Not surprisingly, increased overall stress levels correlated with worsening of her symptoms. Neuropsychological testing As part of the initial psychiatric assessment, extensive neuropsychological profiling was undertaken (Table 1). Memory functions, attention span, visuo construction and frontal-executive functions were examined. No significant cognitive deficits were detected, except for underperformance in the test for phasic attention. With respect to her mental wellbeing, the patient’s Inhibitors,research,lifescience,medical self assessment indicated a light to medium depressive and anxiety disorder, most likely attributable to the chronic distress resulting from the abnormal perceptions. She had low self esteem, was emotionally

unstable and introverted. Table 1. Psychological tests. A repeat assessment 19 months later showed a continued improvement of her already normal to above average attention performance which was at odds with the patient’s subjective Inhibitors,research,lifescience,medical perception of diminished concentration faculties in everyday life. No change was observed in her mental state, with a persistent low to medium depression indicative of a dysthymic disorder Inhibitors,research,lifescience,medical (Beck Depression Inventory IV, Self-report Symptom Inventory 90 Items – Revised). Thus, the serotonergic antidepressants administered

during this period proved largely ineffective. However, the patient noticed a reduction in her anxiety and phobias that was also reflected in her psychological test scores. As for her personality, the patient’s self esteem deteriorated even further during the 18-month observation period whereas obsessive–compulsive and anti-social traits receded. Additional investigations Results from brain magnetic resonance imaging scans, median nerve somatosensory evoked potentials, Inhibitors,research,lifescience,medical electroencephalograms and visual evoked potential tests were all normal. Discussion HPPD as defined in DSM-IV-R is a post- hallucinogen intoxication disorder encompassing a range of mostly visual

perceptual disturbances that occur within a certain Inhibitors,research,lifescience,medical time frame after cessation of drug use. The definition PHA-665752 cost of this disease entity is entirely based on studies involving chronic LSD users [Abraham, 1982, 1983]. However, any additional psychopathological symptoms that may have occurred in this patient population were not given any consideration. Pharmacotherapy of this very distressing condition is limited and any recommendations are based DNA Damage inhibitor almost entirely on uncontrolled studies on small patient populations or even single case observations. Thus far, SSRIs, benzodiazepines, risperidone, olanzapine and naltrexone have all been tried with sometimes contradictory outcomes (Table 2). Table 2. Case reports on HPPD treatment. Here we present the case of a 33-year-old female former LSD user who displayed typical symptoms of HPPD over an extended period of time. Concomitantly, she developed a depressive and anxiety disorder.