tlehmbecker

I don't see why they wouldn't prescribe you those meds. They're not controlled and they certainly don't have any potential for addiction/abuse. I would understand them being hesitant to prescribe something that's controlled (like benzos, my psych was hesitant with this, and I didn't even want to be put on it honestly). I'm on lamotrigine, but 5 or so months in (about 3 of which have been at my target dose of 200mg daily) and I haven't seen many benefits. Maybe a 10-20% improvement during dosing in, but all that is going away now and is actually getting worse it seems. So, I would say Keppra. More people on the forums have tried it and anecdotally it has had more success than lamotrigine. However, lamotrigine has the most literature support for treating HPPD. So, it's up to you.

I'll be seeing my psychiatrist again, this friday. It seems my symptoms are getting worse and I can't tell if it's just because of stress (school started up again) or something else (anxiety isn't an issue since I'm doped up on clonazepam all day). This is interesting considering it seemed to be getting better, but now it's getting worse for seemingly no reason. With regards to my other disorders (except panic disorder), those have also been in a downward spiral and I can't figure out why. So, I'll definitely be bringing those up. I also think I need to be more upfront with him about my drug use. While the statements regarding MDMA use are true (only done once), regarding weed/THC use I actually experimented 4-5 times before with positive results before having my nightmare of a trip (yet I still want to smoke it I guess as an escape). Also, my statements regarding DPH use (abuse really) were not true when I first saw him. When I first saw him, I told him I did at most 50mg 3-4 times per week for insomnia. The reality is that I was doing 200-300mg on a nightly basis for almost two years straight (there were periods of a month or two where I would go without doing DPH). Also, I didn't mention I used to frequently mix DPH with other drugs, usually hypnotic drugs like zolpidem and strong RC benzos and sometimes with other antihistamine sedatives (doxylamine, dimenhydrinate, etc.). Even mixed DPH with extremely high doses of melatonin for about 3 months (we're talking 40mg or more of melatonin). Mixed it with DXM as well (though the DXM was taken at sub-psychoactive doses, i.e. therapeutic doses). I also am going to tell him about how I've been self-harming (I've kept this hidden from him since May which is when I started). Some of the wounds were so severe that I had to go to urgent care, which is incredibly awkward when you have to explain how you got the injuries, especially so when you're a rather big guy like myself, I was met with that sort of surprised/sudden realization "Oh...". I started self-harming as an escape and for that unparalleled rush you get from adrenaline and endorphins flooding your body. Also do it as punishment, though I don't really want to explain why here on these forums. Don't really know why I'm starting this thread. I guess just as an update and potentially discussion on why symptoms could be getting worse.

Macroscopia/microscopia are two common symptoms of HPPD. In other words, your depth perception gets effed.

A psychiatrist is good, a neurologist is better. They both have the same understanding of how the brain works, it's just psychiatrists focus more on the psychological aspects of the brain while a neurologist focuses on the physical aspect of the brain, the part which HPPD affects. I'm trying to setup an appointment with a neuro, but in my area they're hard to come by and require referrals from a primary care doctor (which I don't have, though I could ask my psychiatrist for a referral). A neurologist will also order specific imaging and cognitive tests for you (MRI, qEEG/EEG, scintography, etc.), which a psychiatrist might do but they usually only do it to rule out certain conditions (mine ordered a CT scan to rule out brain tumors), not verify that a particular condition is there. Mind you, any doctor regardless of specialty can order any medical test to be done, but you'll have better luck asking for/getting neurological tests from a neurologist. Same goes for neurological medicines.

Nicotine buzz? I know I got it from when I vaped really strong e-liquids. Couple puffs and I would be buzzing (it was some ridiculous concentration like 24mg/ml, fatal if you ingested the liquid straight up). Didn't make visuals worse, but I certainly didn't feel "right".

