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Hallucinogen Persisting Perception Disorder (HPPD) Support Forum

tlehmbecker

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Posts posted by tlehmbecker


  1. Hey all,

    I've been on aripiprazole, duloxetine, and gabapentin for about 4 months now with no adverse effects on my HPPD. I know that generally, people get worse on such medications, but for me things are going alright. They haven't caused any symptoms to get worse and are helping with my comorbid disorders somewhat. That said, they aren't making my symptoms better by any means. I'm more or less still at my HPPD baseline.

    For those wondering, I was prescribed the aripiprazole for MDD w/ psychotic features, the duloxetine for MDD, and the gabapentin for anxiety and seizure prevention when I had to cold turkey benzos while in the psych ward. So, for those with similar comorbid disorders, these meds might be worth a shot, but as always YMMV. Hopefully, in the long run, these meds help with the HPPD by nudging my brain chemistry in the right direction, but who knows.

    Peace.


  2. I use a nootropic stack, but it seems very ineffective at this point.

    Anyway, my stack:

    MORNING

    10mg Abilify

    300mg gabapentin

    100mg 50% alpha-GPC

    200mg CDP choline

    800mg piracetam 

    750mg oxiracetam

    100mg caffeine

    200mg L-theanine

    Nicotine from 1-2 cigarettes

    AFTERNOON/EARLY EVENING

    300mg gabapentin

    100mg 50% alpha-GPC

    200mg CDP choline

    800mg piracetam

    EVENING

    300mg gabapentin

    50mg hydroxyzine pamoate

    Another cigarette

    Sleep

     

    And that's it.


  3. So, after a hospitalization for a suicide attempt I've been put on 10mg Abilify (aripiprazole) and have been taking it daily.

    Haven't noticed my symptoms getting worse. Perhaps slightly, but nothing unbearable at this point. 

    Additionally I have tried 1:1 THC:CBD weed with no worsening of symptoms. This suggests to me at least that the mechanism behind my HPPD is entirely different than the common hypotheses.


  4. So, for the past week or so I've been smoking a strain that's nearly all CBD and (almost) no THC (I think it's about 13% CBD and maybe 1% THC). I smoke it in joint form, usually shortly before bed.

    I haven't noticed anything getting better or worse. However, it has done wonders for my insomnia and helps me feel relaxed before I hit the sack. Excellent stress relief.

    I have a strain that's nearly 1:1 THC to CBD to try still, so I have no idea how the THC will play into things. Planning on doing that this weekend since this will give me ample recovery time should I have a bad time (I don't expect to though).

    Also, the joints I roll tend to be pretty light, about the size of a hand-rolled cigarette.

    Also, as a sidenote, I have asthma and the smoke hasn't aggravated it all, usually only if I take a hit that was a little too much. Even then, a few hearty coughs and sips of water later and I'm fine


  5. Well, my journey with HPPD (and mental illness in general) has come a long way in the two years since I started having issues, and it hasn't really improved.

    It feels like I've plateaued in terms of my illnesses. For awhile it was really bad and getting worse, but everything has tapered off some and I'm just kind of stuck at the same level, not really improving nor worsening (though I do feel like I'm getting worse). Through everything my HPPD hasn't improved and if anything, has actually gotten worse. I've learned to live with it somewhat, but it still causes me a lot of distress. I really just want something to actually help. Everything I've tried has failed in one way or another. Even if that something only reduces my symptoms by 10 or maybe 20% I'd be happy. Anything that makes me feel normal, like how I felt prior to 2015, is a plus and so far I've found nothing.

    Sure, the clonazepam has helped tremendously with my anxiety, but I've traded one problem for another, namely dependence and tolerance. While I've managed to halve my daily dosage, I'm still dosing daily and I don't want to. Not only that, but the clonazepam is losing it's effectiveness. Before it used to kill all my anxiety, now it just sort attenuates the lingering, daily anxiety and does nothing for circumstantial anxiety unless I pop another tab on the spot (I had two panic attacks on Saturday, both simply because my phone rang and it took me several hours and an extra clonazepam just to get back to baseline). 

