%. Most people who use hallucinogens do not develop persistent perceptual disturbances, but those with certain vulnerabilities may be at higher risk.
References
- ↑ Hadley, M., Halliday, A., & Stone, J. (2023). Association of Hallucinogen Persisting Perception Disorder with Trait Neuroticism and Mental Health Symptoms.. Journal of psychoactive drugs, 1-7 . https://doi.org/10.1080/02791072.2023.2287081.
- ↑ Nutting, S., Bruinsma, T., Anderson, M., & Jolly, T. (2020). Psychotic and Still Tripping—Hallucinogen Persisting Perception Disorder and First Break Psychosis in an Adolescent. International Journal of Mental Health and Addiction. https://doi.org/10.1007/s11469-020-00338-5.
- ↑ https://www.frontiersin.org/articles/10.3389/frcha.2024.1364617/abstract
- ↑ Zhou K, Wied D de, Carhart-Harris RL, Kettner H. Prediction of hallucinogen persisting perception disorder and thought disturbance symptoms following psychedelic use. PNAS Nexus. 2025;4(4). doi:https://doi.org/10.1093/pnasnexus/pgae560