Sativas, typically, have a higher THC amount. However, as is the case with Harlequin which is a sativa dominant hybrid, not all sativas are high in THC and can in fact be quite the opposite (like Harlequin). The best, though hardest way to do an extract is to use supercritical CO2 . It gives you the cleanest oil you can get, but the process is long, expensive, and somewhat dangerous (highly pressurized vessel of CO2 + heat). Basically, you get some sort of steel vessel capable of withstanding high pressure. Then you take the material, place it in the vessel which hopefully has a collection chamber, and fill it with CO2. Once that is done, you start heating the vessel until the CO2 becomes supercritical (supercritical means it acts as both a liquid and a gas which gives it some very strange properties, Notably, it starts to act like a solvent when it normal doesn't). This will then pull pretty much everything out of the plant aside from the fibrous, non-soluble parts. Once you start depressurizing the vessel and collecting your oil, the CO2 instantly turns into a gas (this is where some caution is needed as it will cause sputtering and you don't want to lose your oil). Additional, before placing the material in the vessel, you usually soak it in water which will act as a carrier. The next best method is to do an essential oil extraction. Requires a some chemistry equipment though. Basically, you take your material, soak it with some solvent (usually alcohol or another organic solvent like acetone or DCM, sometimes you can use water), put it in a round bottom flask of suitable size, attach a reflux condenser (or a normal Liebig condenser) and distill it. Kind of the same process as vaping, but the solvent helps bring the oils out of the plant. Once you have enough oil collected, all you need to do is evaporate off the solvent leaving behind the oil. A better way to do this would be a fractional distillation, but that requires a little bit more work and a little bit of organic chemistry knowledge and you need to know the boiling points of each possible oil in your material, the solvent, THC, CBD, other alkaloids, etc. and you need to change out your collection flask at each boiling point. Also, some of these oils may have a very close boiling point which would make it impossible to separate even with fractional distillation unless you were very carefully controlling temperature (something you can really only do in a lab). Refluxing gives you the highest purity since that oil the boils off, recondenses and then falls back into solution. BHO extraction is a crude and cheap method of doing this, but I wouldn't recommend it if you're looking for purity (ratio of alkaloids/oils to junk like solvents, reaction byproducts, etc.)

Interesting how sensitive you are to THC. Just doing some rough math with a high CBD strain and a joint, you're looking at 150.6mg CBD per gram and 11.6mg THC per gram. If you take the low end (10%) that means with each joint you get 15mg or so of CBD per joint and 1mg or so of THC. So, the strain shouldn't be psychoactive at all considering CBD inhibits THC and there's already a low amount of THC present in the strain. This doesn't account for metabolism though, so the actual amount you receive might be lower. Then again, Jay, your case of HPPD is magnitudes worse than mine so no doubt your brain is ultra-sensitive to psychoactive compounds.

I'm glad I have supportive family, if only emotional and sometimes with resources (like finding counselors, whether something covered by my insurance, etc.). The only person of my family that doesn't know I have HPPD is my father. Well, at least I don't think he knows (my mother may have told him). I don't really plan on telling him directly since he also has a lot of mental issues, many of which are linked to his past drug and alcohol abuse which came about from having an abusive mother and suffering quite a few on the job injuries (blown out knees, herniated disks, blown out ankles, you name an injury you can get working in construction and I bet you he's had it happen, aside from amputations. He even once took a hit from a nailgun in his thigh). If he finds out about my HPPD and that it's caused by drug use, I think it would kill him inside because I more or less turned into the person he once was.