    I'm also getting more and more depressed, and the suicidal thoughts are starting to creep back in. Most days it's a chore getting out of bed to go to class and work. Most days I just want to stay at home in my bed sleeping or browsing the internet. I've lost my motivation and joy. This might just be seasonal though as in the summer and fall I was hardly depressed.

    I don't know, maybe it's the stress and pressure of my new job, or some deep seated anxiety about what happens after I get my degree, but I just feel stuck and quite frankly helpless.

    Sorry if this wasn't informative or thought provoking, or anything really. I just wanted to vent since I really don't have anyone to talk to, no friends, no therapists (not to mention I think therapy is a crock of shit), no family, no one that I can turn to and just say, "Hey, is it all right if we just talk for a minute? I really need to get some stuff off my mind." I mean, being lonely and not having anyone really gets to you, and your emotions just sort of bottle themselves up and fester. I've got a lot of things pent up inside, but no release and it's just really getting to me as of late. 

    Thanks guys. 

    • Upvote 1

  6. Thanks for the concern. Anyways, I dropped all nootropics sans Lion's Mane and l-theanine. Don't worry, I had only been using them off and on for a few days. With that said, visuals seem to have mostly returned to baseline. So one or more of the racetams were causing a worsening in symptoms. 

     

    Regarding the clonazepam, I've been doing a daily micro-taper for the past two and a half months, so I can't really just stop. I mean, I can, but then I would have to taper again and daily micro-tapering is a tedious and arduous thing (I have to get up 2 hours before I normally do just to prepare solutions). Also, since I've stopped using racetams there shouldn't be any problems in continuing with a micro-taper. 


  7. So, I started trying out nootropics to get some of my cognitive spark back. My stack *was* as follows

     

    • 750mg oxiracetam
    • 750mg aniracetam
    • 400mg alpha-GPC (in 50% form, so 800mg of powder)
    • 200mg l-theanine in split doses

    But I'm altering it. I believe the aniracetam is making my HPPD worse, my ghosting/double-images in particular. The reason I think this is that aniracetam has an affect on serotonin and dopamine. I can't remember if it's an agonist or antagonist. Since HPPD is apparently linked to serotonin and dopamine to some extent, I would think messing with either would be bad. Then again, it could be anything in my stack. Anyways, I'm dropping aniracetam and seeing where that gets me. I will be adding the following

    • 1g Lion's Mane extract
    • 15mg Noopept (maybe)
    • 300mg pramiracetam (maybe)

    So, I'll see where that gets me. In addition to this I'm also tapering off clonazepam from 2mg/day (I'm down to 1.21mg/day as of today), I'm working my way up to 16mg/day of tiagabine, and I'm holding at 100mg/day lamotrigine. 

     

    So, I don't know, what's your guys' experience with nootropics? I'm mainly interested in if any made HPPD symptoms worse.


  8. So, bit of an update. About 3 weeks into starting this medication. I'm at the full 8mg/day. No noticeable effect on any HPPD symptoms. However, that being said, 8mg/day is a paltry dose compared to the average dose which is 32mg/day or more. I discussed this with my psychiatrist today and he suggested to up my dose to 16mg/day in split doses, 8mg in the morning and 8mg at night since I'm tolerating it well and I don't feel drowsy when taking it. However, it has improved my quality of sleep quite a bit. I may not be getting more sleep or falling asleep easier, but I am certainly getting much more quality sleep (REM/'deep sleep') which leaves me not feeling so groggy and out of it if I only get say 4 hours of sleep (I average 5-6 hours a night during the week and anywhere from 8-12 hours on the weekends since I don't have to get up so damn early). But overall, with regards to HPPD and mental well being, nothing has really changed.

     

    School is starting up soon (tomorrow in fact) and as such I'm going to be trialing some nootropics to aid with studying. Part of my stack is going to be Alpha GPC and Lion's Mane, so those might help with HPPD. I am also going to try thiamine cocarboxylase. And on an unrelated note, I had my psychiatrist write a letter to my university's disability support services so I can take tests in a quiet room and take as long as I want. Tests have always been tough for me because more often than not I know the answer and the process of arriving at an answer, but the way my brain works doesn't allow me to give complete answers in the time allotted. I mean, I can get the answer it just takes me a little longer than average to get it so I need more time to formulate my answers. Not to mention, but the rushed nature of tests at the university level (you usually only have an hour), my anxiety shoots through the roof and I'll just get stuck, sitting there starting at my test wondering what the fuck I'm gonna do and how the hell I'm going to come up with answers in such a short amount of time.


