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How to treat ADHD without making HPPD worse?

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I read someone saying that most people with HPPD have ADHD. The thing is that the medications used to treat ADHD, will probably make HPPD permanently worse. Ritalin for expample, it's supossed to be a NO NO for hppd.


I would like to read other's experiences.


I've avoided medications, because of the risk of making HPPD worse. But ADHD is affecting my life.



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Wouldn't say most HPPDers have ADHD - that would be an interesting poll.  But attention problems are common with HPPD, particularly over-vigilant states such as anxiety and noticing little things.  People like to say it is OCD or ADHD but it isn't the same thing.


That aside, ADHD meds typically boost dopamine and some have reported developing problems in conjunction with taking a bunch of Adderall or Ritalin.


But not all dopamine meds are equal.  I get lots of benefit with Sinemet (levodopa) and there was a drug trial using it with another med where about 1/3 of those who participated got a lot of benefit.


It is good to note that most HPPDers do really bad with anti-dopamine meds (antipsychotics).  Thus the inference would be that some would do well with the opposite of an antipsychotic - a dopamine increasing med.



In choosing a med, it would be helpful for you to list your symptoms ... and which ones you think are ADHD.  Have you always had ADHD?

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I think an AD(H)D poll would be very revealing. Who knows whether ’most’ is accurate or not, till we poll it? I theorise that most of us, pre HPPD, were more sensitive/attuned, more easily prone to negativity /trauma than your average Joe.


You’re right, Visual. AD(H)D symptoms are many and varied. It’s important to be clear on which are your personal ADHD symptoms. If you haven’t already read ’Healing ADD’ by Dr Amen, it would be a really good place to start. I only discovered it post-HPPD (doesn’t life suck?) He identifies 7 different types  of ADD and successfully treats them with mostly natural supplements. If you’re lucky, your type may just benefit from non-stimulants.




http://books.google.de/books?id=M2dn-3pJ6p4C&pg=PT232&lpg=PT232&dq=dr+amen+7+same+dlpa&source=bl&ots=ReAPeudTiZ&sig=amrFNVpOYxGGBWRSsHm-QyWl2qU&hl=en&sa=X&ei=sjvCU-DjBKuQ4gSE2ICQCg&ved=0CDgQ6AEwAw#v=onepage&q=dr amen 7 same dlpa&f=false


I can only talk from my own experience. Yes, I have ADD AND Dyscalculia. Both these can lead to enormous social anxiety. I was on stimulant prescription meds to improve mood/concentration for 6 months before I got HPPD. In my case, Prozac and Ritalin. These are the two worst, strongest and potentially addictive drugs, especially prescribed to young people under pressure. I stopped Prozac because it was dirty shit and soon after, I got HPPD from  my first and only use of hallucinogens: 60 morning glory seeds I’m convinced that without the stimulants,HPPD just wouldn’t have struck. It took me a while to realise that the ritalin made my symptoms worse, and I think most here would agree that it does.


There are several supplements I’ve found useful for the anxiety  side of ADD, mainly L-tyrosine, L-theanine and magnesium. They are well documented on this forum, but not so much for the concentration. I’m still looking into DLPA, as it’s used to treat type 5 ADD, but not sure about the chemistry with HPPD.


I was lucky enough to finally get prescribed Keppra 2 months ago. This had the biggest impact on my concentration. I started off on 250mg a day. After a couple of days, my whole world just zoomed back into focus. It was as if my head was screwed back on again. That’s the only way I can describe it. I went up gradually to 1000mg a day, but increasing dose didn’t  increas benefits. It helps a bit with the visuals, but mostly with the DP and DR. It’s not an easy ride, Keppra rage is no myth . Now, being able to think more clearly about the future sometimes just brings all the visuals flooding back. Also, if I’m late with a dose, I feel like I’m starting to really trip again, which is pretty scary.


Good luck, g29. I hope you find something that helps you.

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That is interesting about Keppra.  Wonder if it would have helped you with ADD before developing HPPD.  I find Keppra messes with concentration and memory ... and the rage is real, even somewhat inducing psychopathy.  But tolerate 200mg before bed - very sedating and helps insomnia.  At that dose is doesn't mess too much - but who knows, maybe I'm enjoying being a psychopath, lol ... beats worrying about the opinions of others.  Doesn't effect visuals but has slight DR improvement.


Also, wonder how much being on prescription meds in conjunction with recreational use has contributed to developing HPPD.  With both pushing neurotransmitters around, overload becomes a greater problem.  Ritalin pushed DA and NE, has strong (yet undefined) action on a couple Serotonin receptors, and even some opiod action.  Some HPPDers benefit with DA but NE and Serotonin can be hell.


How did Ritalin affect you before HPPD?



Having anxiety or depression is very common with ADHD.  ADHD is largely contributed to genetic weaknesses with the dopamine system but other genes are involved too.  Its hard to say which meds would help you.  Of course Klonopin helps with anxiety.  I've tried several dopamine meds (though not Ritalin) and those that directly effect NE can be rough. 


Have you tried meds besides Ritalin and Prozac?


Have you tried any sort of genetic testing?

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If there'll be a ADHD/ADD poll, the question must be if one has been diagnosed and not think they have it. I was diagnosed post-HPPD when conducting a lot of tests due to HPPD. Problem solving etc. gave me ADD on paper.

Meditation and low-carb diets works very well for some.