You should never, ever cold turkey with benzos, it only leads to problems, potentially fatal ones at that (benzo and alcohol withdrawal are the only two I know of that can kill you, both because you can end up having status epilepticus seizures which can and will kill you if you don't get emergency treatment right away). That's why you always need to taper very, very slowly. For some people, it takes more than a year to taper off (this is usually only for people who were on high doses for a very long period of time)

I know that in general, SSRIs, atypical antipsyhotics, and a handful of other drugs often make HPPD worse for most people, but what I've been wondering is the time course it took for symptoms to worsen. Basically, when it got worse from the meds, how long did it take? Was it instantaneous (day of taking/within hours of taking) or did it take awhile to notice an increase in symptoms (say a couple days to a couple weeks)? Mainly wondering because my pdoc wants me to try haloperidol, a first generation (typical) antipsychotic since it had some literature support (the 1971 Moskowitz study and A.G. Lerner's clinical review) for treating HPPD and for the fact that I am developing (mild) schizophrenia (I technically am schizophrenic according to the DSM since my mild symptoms persisted for at least 6 months. Also, as a side note, these symptoms were present before I got HPPD, so they may be causing my HPPD or this can be seen as evidence that they're unrelated since the visual symptoms developed spontaneously overnight). I have an appt. with him in just over a week from now, and I want to at least say I've tried it, but I'm sort of afraid to if it's going to make my symptoms worse instantly. I'm not too worried about anxiety and DP/DR since those are pretty much nonexistent right now thanks to clonazepam and lamotrigine (and learning mindfulness and grounding techniques, which I highly recommend if you want to treat your anxiety or DP/DR without meds).

So I went to the dispensary and got some of that strain (it's called Harlequin, 75/25 sativa/indica hybrid) and it's actually 15.06% CBD and 1.16% THC (1.11% THCA and 0.05% THC). Haven't tried it, but will within the next 2 weeks (college is starting up in the next two weeks and no doubt my friends are gonna want to have a smoke session). Again, it'll likely only be one hit off a small joint. So, with regards to the CBD oil, I'm assuming you were vaping it, correct? That might explain the spike (also, how long did the spike last?) since you get somewhere between 80% and 95% of the total alkaloids in the oil/plant material (compared to a joint where you get between 10-25% total alkaloids). Also, were you taking multiple hits or just one? Just trying to get a rough estimate of what to expect.

Jay, excellent point. The one dispensary I went to has a special strain that's high CBD (~16%) and very low THC (~3%), typically stuff you only find in medical dispensaries, but apparently there's enough of a market in the recreational scene for them to carry it.

So, I have a question for those that are either currently smoking weed or used to when they HPPD. My questionsare, how much did you smoke? Was it the normal amount you smoked? More? Less? A single hit? Additionally, if you did it in small amounts (less than what you normally did or just a single hit, big or small), how much worse did it make your HPPD, if at all? I live in the US in the great state of Washington (there's the state and the capital, I live in the state) where recreational use/purchase of weed is legal. The temptation was just too much and I ended up buying just over an eighth from 2 well known and reputable dispenenaries in my city. One strain is a milder one that the cashier ("budtenders" as they like to call themselves) reccommended for anxiety (low THC indica hybrid), and the other is a high THC, high CBD indica. I haven't smoked any of it though, but when and if I do, I'm only going to take one small hit or enough to feel a little buzz (my tolerance is low enough that one hit is probably going to do it for me) Long story short, if I smoke a tiny amount of weed (one small hit), will my HPPD become significantly worse and/or permanent or will it be benign? Thanks in advance

Zyrtec and Claritin come to mind regarding allergy pills that don't possess some sort of anticholinergic effect. Flonase works great if you have nasal problems as well (it's a corticosteroid that you spray into your nose that ultimately reduces inflammation from allergies which reduces stuffiness and mucus). You could also look at allergy meds that contain doxylamine succinate, but the medications that contain doxylamine are usually combined with DXM in a syrup. You can find tablets of just doxylamine though. However, doxylamine is a close relative to DPH so you might want to avoid it as well.

That's probably why you felt a little better. It sort of grounded you, brought you back into your mind.

Why do you keep using drugs? I know noscapine is primarily an antitussive (cough suppressant), but in higher doses it has effects similar to DXM.

