HPPD Assessment & Management
Specialist psychiatric care for Hallucinogen Persisting Perception Disorder. Comprehensive assessment, evidence-based treatment, and ongoing support via secure telehealth.
Book a ConsultationWhat is Hallucinogen Persisting Perception Disorder?
HPPD is a recognised psychiatric condition in which visual and perceptual disturbances persist or recur after hallucinogenic substance use has stopped. Unlike substance-induced psychosis, individuals with HPPD retain full insight into their symptoms and understand that they are perceptual disturbances rather than external reality.
The condition is widely underdiagnosed. Research suggests that individuals may consult multiple clinicians before receiving a correct diagnosis. Symptoms are frequently misattributed to anxiety, psychosis, or migraine, potentially leading to treatment approaches that may not address the underlying condition.
HPPD has been reported following use of substances including LSD, psilocybin, MDMA, cannabis, and synthetic psychoactive compounds. Not all individuals who use these substances develop HPPD, and the condition may involve individual vulnerability factors that are not yet fully understood.
The clinical presentation varies considerably. Some individuals experience brief, intermittent episodes, while others report persistent perceptual changes lasting months or years that may significantly affect daily functioning and quality of life.
Common presentations
Visual snow, afterimages, trailing of moving objects (palinopsia), halos around lights, intensified colours, and geometric patterns in the visual field.
Size distortion (macropsia, micropsia), false perception of movement in peripheral vision, photophobia, and increased awareness of floaters.
Depersonalisation and derealisation, anxiety, low mood, tinnitus, sleep disturbance, and difficulty concentrating. These commonly accompany the visual symptoms.
Ophthalmological and neurological investigations are typically normal in HPPD. A thorough psychiatric assessment can help distinguish HPPD from other conditions with overlapping symptoms, such as visual snow syndrome, migraine aura, or anxiety-related perceptual disturbances.
How we can help
Comprehensive Assessment
Detailed clinical history, substance use timeline, symptom characterisation, and screening for comorbid conditions such as anxiety, depression, and depersonalisation. Differential diagnosis to distinguish HPPD from other causes of visual disturbance.
Individualised Treatment
Treatment is tailored to symptom severity and individual circumstances. Options may include medication trials (guided by current evidence), psychological strategies for symptom management, psychoeducation, and lifestyle modifications including substance abstinence.
Ongoing Management
Regular follow-up to monitor symptom progression, adjust treatment where needed, and provide ongoing support. Coordinated care with your GP and, where appropriate, referral for ophthalmological or neurological assessment.
“A condition that is often misunderstood deserves specialist attention.”
Common questions
What is HPPD?
Hallucinogen Persisting Perception Disorder (HPPD) is a recognised psychiatric condition in which visual and perceptual disturbances persist or recur after the use of hallucinogenic substances has stopped. It is classified in the DSM-5 and involves symptoms such as visual snow, afterimages, halos, and trailing. HPPD is distinct from substance-induced psychosis and does not involve hallucinations in the traditional sense. Individuals with HPPD typically retain full insight into their symptoms.
Can HPPD be diagnosed and managed via telehealth?
Yes. HPPD is primarily diagnosed through a detailed clinical history, and there are no specific laboratory or imaging tests required. Ongoing management, including medication review, psychological strategies, and psychoeducation, can be effectively delivered via secure video consultation. Your psychiatrist may recommend ophthalmological or neurological assessment to help exclude other causes of visual symptoms.
What treatments are available for HPPD?
Treatment is individualised and may include medication trials (such as lamotrigine or clonazepam), psychological approaches for managing distress, psychoeducation about the condition, and lifestyle modifications. The evidence base for HPPD treatment is still developing, and there are currently no specifically approved medications for HPPD. Your psychiatrist will discuss the potential benefits and limitations of available options, including known side effects.
Is HPPD covered by Medicare?
Psychiatric consultations for HPPD are eligible for Medicare rebates under standard psychiatry item numbers, including telehealth items. A GP referral is required. If eligible, the Medicare rebate will be deposited directly into your account by Medicare. Out-of-pocket costs will depend on the consultation type and duration.
Which substances can cause HPPD?
HPPD has been reported following use of LSD, psilocybin, MDMA, cannabis, DMT, mescaline, and various synthetic psychoactive substances. LSD is the most frequently reported trigger in the literature. Not all individuals who use these substances will develop HPPD, and the condition may involve individual vulnerability factors that are not yet fully understood.
How is HPPD different from flashbacks?
Flashbacks (sometimes referred to as Type 1 HPPD) are brief, intermittent episodes of perceptual re-experiencing that are typically self-limiting and may not cause significant distress. Type 2 HPPD involves persistent or near-constant perceptual disturbances that can last months or years and are often associated with anxiety, depersonalisation, and functional impairment. Both are distinct from PTSD-related flashbacks.
Seeking specialist assessment for HPPD?
Book a consultation to discuss your symptoms and explore your treatment options. A GP referral is required. We can guide you through the process.