LSD-Like Panic From Risperidone in Post-LSD Visual Disorder

Risperidone, a medication that blocks serotonin-2 and dopamine D2 receptors, worsened symptoms in three patients with hallucinogen-persisting perception disorder (HPPD), a condition sometimes triggered by LSD that causes ongoing visual disturbances and panic. The exacerbation of LSD-like panic and visual symptoms suggests that HPPD may be a relative contraindication for risperidone use.

Study at a glance

Abstract

Risperidone, a novel antipsychotic agent, is an antagonist of postsynaptic serotonin-2 and dopamine D2 receptors. In certain individuals, the hallucinogenic drug lysergic acid diethylamide (LSD) is associated with apparently lifelong continuous visual disturbances, characterized in DSM-IV as hallucinogen-persisting perception disorder (HPPD). Because the hallucinogenic mechanism of LSD is known to act in part at postsynaptic serotonin-2 receptors, it is noteworthy that three HPPD patients treated with risperidone reported an exacerbation of LSD-like panic and visual symptoms. We conclude that HPPD may be a relative contraindication for the use of risperidone.