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David S. Kozin

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  1. Related Articles Hallucinogen persisting perception disorder: what do we know after 50 years? Drug Alcohol Depend. 2003 Mar 1;69(2):109-19 Authors: Halpern JH, Pope HG 'Flashbacks' following use of hallucinogenic drugs have been reported for decades; they are recognized in DSM-IV as 'Hallucinogen Persisting Perception Disorder (Flashbacks)', or HPPD. We located and analyzed 20 quantitative studies between 1955 and 2001 examining this phenomenon. However, many of these studies were performed before operational criteria for HPPD were published in DSM-III-R, so they are difficult to interpret in the light of current diagnostic criteria. Overall, current knowledge of HPPD remains very limited. In particular (1) the term 'flashbacks' is defined in so many ways that it is essentially valueless; (2) most studies provide too little information to judge how many cases could meet DSM-IV criteria for HPPD; and consequently (3) information about risk factors for HPPD, possible etiologic mechanisms, and potential treatment modalities must be interpreted with great caution. At present, HPPD appears to be a genuine but uncommon disorder, sometimes persisting for months or years after hallucinogen use and causing substantial morbidity. It is reported most commonly after illicit LSD use, but less commonly with LSD administered in research or treatment settings, or with use of other types of hallucinogens. There are case reports, but no randomized controlled trials, of successful treatment with neuroleptics, anticonvulsants, benzodiazepines, and clonidine. Although it may be difficult to collect large samples of HPPD cases, further studies are critically needed to augment the meager data presently available regarding the prevalence, etiology, and treatment of HPPD. PMID: 12609692 [PubMed - indexed for MEDLINE] View the full article
  2. Related Articles Clonazepam treatment of lysergic acid diethylamide-induced hallucinogen persisting perception disorder with anxiety features. Int Clin Psychopharmacol. 2003 Mar;18(2):101-5 Authors: Lerner AG, Gelkopf M, Skladman I, Rudinski D, Nachshon H, Bleich A An unique and intriguing characteristic of lysergic acid diethylamide (LSD) and LSD-like substances is the recurrence of some of the symptoms which appear during the intoxication, in the absence of recent intake of hallucinogens. Hallucinogen persisting perception disorder (HPPD) is a condition in which the re-experiencing of one or more perceptual symptoms causes significant distress or impairment in social, occupational or other important areas of functioning and may be extremely debilitating. Benzodiazepines are one of the recommended agents for the treatment of HPPD but it is unclear which of them may be more helpful. The goal of our investigation was to assess the efficacy of clonazepam in the treatment of LSD-induced HPPD. Sixteen patients fulfilled entrance criteria. All complained of HPPD with anxiety features for at least 3 months and were drug free at least 3 months. They received clonazepam 2 mg/day for 2 months. Follow-up was continued for 6 months. They were weekly evaluated during the 2 months of clonazepam administration and monthly during the follow-up period using the Clinical Global Impression Scale, a Self-report Scale and Hamilton Anxiety Rating Scale. Patients reported a significant relief and the presence of only mild symptomatology during the clonazepam administration. This improvement was clearly sustained and persisted during a 6-month follow-up period. This study suggests that high potency benzodiazepines like clonazepam, which has serotonergic properties, may be more effective than low-potency benzodiazepines in the treatment of some patients with LSD-induced HPPD. PMID: 12598822 [PubMed - indexed for MEDLINE] View the full article
  3. Related Articles Flashback and Hallucinogen Persisting Perception Disorder: clinical aspects and pharmacological treatment approach. Isr J Psychiatry Relat Sci. 2002;39(2):92-9 Authors: Lerner AG, Gelkopf M, Skladman I, Oyffe I, Finkel B, Sigal M, Weizman A One unique characteristic of lysergic acid diethylamide (LSD) and LSD-like substances is the recurrence of some of the symptoms which appeared during the intoxication after the immediate effect of the hallucinogen has worn off. This recurring syndrome, mainly visual, has not been clearly understood, appreciated or distinguished from other clinical entities by clinicians. The terms Flashback and Hallucinogen Persisting Perception Disorder (HPPD) are used interchangeably in the professional literature. Flashback is a usually short-term, non-distressing, spontaneous, recurrent, reversible and benign condition accompanied by a pleasant affect. In contrast, HPPD is a generally long-term, distressing, spontaneous, recurrent, pervasive, either slowly reversible or irreversible, non-benign condition accompanied by an unpleasant dysphoric affect. Flashback and HPPD appear to be part of a vast and broad spectrum of non-psychopathological and psychopathological states reported by hallucinogen users. Pharmacological agents such as clonidine, perphenazine and clonazepan have been shown to ameliorate this syndrome in some of the individuals seeking treatment. PMID: 12227234 [PubMed - indexed for MEDLINE] View the full article