Dude, you aren't developing schizophrenia. You have to be very careful when talking to psychiatrists/clinical psychologists about HPPD. If you use the word hallucination, most will immediately jump to schizophrenia. You need to say they're visual disturbances, not hallucinations. You also need to describe the associated non visual symptoms (DP/DR, anxiety, etc.). I made that mistake, but luckily I have a psychiatrist that doesn't immediately jump to the schizophrenia conclusion when he hears the word "hallucinations" (especially when I described the visual symptoms in detail, he said they could be attributed to anything, stress, anxiety, sleep deprivation, etc. He didn't attribute them to HPPD until I told him about it the 2nd time I saw him and gave him some literature on it). If you do/did use the word "hallucinations" make sure you describe them in agonizing detail so that your shrink (I kind of dislike that word because of the negative connotations) understands they aren't schizophrenic hallucinations.

I understand, but there isn't really a pharmocological solution to DP/DR. The best way to treat DP/DR is to see a therapist familiar with treating the disorder. For anxiety, there are certainly pharmocological solutions to it, as I said SSRIs (Prozac like you said) and benzos. However, SSRIs will probably make your HPPD worse and as a consequence, your DP/DR may get worse. With HPPD, there's no easy solution or fast solution.

I work part time as an IT Professional Assistant as well go to school full time for computer science (I'm in my final year of study). This summer, I actually got a research gig that was the most fulfilling 2 months of my life. Never before have I felt that good than when I was working there (Boise State University). I met a lot of new friends, did some exciting work, and did a lot of things that made me happy and content with life. My HPPD was still in effect, but with all the good in my life at that time I barely noticed it. I guess the main part of it was having people around that I could level with and whom I enjoyed spending time with. Every day there was a good day, even when things didn't go as planned. I can honestly say, aside from my senior of high school when the high school concert band flew down to LA to play at Disneyland, that was probably one of the best times of my life up until now (I've still got at least another 50 years, so who knows what comes next). In that short time span I also learned guitar, and any mental fog I had from HPPD went away almost completely. But now that I'm back to the monotony of my old job and life, I've only sunk lower and lower. In the span of two weeks or so, I went from feeling like a 10 to feeling like a 3, and it just keeps dropping. However, my creativity has been markedly peaked right now, I'm writing poems, songs, drawing trippy geometric things (which actually brings me a lot of calm and grounds me a lot since it takes a lot of concentration), reading books on topics I've always been interested in (mostly books about mathematics, cryptography, graph theory, and topology in particular), and writing short stories. But no matter what I do, I still feel like crap. I guess it's just the monotony and dullness of my old life that's getting to me. I think the thing that's key to all this is to have a support network, not just family, but friends that you want to be around and that want to be around you. That's what it was like at the research gig. Me and my new friends were always hanging out, whether it was playing video games, watching movies, bumming around downtown, throwing the frisbee around, bowling, or playing pool basketball. You need to have people in your life that get you out of the monotony and get you to do fun things, things that get your mind off HPPD.

I think we all realize that this is our fault, and we only have ourselves to blame for it. The problem is that people get too caught up in it and worry 24/7 about it (I was like this for the first couple of months or so after I developed HPPD) or doctors far too often write patients with HPPD off because they did this to themselves and did so with illicit drugs, so these doctors see it as a sort of punishment or lesson to be learned (which it should be a lesson to be learned) and don't want to treat it. This just makes people feel worse about their situation. The key is to start learning to live with it (like I am, though I'm still seeking at least a pallatative treatment because the visual symptoms make daily life very difficult for me. Not so much psychologically, I've sort of gotten over that part, but physically. It's hard to do any amount of extended work when you're basically tripping balls 24/7, and I can't really tell my boss this since I'm sure I'll be fired because of my past drug use) and to find a doctor will to work with you. Good psychiatrists or neurologists to look at would be ones that have experience treating drugs users or addicts since they're willing to look past the drug use and at the patient instead. I think that's what is key to getting out of the victim stage of HPPD and into the healing stage of HPPD.