The best is a high dose magnesium supp imo

On Keppra, i do acknowledge some of what you are talking about, Visual. Still its not that easy, my anx is gone and though i am not careless I am carefree. Not sure if i want to "feel" too much. Thats probably why i still hesitate to lower my dose. That as well as getting temporary worse again. And getting more emotions back :P

Keppra is indeed a two-edged sword. Makes me more focused but less interested in creative things. Flatlined...

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Self diagnosis is always a problem.  And frankly, so can professional diagnosis - although it is wise to get multiple opinions ... and not just one's own.


For example, just read wiki on ADHD.  Some argue it is an invented disorder, so there are variations of how many people have it based on various diagnostic tables.  Evolutionist claim ADHD is good for the community thought not for the individual.  When I read the various major symptoms it pegs much of childhood and adolescents, yet key points are opposite of my life ... so who knows.  Never had the diagnosis, but extended family had plenty of neurological issues (ALS, ET, PD, anger/grumpy, ...) - crap genes as they say.


But ADD/ADHD and all the rest of dopamine problems, can make life less enjoyable until you learn to work around or with the problem.  And if a med helps, then by all means.


Your description of Keppra is curious: more focused, less creative, flat-lining.  Levodopa usually increases focus, creativity but can agitate a little.  If overall Keppra helps then it good to take.  In muscle control, acetylcholine and dopamine work in opposites.  Just more sea/saw - push/pull stuff.  Besides focus, what else do you think Keppra helps?


You mention temporary worse again.  And this occurs from time to time in your posts.  Do you have ideas why?  To busy/active?  Sickness?  Exposure to triggers?

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I have diagnosed ADHD (combined type) and I also have a HPPD diagnosis.


And I think I some kind answer on the question "how to treat ADHD without making HPPD worse".

I'm currently on 54 mg of Concerta (methylphenidate), 1000 mg Keppra, 300 mg Wellbutrin per day. Will probably increase the Concerta and Keppra dose and remove Wellbutrin entirely soon, for optimal effects.

Since I began medicating with Concerta, I've had close to zero increase of HPPD symptoms. And it's thanks to Keppra! 

When I started Wellbutrin 3 years ago I hade a huge flare up of the symptoms which lasted for a week. I'm talking strong and colorful geometric patterns with open and closed eyes, neon shimmering color hue shiftings, distortion of space and shapes etc. Like a medium acid trip.. 

At that time I didn't have Keppra.


Wellbutrin is a DNRI and affects some parts of the brain,

Methylphenidate is also an DNRI, but it also increases synaptic firing and affects more brain regions, of those the nucleus accumbens region, the so called "reward" area of the brain. Methylphenidate therefore causes stronger effects.

The receptor binding profile of both meds is most on DA, somewhat on NE, and close to 0% binding at serotonin.


What the Keppra does is to "funnel" the increased electrical activity caused by the CNS stimulant to a more reasonable level, thus protecting the brain from overactivity. The mechanism of action of Keppra is unique and complicated, one thing that's really bizzare is how it selectively allows more GABA and SV2A to pass through the brain-blood barrier. Kind of like a weird selective MAOI exclusively for GABA and SV2A in a sense? More details here:




In short, you'll get the beneficial effects of Concerta on the ADHD, WITHOUT risking a severe increase in HPPD.

I would never ever take any kind of CNS stimulant without an anti-epileptic stabilizer, it would be risky in many ways..


So for a sucessful treatment, you should begin with Keppra, let it take a few months to find the right dose and get your body used to the substance. 

After that you can begin with the Methylphenidate (of which Concerta is the best preparation with longest and smoothest duration), and find the right dose on it.


Concerta has profoundly improved many ADHD symptoms. It has reduced the restlessness and aggression levels to a much more manageable level, thoughts are a lot more straight-lined (not a million thoughts at once!). I function a lot better in social situations, can wait my turn in a conversation and can express myself more coherent. Concentration and attention is really great now. I'm less nervous, more self-confident and a lot more harmonic and calm than ever before. Not many side effects to take note of either.

I stopped my polydrug abuse completely, I self medicated all my problems (ADHD, HPPD, DP/DR, anxiety etc.) with a cocktail of alcohol and benzos mostly.

I feel no need to use them anymore and have not drank a single drop of alcohol in months. The right meds can do a lot!


Keppra also has good effects by itself on the typical sleep problems of ADHD, brain wave intrusion during deep sleep (sleepwalking, toss & turn, waking frequently):




It also is good on restless legs, which is common with ADHD:




And of course HPPD:




Stabilizing effects in bipolar disorder combined with ADHD, could be interesting since the med combo is Methylphenidate and Keppra. If manic episodes can be completely supressed, it would easily supress HPPD increases as well I think?




When you have simultaneous ADHD and HPPD, it's crucial to have the right medication, which IMO is Concerta & Keppra together. Never Concerta alone though!

For me it was clear I needed medication, since my ADHD is so severe it has basically played the major role in ruining my life. Wish I would have gotten medicated earlier, my life would have taken a better turn I'm sure of.. Better late than never anyways!



Sorry for the incredibly long-winded explication of this subject, I hope it will be helpful for you, g29!

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Thank guys


415 STYLEE, Great to know how you are dealing with this problem! very useful information, thanks. Concerta is the same as Ritalin (They are both Methylphenidate), which is even reported to cause HPPD by its own. So basically, you say that it must be mixed with Keppa to avoid any damage. That's pretty interesting. Maybe I'll try that combo,


I tried Wellbutrin, but had to stop it after 5 days, because it made me break out with cystic acne. It didn't affected my visuals, it just made me very anxious.

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