Hallucinogen persisting perception disorder (A guide)

In this guide, we are going to understand the symptoms, causes, and different treatments for HPPD disorder in a particular way.

This disorder represents itself in visual phenomena that appear due to drug misuse.f.Hallucinogen-persisting perception disorder (HPPD) is a disorder that might make itself visible in by prolonged or recurrent consistent symptoms, comparable with acute hallucinogen effects. 

Hallucinogen persisting perception disorder (HPPD) is the only conceded long-term complication of hallucinogen use.

The word, “flashbacks,” is also a second definition for (HPDD) According to the present DSM-IV guidelines, HPPD is the return of physiological and psychological symptoms from the first drug experience without the use of the triggering drug.


A person experiencing anonymous hallucinations should immediately see a doctor.

Almost all such symptoms are alarming.It is also of much importance, especially if he experiences these episodes frequently.

In case a person has used hallucinogenic drugs, his doctor should be informed about this.

A doctor is much concerned with helping him address and fight this sickness. He doesn’t have to judge his previous or recent drug use.

Diagnosing HPPD may be an easy thing for a doctor who is familiar with the condition and past drug use.

He will try to know his personal health history, as well as a detailed account of what he has experienced.

If the doctor suspects another possible cause, such as the side effects of a medication, he may advise taking some blood tests or imaging tests.

These tests will be beneficial to ignore the other irrelevant causes of his symptoms.

If additional tests come back negative, an HPPD diagnosis is likely.

It is essential to build a trust relationship between a patient and a doctor.

The patient should be honest enough to share each detail regarding his condition.

He should inform his doctor about medical history in a particular way.

These factors will help your doctor reach a diagnosis and help you avoid possible complications from drug interactions.

Types of HPPD

There are two types of HPPD.

We divide them according to the kinds of hallucinations the person experiences.

In Type 1, The patient experiences short-termed, random flashbacks.

In Type 2, the condition of the patient becomes more disturbing and persistent, and he can experience consistent changes in vision 

Unlike the obsessive flashbacks that some people have after taking drugs, HPPD flashbacks are purely visual.

It means that a person with HPPD goes through the visual disturbances, such as seeing blurry patterns, size distortion, and bright circles.

These individuals do not conceive any other aspects of the feeling of being on drugs.

HPPD flashbacks are not usually satisfying. These flashbacks might become irritating with frequent episodes.

It results in anxiety eventually. The patients suffering from HPPD do not experience full hallucinations or delusions.

Mostly they are aware of this condition of visual disturbance and can determine what is real.

The patient suffering from visual disturbances in HPPD may experience the following things:

  • He can see the halos or auras around objects.
  • He might claim to see the trails that follow moving objects — it is evident that when an object moves, a path might appear behind it.
  • He can experience some particular changes in color perception — sometimes, colors can be hard to differentiate or may appear to him as a completely different color.
  • He might feel an object seems to be moving when it is still.
  • He can see a pattern on an object that others cannot see — these are often geometric, like a checkerboard, for instance.
  • He might feel the air textured — this is sometimes called visual snow.
  • He could also see the dimensions of an object in a distorted shape — for instance, and an object may seem to change the way or, similarly, objects in peripheral vision might appear larger or smaller than they are.

All these symptoms are stressful for HPPD patients.

It is also usual for the patient not to see things in the way they used to.

It can be unnerving and may cause anxiety.


In some cases, the symptoms appear immediately after a drug experience.

While in other cases, the symptoms arise after some days.

In some rare cases, people reported that their symptoms occurred after many weeks or months after the drug use.

But it’s harder to blame the drug as the sole cause.

Some patients only encounter HPPD after persistent drug use, along with psychedelics and other substances.

But this resulted even after minimal drug use.

Causes of HPPD

The use of Hallucinogen is the primary cause of HPPD. The most common cause of the disorder is LSD abuse.

Although it has apparent similarities with LSD, yet psilocybin has only caused one documented case of HPPD in 2012.

Psilocybin is the psychoactive drug found in magic mushrooms.

Observations show that the person who developed psilocybin-related HPPD might have combined THC with the drug.

This drug holds some hallucinogenic qualities.

THC and heavy alcohol use activate HPPD in some people who have a history of hallucinogen use.

We found rare cases reported that the drugs other than LSD cause HPPD.

