Hallucinogen Persisting Perception Disorder Following Recreational Dextromethorphan Use
Addictive Disorders & Their Treatment December 1, 2021 Robert Rymowicz, Tiffany Tsuang
Hallucinogen persisting perception disorder (HPPD) is a rarely diagnosed condition involving ongoing sensory disturbances after hallucinogen use, with unknown cause and no established treatments. A 20-year-old male developed HPPD after repeated recreational use of dextromethorphan at supratherapeutic doses, experiencing visual snow, motion trails, afterimages, halos, tinnitus, depersonalization, and derealization. Antipsychotic medications worsened his symptoms. Treatment with lamotrigine and clonazepam brought some improvement. Adding ropinirole, a dopamine agonist, further reduced visual disturbances and made him feel better, but he eventually stopped all medications due to side effects. The case suggests ropinirole may be a novel treatment option for HPPD, though more research is needed.