Spokane, WA I'm seeing Dr. W. L. Brown. When I first started seeing him, he hadn't heard of HPPD until I told him about it and gave him some literature. After that, he became interested in it because he remembers treating patients who had used psychedelic mushrooms before with similar symptoms, what treatments he used though he can't remember. Since then, he's been researching it much in the same way I have, scouring literature, looking at the pharmacological profile of drugs and how they might treat HPPD, etc. So, we're taking things experimentally. So, I would say he's a good fit for me at least. I still want to see a neurologist though to get some of the other, more detailed tests (already had a CT scan which yieleded nothing and ruled some of the more scary disorders like CJD or cancer), like a qEEG and scintography. I may be able to convince him to order the tests though considering the experimental nature that we're approaching with this.

Lamotrigine is sometimes used to treat DP/DR. Additionally, naloxone and naltexone have some evidence for treating DP/DR For anxiety, there are really only two effective types of medications, SSRIs and benzos. SSRIs are preferable for long term treatment since they have no addiction/dependence potential. However, a combination of an SSRI and a benzo may prove useful in your case because it might treat your DP/DR and will most certainly kill your anxiety. Your best bet though for treating DP/DR is to see a therapist/psychologist familiar with DP/DR and Cognitive Behavior Therapy (CBT). They'll help you learn grounding exercises (stuff to keep you grounded in reality) as well as help you identify the root cause of your DP/DR and aid you in confronting that root cause.

SSRIs are purported to make HPPD visuals worse, at least anecdotally with some medical evidence to support it. Best to avoid it and try something like Wellbutrin (burpropion) an NDRI or an SNRI like Effexor, that is if you're treating depression. For DP/DR I would avoid anything that has stimulant like properties, such as an NDRI or SNRI would have. There are also SSREs, but thos haven't hit the US market, yet. Those would be an ideal anti-depressant for those with HPPD.

Should I just avoid it and not take it? My doc prescribed it because, as some of you may know, I have/am developing a psychotic disorder. I know it's primarily a dopamine antagonist and that HPPD seems to primarily be linked to the serotonin system. But as I've read on this forum and elsewhere, anti-psychotics should be avoided. However, it seems like most people are talking about atypical anti-psychotics, which are both dopamine and serotonin antagonists, rather than typical anti-psychotics like haloperidol. In my research, I haven't found many reports of using haloperidol to treat HPPD or using haloperidol to treat comorbid psychosis with HPPD. I've read the Moskowitz study, but in that cases it was used to treat flashbacks, not necessarily HPPD since before the diagnostic criteria were introduced into the DSM, flashbacks and HPPD were lumped together, so it isn't exactly clear whether they were treating flashbacks or HPPD. I haven't seen many anecdotal reports either. The ones I have seen are mixed in that they say it either 1) helps, 2) does nothing, or 3) makes HPPD worse. What's disappointing about these anecdotal reports is that the authors don't include much information such as their particular dose, other comorbid disorders, hallucinogen that most likely caused their HPPD, other medications and dosage, etc. They just say whether it worked, didn't, or made things worse. So, if there is anyone on this forum that has tried haloperidol and is willing to give a detailed description of their experience, I would very much appreciate it if you could post in this thread and help me determine whether I should try this med or not. I obviously want to treat the psychotic symptoms, but at this point, my HPPD is what's causing me the most distress, worsening it simply for the sake of treating another disorder that isn't causing me much distress would just push me over the edge. Here's my detailed report: Comorbid disorders: Major depressive disorder, panic disorder, schizophrenia/psychosis NOS Current psychiatric medications: 1mg clonazepam twice daily (helps with anxiety), 100mg lamotrigine twice daily (some improvement of visual symptoms) Current non-psychiatric medications: Albuterol, 2 puffs as needed for asthma Past medications tried for HPPD/other disorders: Escitalopram (stopped at 2.5mg once daily, made HPPD worse, 3 day trial), risperidone (stopped at .5mg twice daily, made HPPD worse, only lasted 1 day) [NOTE: These were taken in roughly the same time period] Drug(s)/hallucinogen(s) most likely to have caused HPPD: DPH (diphenhydramine aka Benadryl), used on a nightly basis for ~2 years at doses of 150mg+, potentially MDMA (only ever tried once), potentially THC (only ever tried once, had a severe panic attack) Proposed dose of haloperidol: 2mg once daily tapering up to 5mg once daily Other proposed medications/supportive agents: Benztropine 1mg twice daily to control EPS of haloperidol The main reason I want a detailed report is so I can make a better judgement as to whether it will worsen it or not and thus whether to take it or not. The detailed report gives me an indication of what the underlying cause is and what system is affected in particular. Knowing the drug that caused it and what drugs made it worse/better gives me an idea of the neurotransmitter system that's affected the most by your HPPD. In my case, it seems like mine is primarily linked to the serotonin system and acetylcholine system considering that my drug of choice was DPH, a well known anticholinergic, and that serotonin antagonists made it worse. In particular, for me, it seems like I likely have an acetylcholine deficiency and something funky with my serotonin system (potentially a sort of serotonin toxicity since risperidone blocks serotonin from being absorbed and escitalopram increases it, thus highly increased levels of serotonin). Thanks in advance

