Mori-Kreiner Anna, Aggarwal Arpit, Bordoloi Meelie
Mori-Kreiner, University of Missouri School of Medicine, Columbia, Missouri, United States.
Aggarwal, University of Missouri School of Medicine, Columbia, Missouri, United States.
Psychopharmacol Bull. 2025 Feb 3;55(2):94-99.
Hallucinogen-persisting Perception Disorder (HPPD) is a rare condition characterized by the re-experiencing of one or more perceptual symptoms that an individual experienced while intoxicated with a hallucinogenic substance when the individual is sober. While there are several case reports of HPPD in adult patients, there is a scarcity of documented cases in children and adolescents. The purpose of this article is to highlight the presentation, diagnosis, and treatment of HPPD in a 16-year-old male patient.
In this case report, the patient is a 16-year-old male with a history of major depressive disorder (MDD) and polysubstance use using Lysergic acid diethylamide (LSD), 3,4-Methylenedioxymethamphetamine (MDMA), psilocybin, cannabis, and benzodiazepines. He endorsed having auditory hallucinations and a heightened sense of hearing in between usage of MDMA for the past eight months and described auditory and visual hallucinations during his 5-day admission at the inpatient child psychiatric unit. Aripiprazole 5 mg was used as treatment for HPPD.
On review of literature, the first-line treatment for HPPD with clonidine and benzodiazepine has been documented by few case reports. Second generation antipsychotics are documented to be less effective with the exception of aripiprazole. The authors witnessed gradual improvement in the patient's symptoms with the use of aripiprazole, although it was not completely resolved during his hospital course.
This case demonstrates the presentation of HPPD and efficacy of aripiprazole in an adolescent patient. The diagnosis was further complicated by the patient's history of polysubstance use, and determining a distinction from non-substance-induced psychotic disorders was paramount.
致幻剂持续性感知障碍（HPPD）是一种罕见病症，其特征为个体在清醒状态下重新体验到自己在使用致幻物质中毒时所经历的一种或多种感知症状。虽然有几例成年患者的 HPPD 病例报告，但儿童和青少年的记录病例却很稀少。本文旨在强调一名 16 岁男性患者的 HPPD 的表现、诊断和治疗。
在本病例报告中，患者为一名 16 岁男性，有重度抑郁症（MDD）病史且使用过多种物质，包括麦角酸二乙酰胺（LSD）、3,4-亚甲基二氧甲基苯丙胺（摇头丸）、裸盖菇素、大麻和苯二氮䓬类药物。他承认在过去八个月使用摇头丸期间有幻听和听力增强的情况，并在住院儿童精神科病房住院 5 天期间描述了幻听和幻视。使用阿立哌唑 5 毫克治疗 HPPD。
查阅文献发现，少数病例报告记录了可乐定和苯二氮䓬类药物作为 HPPD 的一线治疗方法。除阿立哌唑外，第二代抗精神病药物的疗效据记载较差。作者观察到使用阿立哌唑后患者症状逐渐改善，尽管在其住院期间症状并未完全缓解。
本病例展示了一名青少年患者的 HPPD 表现及阿立哌唑的疗效。患者使用多种物质的病史使诊断进一步复杂化，区分它与非物质所致精神障碍至关重要。