  9. So, I'm starting a trial of tiagabine for potential treatment of HPPD symptoms. I'll give a quick rundown and then I guess use this thread as sort of a log.

     

    Tiagabine is, for those that don't know, an anticonvulsant typically used as an adjunctive treatment for seizures. However, it has been used off-label in the treatment of panic disorder and generalized anxiety disorder. Tiagabine works as a selective GABA reuptake inhibitor, specifically it works by blocking the action of GAT-1. In turn this increases the overall level of GABA in the brain. Since GABA is an inhibitory neurotransmitter, it would make sense that increasing the levels of it would increase the inhibition of interneuron transmission which in turn would reduce a number of things, the most notable of which is seizures. However, because of the effectiveness GABA receptor modulators such as benzodiazepines in treating anxiety disorders, increasing GABA levels would suggest it would be effective at treating anxiety disorders as well.

     

    This is where it starts for me. First my psychiatrist considered the effectiveness of clonazepam in treating HPPD (or at least some of the symptoms of HPPD) with which I believe most of you are familiar. Unfortunately, this wasn't necessarily the case for me. Clonazepam had no effect on visual symptoms but it did have a marked effect on my comorbid panic disorder and the DP/DR associated with HPPD. So next he looked at the inhibitory nature of GABA and hypothesized that increasing overall GABA levels would be beneficial since it seems the main hypothesis is that HPPD is simply neuron disinhibition. So that's what led him to suggesting that I at least give it a try.

     

    So far I've run the gamut in terms of medications, SSRIs, NDRIs, antipsychotics, lamotrigine, and clonazepam. I decided to go ahead with it because why not? According to everything I've read it is relatively benign. At the very worst it does nothing, and at the very best it works wonders for HPPD. Somewhere in the middle it simply helps with my panic disorder. Should it not work, we'll just move on and try carbamazepine, and then the other treatments like clonidine, tolcapone w/ levodopa, and naltrexone. 

     

    I'm only 3 days into this new medication so I don't have anything to report. My psychiatrist says that in his experience and in the literature that the effects of tiagabine should come on fairly quickly, within a few days to a couple of weeks. My dosing target is 8mg/day taken at bedtime and my taper schedule is 2mg for 4 days, 4mg for 4 days, 6mg for 4 days and then finally the full 8mg/day. The only negative side effects I have to report at the moment is a headache (though I'm not sure if this is actually a headache or just a manifestation of dizziness, I'm inclined to think dizziness because it is the number one reported side effect) and some abdominal discomfort (also slightly expected). I'll keep posting in this thread with updates, probably on a weekly basis.

    • Upvote 1

  10. I know. They've done studies, mostly in older folks and found that long term use of anticholinergics like DPH definitely have an effect on the brain. Most notably long term use leads to a highly increased risk of Alzheimer's and if you're young like me, both an increased risk of Alzheimer's and earlier onset of Alzheimer's. Not to mention chronic central anticholinergic syndrome.

     

    At least it was just DPH though and not something like MDMA. Hoo lord, if I did MDMA every night, hell even just like 3 times a week, for even just a few months I would be in a much worse position than I am now.


  11. So, awhile ago I began investigating the role acetylcholine might play in HPPD. This was mainly driven by the fact that my case of HPPD was likely caused by diphenhydramine, an antihistamine with potent anticholinergic properties (i.e. it "blocks" the action of acetylcholine). Other driving factors were the fact that many people seem to at least have a temporary worsening of HPPD symptoms when using anticholinergic/antihistamine/antimuscarinic medicines and also to the eerie similarities between central anticholinergic syndrome/anticholinergic toxicity symptoms and HPPD symptoms.

     

    I decided to run a little experiment. I went back to my roots of taking diphenhydramine in a somewhat recreational manner. I was having issues with some nausea of unknown origin (though I likely suspect it has to do with caffeine because at the time I was pounding 2-3 energy drinks back-to-back in the morning, diphenhydramine has antiemetic effects) and insomnia (also probably due to caffeine and also potentially due to my tapering off of clonazepam). I decided to keep the doses relatively small, no more than 50mg at a time and no more than 100mg per day. My condition at the time and also as of present left me quite sensitive to the "recreational" effects of diphenhydramine so a 50mg dose was pretty much enough for me to feel the full effects I used to crave.

