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MAPS: HPPD; PHPD; aka flashbacks
Post Hallucinogen Perceptual Disorder is indeed quite rare, and usually
time limited. "Flashbacks," "Post-Hallucinogen Perceptual Disorder,"
(PHPD) and "Hallucinogen Persisting Perceptual Disorder" (HPPD) are
Symptoms usually resolve in months to 1 year; I am greatly suspicious that
many individuals with these complaints have other psychiatric conditions
in various stages of development.
Peak age for a major psychiatric illness to manifest is the late
teens/early 20's, by the way. Many people look to outside explanations for
their psychiatric illnesses (ie: it was the drugs, man!) because of their
fear of being given a diagnosis which has so much social stigma attached
to it. On the other hand, could a persisting perceptual disorder from
hallucinogen use be far more common than reported? Well, those of us on
the front lines would certainly be talking about it more if this were
true. (So, officially, the answer is "no": most doctors do not minimize
our patients complaints, offer no help, and tell patients "I told you
so.") On the plus side, anyone experiencing troubling, persisting
perceptual symptoms can obtain medical treatment: some antidepressants
appear to decrease the symptoms; antipsychotics, of course, will have an
important role for some; and anxiolytic agents can, at least, ameliorate
associated anxiety. For most, again, the problem goes away on its own...if
it doesn't, then obtaining a thorough psychiatric evaluation is important
because there could be other more likely causes for the perceptual
disturbance. Even more obvious is for people to use common sense: if they
are prone to disturbing "flashbacks," it doesn't matter how good "set and
setting" is for them...they should strongly weigh risks and benefits
before exposing their CNS to such agents.
John H. Halpern, M.D.
Instructor in Psychiatry
Harvard Medical School
Alcohol and Drug Abuse Research Center
115 Mill Street
Belmont, MA 02478-9106
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