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The “Endless Trip”: Psychopathology and psychopharmacology in the Hallucinogen Persisting Perception Disorder (HPPD)

Published online by Cambridge University Press:  23 March 2020

L. Orsolini ,
A. Valchera ,
D. Papanti ,
R. Vecchiotti  and
D. De Berardis
L. Orsolini*
Affiliation:
Villa San Giuseppe Hospital- Hermanas Hospitalarias, Department of Psychiatry, Ascoli Piceno, Italy
A. Valchera
Affiliation:
Villa San Giuseppe Hospital, Department of Psychiatry, Ascoli Piceno, Italy
D. Papanti
Affiliation:
University of Hertfordshire, Department of Pharmacy, Hatfield, United Kingdom
R. Vecchiotti
Affiliation:
Villa San Giuseppe Hospital- Hermanas Hospitalarias, Department of Psychiatry, Ascoli Piceno, Italy
D. De Berardis
Affiliation:
Hospital “G. Mazzini” – ASL 4, NHS – Department of Mental Health – Psychiatric Service of Diagnosis and Treatment, Teramo, Italy
*
* Corresponding author.

Abstract

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Introduction

Hallucinogen Persisting Perception Disorder (HPPD) is a syndrome characterized by prolonged or reoccurring perceptual symptoms, reminiscent of acute hallucinogen effects. HPPD was associated with a broader range of LSD (lysergic acid diethylamide)-like substances, including cannabis, MDMA (methylenedioxymethamphetamine), psilocybin, mescaline and other psychostimulants. Symptomatology mainly comprises visual disorders (i.e., geometric pseudo-hallucinations, halos, flashes of colours/lights, motion-perception deficits, afterimages, micropsy, more acute awareness of floaters, etc.), even though depressive symptoms and thought disorders may be comorbidly present.

Objective

Although HPPD was firstly described in 1954, it was definitely established as a syndrome in 2000 with the revised forth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). However, neuronal substrate, risk factors, aetiology and pathogenesis of HPPD remains still unknown and under investigation. Furthermore, there are still open questions about its pharmacological targets.

Aims

A critical review on psychopathological bases, etiological hypothesis and psychopharmacological approaches towards HPPD was here provided.

Methods

A systematic literature search on PubMed/Medline, GoogleScholar and Scopus databases without time restrictions, by using a specific set of keywords was here carried out. In addition, a case report was here described.

Results and conclusions

Pharmacological and clinical issues are here considered and practical psychopharmacological recommendations and clinical guidelines here suggested.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
EV75
Information
European Psychiatry , Volume 33 , Issue S1: Abstracts of the 24th European Congress of Psychiatry , March 2016 , pp. S310
Copyright
Copyright © European Psychiatric Association 2016
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