     

    I kept my dosing to only when I more or less needed it, when I felt nauseous and at night approximately 1 hour before bedtime. I did not notice an immediate worsening. However, as the "experiment" progressed over these past few weeks, I noticed my symptoms started to get worse. In particular my double-vision/ghosting and trailing, my two major symptoms. These symptoms have remained at this worsened level since the end of the experiment (last week). 

     

    Of course, some might attribute this to the caffeine since so many people have trouble with it. Caffeine for me is not an issue except for mild, temporary worsening of symptoms at high doses and the worsening fades when the caffeine more or less leaves my system.

     

    Getting back to acetylcholine. Acetylcholine acts as a neuromodulator and messing with its function is known to cause neurological/psychological problems. It would make sense that HPPD could be caused by messing with acetylcholine. I mean we think HPPD is a sort of sensory disinhibition and acetycholine is a neuromodulator thus if acetycholine levels are decreased significantly it would make sense for sensory disinhibition to occur.


  12. Xanax aka alprazolam is safe to take with HPPD.

     

    However, alprazolam just like all other benzodiazepines is highly addicting when not used in a controlled manner. With alprazolam it is especially easy to get carried away with it and end up with one of the nastiest addictions to quit, probably second only to alcohol (benzodiazepine withdrawal is hell. Not only could it potentially kill you, but the effects could last years if you don't come off it properly, and coming off of it properly takes months to years for some people and even then they still could exhibit withdrawal symptoms).

     

    Even when you do use it in a controlled manner, if you use it for more than a month (in general), you'll probably end up psychologically and physically dependent on it. You won't be addicted to it in the sense that you'll have to keep taking more and more to get your fix, but your body and brain will simply not allow you to stop taking it without consequences.

     

    Ergo, tread very carefully when dealing with benzos.


  13. Mainly because I don't have another appointment with him for another 2 weeks and I can't necessarily talk to him over the phone (he's booked from 8-5 on most days). I know his suggestion would be a quick taper since I've only been on it a few weeks (counting the taper week). I've stopped cold turkey on meds before, but those were of course different meds.

     

    Anyways, I stopped cold turkey (I know, I know, you should never cold turkey any med) and haven't noticed anything adverse. I still have the pills on hand should things start to go south. I'm gonna give it a week, if nothing happens then fine. If something does happen I still have the pills so I'll be fine. 

     

    I will talk to my doctor about it though.

     

    Also, it's worth noting that my condition isn't that severe. I've managed my symptoms without meds for over a year, I just decided to try this because of it's potential benefits for HPPD and my other symptoms.


  14. So, 2 weeks on haloperidol now. Stopped the benzotropine because I was only supposed to take it the first 14 or so days to keep dystonia in check (still have to keep some around in case dystonia pops up). Quick summary I suppose:

    • No affect on HPPD symptoms yet, positive or negative in nature.
    • Knocks me out and makes me feel like a zombie all day. Oddly enough, it causes some insomnia as I've been waking consistently in the middle of the night and having a hard time falling back asleep.
    • No affect on cognitive function
    • Makes my eyes blurry and dry feeling when I wake up. Usually dissipates within an hour.
    • Blurred vision somewhat, though this was expected since it is a side effect. No way I'd pass an eye exam now (maybe I should get one done, never have and I do remember having some vision problems when I was a kid).
    • "Voices" in my head and "wandering" mind significantly reduced.
    • Makes me feel spaced out sometimes.

    Other than that, nothing special to note. From my perspective it's a fairly benign medication. The zombie-ness is probably from its antagonistic action at the D2 and D4 sites. Since it has no action at the 5-HT2A sites, I don't expect it to increase HPPD symptoms.


  15. told ya..opioids/opiates are great against hppd and anxiety for most people.

    no need man...ill be the guinea pig

    Nothing I said indicated it helped with anxiety or HPPD. I simply said it didn't affect HPPD and increased DP/DR (which may not even be linked to the opioid in question) which consequently led to an increase in anxiety, contrary to what you claimed.

