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Cited by 99Psychedelics and Drug StudiesHallucinations in medical conditionsForensic Toxicology and Drug Analysis

The “Endless Trip” among the NPS Users: Psychopathology and Psychopharmacology in the Hallucinogen-Persisting Perception Disorder. A Systematic Review

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Orsolini, Laura, Papanti, Gabriele Duccio, De Berardis, Domenico, Guirguis, Amira, Corkery, John Martin, Schifano, Fabrizio·2017·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2017.00240PMC PMC5701998
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Abstract

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, cannabis, methylenedioxymethamphetamine (MDMA), psilocybin, mescaline, and psychostimulants. The recent emergence of novel psychoactive substances (NPS) posed a critical concern regarding the new onset of psychiatric symptoms/syndromes, including cases of HPPD. Symptomatology mainly comprises visual disorders (i.e., geometric pseudo-hallucinations, haloes, flashes of colors/lights, motion-perception deficits, afterimages, micropsia, more acute awareness of floaters, etc.), even though depressive symptoms and thought disorders may be comorbidly present. Although HPPD was first described in 1954, it was just established as a fully syndrome in 2000, with the revised fourth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). HPPD neural substrates, risk factors, and aetiopathogenesys still largely remain unknown and under investigation, and many questions about its pharmacological targets remain unanswered too. A critical mini review on psychopathological bases, etiological hypothesis, and psychopharmacological approaches toward HPPD, including the association with some novel substances, are provided here, by means of a literature search on PubMed/Medline, Google Scholar, and Scopus databases without time restrictions, by using a specific set of keywords. Pharmacological and clinical issues are considered, and practical psychopharmacological recommendations and clinical guidelines are suggested.

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  • Orsolini and colleagues offered a nuanced analysis of different pharmacological agents used in clinical practice for HPPD treatment, formulating hypotheses on possible working mechanisms without providing a clear answer as to which compounds may be superior in specific circumstances.

    “In an even earlier study based on 15 publications, Orsolini and colleagues2 offered a nuanced analysis of different pharmacological agents used in clinical practice for HPPD treatment. They formulated hypotheses on possible working mechanisms, without, however, providing a clear answer as to which compounds may be superior in specific circumstances.”

    From Pharmacological Treatment of Hallucinogen Persisting Perception Disorder (HPPD): A Systematic Review (2025) · cites this paper as [2]

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  • Flashbacks and hallucinogen-persisting perception disorder sometimes occurring in LSD users may call for reassessing the notion that visual hallucinations are only due to acute pharmacological activation of serotonin receptors.

    “Finally, the phenomena of “flashbacks” and hallucinogen-persisting perception disorder (HPPD) sometimes occurring in LSD (1) users [21] may call for reassessing the notion that visual hallucinations are only due to acute pharmacological activation of serotonin receptors [22].”

    From Molecular and Functional Imaging Studies of Psychedelic Drug Action in Animals and Humans. (2021) · cites this paper as [21]

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Authors
Orsolini, L., Papanti, G. D., De Berardis, D., Guirguis, A., Corkery, J. M., & Schifano, F.
Affiliations
University of Hertfordshire (GB)
Corresponding author
Orsolini, Laura
ORCID
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2017-11-20
Volume
8
Pages
240-240
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2017.00240
PMC
PMC5701998
OpenAlex
W2771056291
Cited by
99
References
3
Citations by year
2026: 9 · 2025: 6 · 2024: 7 · 2023: 8 · 2022: 14 · 2021: 12 · 2020: 31 · 2019: 5 · 2018: 7
FWCI
1.79
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • University of Hertfordshire Research Archive (University of Hertfordshire) (acceptedVersion, cc-by)
  • University of Hertfordshire Research Archive (University of Hertfordshire) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Università Politecnica delle Marche (Università Politecnica delle Marche) (submittedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Hallucinations in medical conditions
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Forensic Toxicology and Drug Analysis
Keywords
hallucinogen persisting perception disorder, new psychoactive substances, psychopharmacology, psychopathology, etiopathogenesis, afterimages, micropsia, depressive symptoms, thought disorder, risk factors, treatment guidelines

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