  4. Related Articles LSD-induced Hallucinogen Persisting Perception Disorder with depressive features treated with reboxetine: case report. Isr J Psychiatry Relat Sci. 2002;39(2):100-3 Authors: Lerner AG, Shufman E, Kodesh A, Kretzmer G, Sigal M We would like to present the case of a patient who had a prior history of cannabis, ecstasy (MDMA) and LSD abuse and who developed both Hallucinogen Persisting Perception Disorder (HPPD) and a major depressive episode. Following two unsuccessful SSRIs trials, reboxetine was prescribed. During a six-month follow-up period on reboxetine 6 mg./day, no exacerbation of the visual disturbance or recurrence of the depressive features were reported. Reboxetine may have an alpha 2 adrenoreceptor modulating effect on both noradrenaline and serotonin release, thus reboxetine's alpha 2 adrenoreceptor modulating effect on noradrenaline release may affect sympathetic activity and be involved in the recovery process. PMID: 12227224 [PubMed - indexed for MEDLINE] View the full article
  5. Related Articles Persisting continuous visual perception disorder in a chronic MDMA ('ecstasy') user. Aust N Z J Psychiatry. 2002 Apr;36(2):266-7 Authors: Passie T, Schneider U, Emrich HM PMID: 11982553 [PubMed - indexed for MEDLINE] View the full article
  6. Related Articles EEG coherence in post-LSD visual hallucinations. Psychiatry Res. 2001 Oct 1;107(3):151-63 Authors: Abraham HD, Duffy FH LSD use in certain individuals may result in chronic visual hallucinations, a DSM-IV syndrome known as hallucinogen persisting perception disorder (HPPD). We studied 38 HPPD subjects with a mean of 9.7 years of persistent visual hallucinations and 33 control subjects. Measures of local and medium distance EEG spectral coherence were calculated from all subjects. Coherence, a measure of spectral similarity over time, may estimate cortical coupling. In the eyes-open state in HPPD subjects, widespread reduction of coherence was noted. However, upon eye closure, the occipital region demonstrated augmented regional coherence over many frequencies but with reduced coherence of the occipital region to more distant regions. This occipital coherence increase correlated with previously reported shortened occipital visual evoked potential latency for HPPD subjects. We speculate from coherence and known clinical and psychophysical data that, in HPPD, there is widespread cortical inhibition in the eyes-opened state, but localized and isolated occipital disinhibition upon eye closure, a state known to facilitate hallucinatory experiences. An analogy is drawn to findings in the interictal and ictal epileptic focus. In HPPD, we speculate that occipital EEG hypersynchrony resulting from increased regional coherence, when coupled with relative isolation of visual cortex, especially upon eye closure, facilitates hallucinations and illusions. PMID: 11566431 [PubMed - indexed for MEDLINE] View the full article
  7. Related Articles LSD-induced Hallucinogen Persisting Perception Disorder treated with clonazepam: two case reports. Isr J Psychiatry Relat Sci. 2001;38(2):133-6 Authors: Lerner AG, Skladman I, Kodesh A, Sigal M, Shufman E Benzodiazepines are recommended for the treatment of Hallucinogen Persisting Perception Disorder (HPPD), although it is unclear which may be more helpful. Two out-patients with LSD-induced HPPD were successfully treated with clonazepam. They had not responded to low potency benzodiazepines or low doses of classic antipsychotics. After clonazepam discontinuation they reported a marked improvement and only mild symptomatology which persisted during a six month follow-up period. High potency benzodiazepines like clonazepam, which has serotonergic properties, may be superior to low-potency benzodiazepines in the treatment of some patients with LSD-induced HPPD. PMID: 11475916 [PubMed - indexed for MEDLINE] View the full article
  8. All file uploads will generate topics, and a special Category/Section will be created for this purpose.
  9. File Name: Current Opinion of Psychiatry: HPPD, a differential diagnosis. File Submitter: David S. Kozin File Submitted: 18 Oct 2010 File Category: HPPD Research Articles A response to a case report with symptoms similar to HPPD. Click here to download this file
  10. I have resources that should be helpful. I work with a treatment team in an acute inpatient co-occurring dual-diagnosis substance abuse unit with a conselor with a similar degree program. Having front line clinical specialists with knowledge on drug-induced disorders is always a major bonus. We are working on the research you are describing and will be glad to help with references and material. Science is to be shared and it isn't about who gets excusilve rights to do it, but the more validation we can accomplish the better the results in the end. Best, David
  11. I discovered an iPhone application for this Board that is native to the iPhone! Alas, I can do something. Yes, the GoDaddy template site I had created was before I knew of a solution. This morning,, I am reading about d-LSD's affect on genetic expression of 5-HT receptor regulation of GABAergic inhibitory neurons. Examining disorders that occur when the 5-HT2A receptor is in lower concentrations than normal in this system. I am working from 3 - 11:30 pm Today, Tomorrow, Saturday, and Sunday. I am trying to extract the email list from the old board to send out a broadcast message, but believe that it may also be good to let members continue their break until they feel necessary to try the HPPDonline.com web address again. Addittionally, AlteredPerceptions.com is in my hands and will point to the site. Update: I am submitting a research proposal to the IRB to allow me to collect case histories from members with their approval, and administer a new research instrument over the phone to begin to validate the theory presented in my thesis. It would be powerful for the reader to hear life stories and how this disorder has affected their lives. I am consulting with Dr. Davis on the forum set-up, and I will be uploading files on HPPD. The positive attitude towards accepting change from the both of you is refreshing. All my best, David
  12. Trying to set this up...