     

    You need to stop making blanket statements as well and contradicting yourself (not too long ago in a thread of mine you said fuck meds yet opiates/opioids are meds).. What works for you will not always work for someone else.

     

    I also 2nd Jay in that I think you're just looking for an excuse to get high considering how hard you're pushing opioids and opiates (opioids are entirely synthetic, opiates are either natural or derived from other naturally occurring opiates like morphine or thebaine).


  16. Maybe I'm a little late to the party, but in my experience opioids don't affect HPPD, visually at least, but did increase DP/DR. Can't be definitive though as the only form I've had came in the form of a hydrocodone/chlorphenamine syrup, so it may have just been the chlorphenamine and not the hydrocodone. I have some tramadol lying around, but I'm not going to use it unless I really need to so no guinea pigging for me.


  17. So, 4 days now on haloperidol and benzotropine.

     

    So far no effects positive or negative. The haloperidol did give me some mild dystonia the first couple days (might not have even been dystonia because over the weekend I rucked quite a distance with a good amount of weight). Only other effect it has is some heavy sedation that lasts all day (probably because haloperidol has a half life between 14 and 27 hours and it absolutely zaps your dopamine).

     

    For dosage, I'm finishing up 1.25mg haloperidol and will now be going up to 2.5mg haloperidol (taper up by 50% every 4 days until the target dose of 5mg is reached, though I may go to 10mg).

     

    I'll post an update in a week or so when I should be at 5mg haloperidol daily.


  18. So, as the days are starting to heat up, it's becoming increasingly difficult to wear long sleeve shirts. 'Why are you wearing long sleeve shirts?' you might ask. Well...

     

    Not too long ago I started self harming. Initially it was easy to "hide" it as I just wrapped my arm in an elastic bandage that held gauze/non-stick pads on the wounds and simply told people I got a burn from messing with fireworks, messing around in the kitchen, etc.

     

    The elastic bandages soon became to cumbersome and too much trouble to go through just to hide some scars (by the now the wounds had healed). Thankfully, the colder months were coming which meant I had a perfectly valid excuse for either wearing a sweatshirt all day or long sleeved shirts.

     

    Well, that time has passed on we're into the spring season and are quickly headed to the hot, dry summer months. As of right now, only a few people know about the scars, family, a few friends, and my doctor of course. So far they've been cool about it, not asking or mentioning them which is good.

     

    The problem is is that I'm not sure if I want to necessarily show them to the public just yet, my employer especially. I'm most worried about my employer since my boss has a very alpha-male personality and I work in a police station. So if I come in with scars up and down my arm, there's bound to be questions and they may even try to get me 'help' (I've already been to a psychiatric hospital and while it was not a bad experience, I just don't want to go back voluntarily or involuntarily because it is very much like a medical jail/prison even though you committed no crime) despite me already getting help.

     

    I'm also worried about what other students (I'm currently a senior at college) are going to say/ask.

     

    2nd thing, I'm also bi and that's something I want to get off my chest. I know that shouldn't be a problem as it's widely accepted now, but I'm just worried about what my parents will think, my mother especially (she's very religious).

     

    Any advice would be much appreciated!


  19.  

    Are you talking about the study that the Army did? Sounds like could work for you

     

    " 8 military prisoners were sucessfully treated with haloperidol. The case description suggest that several subjects suffering from an underlying chronic psychotic disorder "

    http://www.esciencecentral.org/journals/hallucinogen-persisting-perception-disorder-hppd-and-flashback-are-they-identical-jaldd.1000121.pdf

     

    I've been trying to find the article but everything has been a dead end <_<

     

    That is the study that I'm referencing. I can't remember if it was Halpern or Lerner that has some unpublished data about treating HPPD with certain antipsychotics, and they also mention haloperidol as well.

     

    i cant imagine how this could work for someone...meds never helped me and i think its impossible to be cured...and if i cant get cured its not the right solution to my mind...i also hesitate to agree that someone who claims he got over it is cured when he cant take drugs anymore...this is not a cure because this person is still not back to normal..i think being able to consume something is a proof that you dont have hppd/dp/dr or dont have it anymore...

