From the Research
There is no established or FDA-approved dose of quetiapine specifically for Hallucinogen Persisting Perception Disorder (HPPD), and treatment should be individualized and supervised by a psychiatrist experienced with HPPD, with careful monitoring for side effects and potential worsening of perceptual disturbances. When considering treatment for HPPD, it's essential to prioritize the patient's quality of life, morbidity, and mortality. The most recent and highest quality study on HPPD, published in 2023 1, suggests that lamotrigine may be an effective treatment option for perceptual disturbances in HPPD. However, other studies, such as the one published in 2022 2, highlight the need for further research on the treatment of HPPD, and the use of quetiapine is not explicitly recommended. In clinical practice, quetiapine may be used off-label for HPPD, starting at a low dose of 25-50mg at bedtime and gradually increasing as needed and tolerated, potentially up to 300mg daily in divided doses, as suggested by earlier studies 3, 4. Other medications like clonazepam or lamotrigine may be preferred first-line options, and any medication trial should include careful monitoring for side effects, including sedation, metabolic changes, and potential worsening of perceptual disturbances. It's crucial to note that the diagnosis of HPPD should be made by ruling out other possible underlying causes, and treatment should be tailored to the individual patient's needs and response to medication, as highlighted in the case report published in 2025 5. Ultimately, the goal of treatment should be to improve the patient's quality of life, reduce morbidity, and minimize mortality, while carefully managing potential side effects and treatment complications. Key considerations in the treatment of HPPD include:
- Individualized treatment plans
- Careful monitoring for side effects and potential worsening of perceptual disturbances
- Supervision by a psychiatrist experienced with HPPD
- Consideration of alternative treatment options, such as lamotrigine or clonazepam
- Prioritization of the patient's quality of life, morbidity, and mortality.