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LSD-like panic from risperidone in post-LSD visual disorder

H D Abraham1, A Mamen

  • 1Department of Psychiatry, Tufts University School of Medicine, Boston, Massachusetts, USA.

Journal of Clinical Psychopharmacology
|June 1, 1996
PubMed
Summary
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Risperidone, an antipsychotic, may worsen symptoms in patients with hallucinogen-persisting perception disorder (HPPD). This condition involves LSD-like visual disturbances, and risperidone

Area of Science:

  • Neuroscience
  • Psychiatry
  • Pharmacology

Background:

  • Risperidone is a novel antipsychotic agent.
  • It functions as an antagonist of serotonin-2 and dopamine D2 receptors.
  • Hallucinogen-persisting perception disorder (HPPD) involves persistent visual disturbances after hallucinogen use.

Observation:

  • Lysergic acid diethylamide (LSD) exerts its hallucinogenic effects partly through serotonin-2 receptors.
  • Three patients with HPPD experienced an exacerbation of LSD-like panic and visual symptoms when treated with risperidone.

Findings:

  • Risperidone's antagonism of serotonin-2 receptors may contribute to the observed symptom exacerbation in HPPD patients.
  • This suggests a potential interaction between risperidone and the neurobiological underpinnings of HPPD.

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Implications:

  • Hallucinogen-persisting perception disorder (HPPD) could be a relative contraindication for prescribing risperidone.
  • Further research is warranted to understand the specific mechanisms and clinical implications of this interaction.
  • Clinicians should exercise caution when considering risperidone for patients with a history of hallucinogen use and persistent perceptual disturbances.