From the Research
Quetiapine is not specifically recommended for HPPD (Hallucinogen Persisting Perception Disorder) and may potentially worsen anxiety or cause panic attacks in some individuals due to its complex effects on neurotransmitters. The use of quetiapine in anxiety disorders, such as generalized anxiety disorder, has been studied, and it has been found to be efficacious in reducing symptoms, but its tolerability is a concern, with common side effects including sedation and fatigue 1, 2. However, for HPPD, the evidence is not sufficient to support its use, and other alternatives may be more beneficial. Better alternatives for HPPD management include:
- lamotrigine (starting at 25mg daily, gradually increasing to 200-400mg daily), which has shown some benefit by modulating glutamate activity
- clonazepam (0.5-2mg daily), which can reduce visual symptoms and anxiety through GABA enhancement
- Selective serotonin reuptake inhibitors (SSRIs) like sertraline (50-200mg daily) may help with accompanying anxiety or depression, though some patients report mixed results Non-medication approaches are also important, including:
- avoiding all recreational drugs (including cannabis and alcohol)
- practicing stress reduction techniques
- cognitive behavioral therapy to address anxiety related to symptoms Treatment for HPPD often requires individualized approaches, as response varies significantly between patients, and should always be supervised by a healthcare provider familiar with this condition. The most recent and highest quality study on the topic of atypical antipsychotics in anxiety disorders, including quetiapine, was published in 2014 2, and it highlights the need for careful consideration of the risks and benefits of these medications in the treatment of anxiety disorders.