I.

II.
III.
IV.

Name: Hallucinogen Persisting Perception Disorder (HPPD)

DSM-IV Diagnostic Code: 292.89
Chief Researcher: Dr. John Halpern
Prevalence: Unknown
a. Possibly impacts about 5% of heavy users of psychedelic drugs (Dr. Baggot, UC Berkeley, 2006)

V.

Induced by:
a. Abusing LSD especially, but also by abusing mescaline and its derivatives (DOx, 2C-x, 25x)
i. HPPD has also been frequently reported as a result of MDMA abuse
1. In fact, most of the people in the online HPPD support groups are former MDMA
abusers (ravers), who just didnt know that MDMA can lead to HPPD
ii. There are occasional reports that abusing tryptamines (DMT, psilocybin), cannabanoids
(THC, CBD), and some dissociatives (PCP, ketamine, MXE, nitrous, DXM, etc.) can lead
to HPPD
b. There appears to be a genetic and/or psychiatric component: people with certain perceptual
systems and/or certain latent psychiatric problems seem to get HPPD more often than others
i. Also, abuse in terms of frequency of use is more likely to lead to HPPD than abuse in
terms of sheer amounts

VI.

Common Symptoms:
a. Residual visual distortions, especially in bright light or when sleep deprived
i. increase in the blue field entoptic phenomenon
ii. increase in the awareness of floaters
iii. increase in visual snow or the first time appearance of visual snow
iv. seeing stars (starbursting), especially when standing up or out in the heat
v. visual halos around bright objects
vi. visual trailers around moving objects, especially bright ones
vii. visual afterimages of objects on when you close the eyelids, especially of bright objects
viii. unwanted visual movements of complex visual images
1. For example, Persian rugs and printed text tend to start moving on their own
ix. persistent colors and/or geometry seen when in the dark or on the backs of the eyelids
when they are closed
1. Of course, the colors and geometry vary with the color, pattern, and intensity of
the light projected upon the eyelids
b. Increased visual sensitivity
i. increased sensitivity to light
ii. some increased sensitivity to complete dark since with HPPD you still see some colors in
the dark
1. Youll never see pure black when you close your eyes ever again, and this is
disturbing, at least at first
c. Ability to enter a low level psychedelic state at any time
i. Staring, holding your eyes in a certain way, or using a focusing tube, for example, can cause
LSD-like visions to appear at any time
ii. Psychoactive substances make the visions stronger and easier to slip into
1. For example, smoking marijuana will do this
a. THC is highly psychoactive and remember that it brings back LSD when
you smoke it; naturally, marijuana intensifies HPPD when you smoke it too
iii. Easiest to do with multifarious surfaces like carpet, tree bark, etc.

PLEASE FLIP OVER

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VII. Psychiatric complications of HPPD:

a. Fear of the unknown
i. Must sufferers dont know what HPPD is or how you get it and, at least at first, they tend
not to know whats happening to them
b. Trouble coping
i. If you need to read for work and cant stop the type from moving, then you have a
practical, coping problem, at least until the visual distortions tend to subside, cf., VIII.
Treatments, below.
ii. Feeling like youve been changed into a different person, and thus having trouble
interacting with and connecting with friends, relatives, and co-workers
c. Depression
d. Anxiety, generalized as well as social
e. Feeling irreparably damaged and/or different from others (leads to further social isolation)
i. Can lead (and for me the first time did lead to) serious suicidal ideations
f. Depersonalization and/or derealization can occur, especially in individuals who come to
believe that psychedelics reveal a truer world behind everyday reality
i. These people tend to think that their HPPD-associated visual distortions actually
represent a change to a higher state of consciousness in which they become aware,
even when they are not on substances, of deeper states of the ego or of deeper realities
than those who do not see such distortions
ii. There is some truth to this: HPPD sufferers tend to see floaters more often than they did
before they got HPPD; the perceptual systems that tend to screen floaters out of the visual
image have been altered in the HPPD sufferer in such a way that he can then access real,
suppressed visual information (the real shadow from the real floater cast from the real
light passing through the real vitreous humor)
1. However, such thoughts and beliefs when combined with other psychiatric
problems, especially social isolation, can balloon into depersonalization and
derealization problems.

VIII. Treatments
a. Stop all psychoactive substances (especially psychedelics and MDMA), including marijuana
b. Wear sunglasses
c. Stop looking at the residual visions (indulging) and they will start to fade (mine fade to almost
to nothing)
d. Stop obsessing about being damaged and you will see that you are not damaged and everything
is fine
i. Logic, memory, and verbal games will rebuild your brain and show you that you arent
suffering from permanent cognitive deficits; you just have perceptual changes
e. Drugs that seem to help:
i. benzodiazepines, especially Klonopin (for anxiety as well as reducing visual distortion)
ii. anti-psychotics, especially Lamictal or Seroquel
1. however, Risperdal makes HPPD worse!

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