So, it's been a couple months and I'm at my target dose of 200mg lamotrigine daily. Still on 2mg clonazepam daily, but will be starting a taper off of it within the next month or so. No signs of addiction or dependence so I'm not too worried about tapering off it. I'm pretty much the same as I was when I posted the first report. However, the double images/ghosting has improved quite a bit and now seems to come in waves rather than being constant. There are days where it's the same as it was before treatment, and the there are days where it's almost not noticeable unless I purposefully look for it. Another thing of note, it seems to now only occur with brightly colored/reflective objects that are being hit with intense light OR with lights that emit at a high intensity. Also, it sort of follows a cosine like trend where it's at its worse in the morning and night, but not so bad midday (this is perhaps a function simply of eye adjustment, i.e., the eyes adjust to light after being in darkness for an extended period and the eyes adjusting to darkness after being exposed to light for an extended period of time). Ghosting/double vision with text on a computer screen is almost nonexistent now, it comes and goes but for the most part, it isn't present. However, all other archetypal symptoms are still present at their normal intensities. I plan on going the full recommended 12 months to see how this turns out. The improvements make me hopeful. Another thing of note, I will be starting a course of haloperidol soon due to an increase in psychotic symptoms (pdoc is starting to get worried and wants to get this under control ASAP before I end up in the looney bin). My target dose will be 5mg once daily, starting at 2mg once daily. He recommended it since it primarily affects only the dopamine receptors, specifically the D2 receptors and HPPD seems to be primarily linked with the serotonin receptors, as we all know by now the 5-HT2A receptors in particular, which most modern APs have an affinity for along with the dopamine receptors. In his words, he said it would either have a positive effect for HPPD or be completely benign. In Lerner's clinical literature review, dopamine antagonists (i.e. typical antipsychotics) seem to be either helpful or benign with regards to HPPD. So, I'm hoping it helps or is benign and doesn't worsen HPPD. The only thing that surprises me is that no one has really tried it yet with HPPD, except for a few people here on the forums. I think this is because most HPPD'ers are told not to even approach APs regardless of their generation (typical/atypical), but this seems to stem mostly from experiences with only one AP, risperidone and not others. We'll see how this plays out. If there is anyone else that has tried haloperidol with HPPD, it would be much appreciated if you could give an anecdotal report of your experience, was it a success, complete failure, so-so results, etc. If it works, great. If it doesn't, well, I'll just keep on keeping on and move on to something else (likely clonidine, levetiracetam, perphenazine and a few others, definitely not levodopa though since I have an underlying psychotic condition).