But the following drugs have reportedly caused the condition:

  • Ketamine
  • Ecstasy (MDMA)
  • Mescaline (Peyote)
  • Dextromethorphan
  • THC
  • phenylcyclohexyl piperidine

There is no proof that heavy Hallucinogen has any association with an increased risk of HPPD.

A study on around 500 members of the Native American Church who had taken peyote at least 100 times revealed zero incidences of HPPD.

Moreover, THC is the most commonly used drug in the United States, but reports of HPPD among THC users are uncommon.

The experts researching on this do not know the biological cause of HPPD.

They believe hallucinogens may inhibit systems in the brain that always filter signals that affect our perception.

The minds of people with HPPD may be unable to filter unnecessary messages, causing visual distortions.


  1. Flashbacks defined as short-termed are fits of hallucinogen-like activity that often occur without distress. They tend to arise rarely, and the frequency fades over time. The duration of these flashbacks may only last for a few seconds or minutes. Some people take it as an enjoyment, viewing them as a “free trip” or a moment of nostalgic psychedelia.
  1. The individuals going through this form of HPPD experience it occasionally. They might experience no or only minor persistent symptoms, such as visual snow. Brevity and intermittency are their specific conditions. Distress is also diagnosed with it and as a part of the potential impairment.
  1. Visual phenomena are always present. Although it may sometimes be more or less in intensity. Generally, episodic nature may also exist, with the effects increasing gradually in response to specific triggers.

Treatments for Hallucinogen Persisting Perception Disorder

The primary therapy for HPPD is medications.

We can not say with certainty that prescription drugs don’t cure the disease, but they may help alleviate some symptoms.

There are no comprehensive studies available on medications, but researchers have analyzed conventional treatments used in case reports or small studies.

The most effective treatment is Benzodiazepines, such as Xanax (alprazolam) or Klonopin (clonazepam).

The less powerful, such as Ativan (lorazepam), aren’t as beneficial.

However, benzos have high prospects for abuse.

Some other medications may be more appropriate for people with addiction history.

The significant medications that have had mixed success in case reports of people treated for HPPD include:

  • Clonidine
  • Selective serotonin reuptake inhibitors (SSRIs)
  • Naltrexone
  • Calcium channel blockers
  • Beta-blockers

These medications may not be sufficient in every case.

Sometimes, they have caused worsening symptoms.

The medication treatment varies from one patient to another.

Behavioural or talk therapy may help individuals to deal with the complications of HPPD, such as co-occurring anxiety or depression.

This therapy helps individuals to overcome impairment.

However, it’s unlikely to relieve symptoms of HPPD directly.

HPPD is an exhausting disease that isn’t fully understood. It is a rare side effect of hallucinogen use.

The most effective treatment for HPPD remains still unknown. But medications and therapy have helped some people cope with symptoms.

How to cope with HPPD?

Mostly, the visual episodes of HPPD can be unpredictable.

When they do happen, you may want to prepare yourself with techniques for handling the symptoms.

For example, if these episodes cause you high anxiety, you may need to rest and use calming breathing techniques.

Too much worrying about an HPPD episode could make you more likely to experience one.

Fatigue and stress may also stimulate an event. An excellent coping option is talk therapy.

A therapist or psychologist can help you learn to respond to stressors when they occur.


HPPD is not a common disorder. It is not so that everyone who uses hallucinogens will develop HPPD.

There are some cases studies to show that some people experience these visual disturbances only once after using hallucinogenic drugs.

For others, the disruptions may occur frequently but not be very bothersome.

There is a little research present to explain why it occurs and how it’s best treated.

So to better handle this disorder, work with your doctor to find a treatment technique or coping mechanisms that help you manage the disturbances and feel in control when they do occur.

Self Help

Following books on HPPD can be very helpful in better understsnding HPPD and also making positive changes in ypur personality. 

1 HPPD: My Experience: Hallucinogen Persisting Perception Disorder Kindle Edition

by David Graciano (Author)

2 Abnormal psychology in Context: Voices and Perspectives 1st Edition

by David Sattler (Author), Virginia Shabatay (Author), Geoffrey Kramer (Author)

3 Hallucinogens: Drugs (Compact Research: Drugs) Library Binding – September 1, 2007

by Crystal McCage 

4 The Tools: Transform Your Problems into Courage, Confidence, and Creativity Hardcover – May 29, 2012

By Phil Stutz and Barry Michels

5. The 12 Rules for Life: An Antidote to Chaos Audible Audiobook – Unabridged

Jordan B. Peterson (Author, Narrator)



Was this helpful?

Thanks for your feedback!