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A Review of Hallucinogen Persisting Perception Disorder (HPPD) and an Exploratory Study of Subjects Claiming Symptoms of HPPD

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Image Behavioral Neurobiology of Psychedelic Drugs

Part of the book series: Current Topics in Behavioral Neurosciences ((CTBN,volume 36))

Abstract

Hallucinogen persisting perception disorder (HPPD) is rarely encountered in clinical settings. It is described as a re-experiencing of some perceptual distortions induced while intoxicated and suggested to subsequently cause functional impairment or anxiety. Two forms exist: Type 1, which are brief “flashbacks,” and Type 2 claimed to be chronic, waxing, and waning over months to years. A review of HPPD is presented. In addition, data from a comprehensive survey of 20 subjects reporting Type-2 HPPD-like symptoms are presented and evaluated. Dissociative Symptoms are consistently associated with HPPD. Results of the survey suggest that HPPD is in most cases due to a subtle over-activation of predominantly neural visual pathways that worsens anxiety after ingestion of arousal-altering drugs, including non-hallucinogenic substances. Individual or family histories of anxiety and pre-drug use complaints of tinnitus, eye floaters, and concentration problems may predict vulnerability for HPPD. Future research should take a broader outlook as many perceptual symptoms reported were not first experienced while intoxicated and are partially associated with pre-existing psychiatric comorbidity.

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Acknowledgments

The authors thank Vicka Corey, Ph.D. for numerous helpful comments and suggestions to an earlier draft of the manuscript.

Conflict of interest:

The authors declare that there is no conflict of interest.

Funding:

Supported in part by an unrestricted grant by the HPPD Foundation (www.hppdfoundation.org).

Author information

Authors and Affiliations

  1. Laboratory for Integrative Psychiatry, Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Oaks Building, Belmont, MA, 02478-1064, USA

    John H. Halpern & Torsten Passie

  2. Department of Psychiatry, Harvard Medical School, Boston, MA, USA

    John H. Halpern & Torsten Passie

  3. Lev Hasharon Mental Health Center, Pardesya, Israel

    Arturo G. Lerner

  4. Sackler Medical School, Tel Aviv University, Tel Aviv, Israel

    Arturo G. Lerner

  5. Senckenberg Institute for History and Ethics in Medicine, Goethe-University Frankfurt/Main, Frankfurt, Germany

    Torsten Passie

Authors
  1. John H. Halpern
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  2. Arturo G. Lerner
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  3. Torsten Passie
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Corresponding author

Correspondence to John H. Halpern.

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Editors and Affiliations

  1. Department of Psychiatry, University of California San Diego, La Jolla, CA, USA

    Adam L. Halberstadt

  2. Psychiatric University Hospital, Heffter Research Center Zurich, University of Zurich, Zurich, Switzerland

    Franz X. Vollenweider

  3. Division of Chemical Biology and Medicinal Chemistry, University of North Carolina, Chapel Hill, NC, USA

    David E. Nichols

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Halpern, J.H., Lerner, A.G., Passie, T. (2016). A Review of Hallucinogen Persisting Perception Disorder (HPPD) and an Exploratory Study of Subjects Claiming Symptoms of HPPD. In: Halberstadt, A.L., Vollenweider, F.X., Nichols, D.E. (eds) Behavioral Neurobiology of Psychedelic Drugs. Current Topics in Behavioral Neurosciences, vol 36. Springer, Berlin, Heidelberg. https://doi.org/10.1007/7854_2016_457

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