    1. Show previous comments  1 more
    2. David S. Kozin

      David S. Kozin

      www.hppdonline.com in the browser window. Once here, I would bookmark the web site. www.alteredperceptions.com (and a few other sites will have links to this site.) A link to this site is also on Wikipedia.

    3. lrisner59@yahoo.com

      lrisner59@yahoo.com

      David I want to tell you the day I stumbled across your website and was able to finally give this thing a name and more importantly understanding was nothing short of a miracle. I just want to thank you for all your selfless hard work and sacrifices for all us sufferers. If there is anything I can ever do to help with your research please don't hesitate to count me in! God Bless , Larry

    4. alisa

      alisa

      Hi David, I've been a little out of the loop for health reasons and have missed this site. I really like the examples you have of visual snow etc. People ask me so what's the problem with your eyes and your photo's describe perfectly what I try to tell people and they just look at me like I'm crazy or making it up. thank you for your work on this. Also dealing with the medical community with other issues (surgery last week) is really tough as there is little understandin...

  13. Welcome to your new Invision Power Board! Congratulations on your purchase of our software and setting up your community. Please take some time and read through the Getting Started Guide and Administrator Documentation. The Getting Started Guide will walk you through some of the necessary steps to setting up an IP.Board and starting your community. The Administrator Documentation takes you through the details of the capabilities of IP.Board. You can remove this message, topic, forum or even category at any time. Go to the documentation now...
  14. NEW ORLEANS -- Relapse rates for patients with treatment-resistant major depression were much lower following transcranial magnetic stimulation (TMS) than is normally seen with drugs or electroconvulsive therapy, researchers said here. View the full article
  15. NEW ORLEANS -- Relapse rates for patients with treatment-resistant major depression were much lower following transcranial magnetic stimulation (TMS) than is normally seen with drugs or electroconvulsive therapy, researchers said here. View the full article
  16. NEW ORLEANS -- Neither obesity nor simple overeating will be included in the DSM-5, the forthcoming revision to the Diagnostic and Statistical Manual of Mental Diseases, but binge eating is on track to become a formal psychiatric diagnosis, it was reported here. View the full article
  17. NEW ORLEANS -- Neither obesity nor simple overeating will be included in the DSM-5, the forthcoming revision to the Diagnostic and Statistical Manual of Mental Diseases, but binge eating is on track to become a formal psychiatric diagnosis, it was reported here. View the full article
  18. NEW ORLEANS -- As psychiatrists work to bring the Diagnostic and Statistical Manual of Mental Diseases (DSM) up to date, no category is likely to see more sweeping changes -- in nomenclature at least -- than sleep disorders. View the full article
  19. NEW ORLEANS -- As psychiatrists work to bring the Diagnostic and Statistical Manual of Mental Diseases (DSM) up to date, no category is likely to see more sweeping changes -- in nomenclature at least -- than sleep disorders. View the full article
  20. NEW ORLEANS -- Youngsters who were disruptive in school improved significantly after a school-based program that taught behavioral self-control through the use of puppets, researchers said here. View the full article
  21. NEW ORLEANS -- Youngsters who were disruptive in school improved significantly after a school-based program that taught behavioral self-control through the use of puppets, researchers said here. View the full article
  22. NEW ORLEANS -- The atypical antipsychotic aripiprazole (Abilify) appears to be safe for longer-term treatment of irritability associated with autism, but patients are at an increased risk of weight gain, researchers said here. View the full article
  23. NEW ORLEANS -- A once-monthly injection of naltrexone (Vivitrol) kept more patients off opioids than did placebo, researchers reported here. View the full article
  24. NEW ORLEANS -- A once-monthly injection of naltrexone (Vivitrol) kept more patients off opioids than did placebo, researchers reported here. View the full article
  25. NEW ORLEANS -- A potentially less stigmatizing name isn't likely to put the controversial designation of "psychosis risk syndrome" into the fifth edition of the Diagnostic and Statistical Manual of Mental Diseases (DSM-5), a researcher suggested here. View the full article
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