     

    Just because meds didn't work for you doesn't mean meds won't work for me or anyone else. Regarding drug use, most who have HPPD and get over it tend to abstain from drugs because they realize that drugs can fuck you up in more than one way. Personally, I don't think who has had HPPD and gotten over it should ever do drugs again. I see it as too risky. They already had it once so they're likely to get it again if they start using again. If their brain was susceptible enough in the beginning to get HPPD then it's always susceptible, that won't ever go away. We're not trying to cure HPPD here, just treat it, alleviate the symptoms. If we were going to cure it we would attack the symptoms and the causative factor, but we can't with HPPD. Same thing goes with cancer, you're never cured of cancer. Sure, all the symptoms might be gone, but you can still develop cancer. Curing it would imply that we get rid of the cancer and then make it so ou can't cancer again.


  20. Does your doctor understand that HPPD isn't a psychotic disorder? Or are you experiencing psychosis on top of the HPPD?

    "It is important to note that in contrast to classical psychotic disorders, patients with HPPD recognize the unreal nature of their visual disturbances which qualifies them as pseudohallucinations."

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3736944/

    Yes, he does. I do have an underlying chronic yet mild psychotic disorder (schizoaffective disorder). Also, haloperidol is a potential treatment for HPPD, though that information is rather dated, no one has done any definitive study on it since. That's why we're trying haloperidol. He also knows that atypical antipsychotics like risperidone worsen HPPD symptoms, so we're avoiding those and anything else that messes with serotonin in a dramatic way (most antidepressants) as treatments for my other disorders (major depressive disorder and panic disorder in addition to the schizoaffective disorder).

     

    Being that haloperidol basically has no effect on the 5-HT2A receptors (it acts as a silent antagonist, so it binds there somewhat, but has no intrinsic activity at the site), it is most likely the least dangerous antipsychotic in terms of worsening HPPD (mainly because most serotonergic drugs cause a dramatic worsening of symptoms, and atypical antipsychotics bind to5-HT2A receptors like super glue acting as complete/partial antagonists and inverse agonists).


  21. Well, I'll finally be starting haloperidol (and benzotropine to prevent EPS).

     

    I tried the benzotrpoine by itself last night, no effect on HPPD at all. Classic effects of a high potency anticholinergic were present though. When I woke up my vision was blurry (not in an HPPD way, like being drunk or waking up after being knocked out) and pupils moderately dilated which dissipated over the course of an hour. Still no effects on HPPD.

     

    I'll be starting the haloperidol tonight. I've been looking at the binding profile of haloperidol (from various sources of course) and it appears as if haloperidol is really only a dopamine antagonist. It has relatively negligible binding affinity for other receptors, 5-HT2A being one of them. The only receptors that I saw that it had significant effects on were D4 and D2.

     

    What I'm getting at is that haloperidol may be worth a shot after all since it doesn't have much of an effect on serotonin which is believed to be the major driving force of HPPD. So, I'm going to give it a shot.


  22. Dude, I really don't think shooting up H or popping a few tramadol/vicodin/dilaudid/etc. is a good idea for alleviating panic and anxiety. That's just going to create more problems in the long run (if you get addicted which is very likely). I mean seriously, that's how addictions start. Someone starts to feel bad about something and then they start taking stuff that makes them feel better, perhaps even makes them feel fucking great. They keep doing this over and over again to make the metaphorical (and perhaps physical) pain go away until they start realizing that they need it rather than just want it because when they go without it they start to feel like shit again. Interestingly, it isn't the drugs that necessarily cause addiction (though they do aid in that area with the building of tolerance and whatnot); what causes addiction is when people who are more or less feeling down start to take these types of drugs to not feel so down, and they often do so in relative isolation. We don't see college age kids becoming alcoholics because their drinking is social, they drink when they're already having fun and are around people. People in the hospital who are on painkillers don't always get addicted to them because they're taking them in a non-recreational manner, under close supervision, and with a support base.

     

    The people who become addicts are people suffering from sort of psychological pain who have little to no support and see taking these drugs as the only way they can get rid of this pain. Of course, that isn't always the case, but that's what happens a lot. Trust me, I grew up in a family of addicts and they were all addicts because at one point or another they went through a bad spot and started self medicating as a result.

     

    I'm not going to stop you though. Your choice. 

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