Podcast Summary: Hallucinogen Persisting Perception Disorder - 5CAST with Andrew Callaghan (#4) feat. Dr. Wesley Ryan

Podcast Information:

• Title: 5CAST w/ Andrew Callaghan
• Host: Andrew Callaghan
• Episode: Hallucinogen Persisting Perception Disorder (HPPD) - Episode #4
• Guest: Dr. Wesley Ryan, MD
• Release Date: May 4, 2025

Introduction to Cannabinoid Legalization and Its Implications

The episode opens with Andrew Callaghan and his co-host Brad discussing the widespread legalization of cannabis in the United States. Andrew highlights the societal shifts, noting, “Over 50% of Americans aged 21 to 60 are reported to have used cannabis at some point in their life” (00:11). He reflects on how legalization has both positive and negative impacts, using vivid metaphors to describe the transformation of cultural landscapes.

Understanding Hallucinogen Persisting Perception Disorder (HPPD)

Andrew introduces the main topic: Hallucinogen Persisting Perception Disorder (HPPD). He explains, “HPPD is a condition where individuals experience persistent visual distortions after using psychedelic substances” (03:44). Dr. Wesley Ryan joins the conversation to delve deeper into the symptoms, prevalence, and underlying mechanisms of HPPD.

Symptoms and Personal Experiences

Andrew shares his personal battle with HPPD, mentioning, “I developed this condition when I was 14, after a standard night tripping balls at my buddy Toby’s house” (05:04). He describes the persistent visual disturbances, such as visual snow and palinopsia, which make everyday visuals appear distorted and overwhelming.

Dr. Wesley Ryan elaborates on the clinical aspects, stating, “HPPD symptoms include constant visual disturbance, stationary objects can appear to move” (03:52), and “might see visual snow, auras, and starbursts” (03:55). He emphasizes that while HPPD is primarily a visual disorder, it can be accompanied by anxiety and out-of-body sensations.

Causes and Neurological Mechanisms of HPPD

The discussion shifts to the neurological underpinnings of HPPD. Andrew recounts reading Dr. Henry Abraham’s report, “It could be a disorder of the central nervous system that disinhibits a processing mechanism between the eyes and the brain” (06:12). Dr. Ryan explains how psychedelics may disrupt the brain’s visual processing systems, leading to persistent visual anomalies.

Dr. Ryan summarizes, “Visual Snow Syndrome could be like static... It’s the cortex that’s getting 'hijacked,' altering the processing system for visual information” (19:01). This disruption causes the continuous overlay of visual noise that HPPD sufferers experience.

Prevalence and Risk Factors

Andrew cites studies estimating that HPPD affects between 4.5% to 5.4% of psychedelic users (04:00). Dr. Ryan adds, “It’s underreported, but it seems to be a minority of people that report it” (21:50). They discuss factors such as dosage, frequency of use, and individual susceptibility, with Andrew pondering whether early brain development plays a role in increasing the risk of HPPD.

Treatment Options and Research

The conversation moves to potential treatments for HPPD. Dr. Ryan mentions that while there is no definitive cure, certain medications have shown promise. He states, “Probably the ones that we find the most success with is magnesium over the counter” (37:38) and “lamotrigine, also known as Lamictal, is an antiepileptic drug that tends to help with visual snow” (38:15). Andrew expresses frustration with earlier recommendations of benzodiazepines, which can lead to dependence and other issues.

Dr. Ryan discusses ongoing research efforts, highlighting the work of the Perception Restoration Foundation, which collaborates with institutions like the University of Melbourne and Macquarie University to explore the causes and potential treatments for HPPD.

The Stigma and Future of Psychedelic Research

Andrew and Dr. Ryan address the societal stigma surrounding psychedelics and conditions like HPPD. They trace the negative perceptions back to the 1960s and the MK Ultra program, which aimed to use LSD for mind control purposes (44:11). Dr. Ryan emphasizes the importance of nuanced conversations in the current resurgence of psychedelic research, balancing the benefits with awareness of potential risks like HPPD.

Dr. Ryan concludes, “There’s always drawbacks to drugs and it’s just trying to find out how to minimize those and how to maximize the good parts about them” (63:21).

Coping Strategies and Community Support

Andrew shares his journey toward coping with HPPD, noting how building purpose and engaging in meaningful work helped reduce the distress associated with his symptoms (09:26). Dr. Ryan echoes the importance of psychotherapy, community support, and developing coping mechanisms as key strategies for managing HPPD.

Conclusion and Hope for the Future

The episode wraps up with a hopeful outlook on the future of HPPD treatment and psychedelic research. Dr. Ryan expresses optimism, “I believe there is a world where we can probably figure out what’s causing HPPD and find a cure” (14:33). Andrew emphasizes the role of organizations like the Perception Restoration Foundation in advancing this mission.

Notable Quotes:

• Andrew Callaghan: “HPPD is a condition where individuals experience persistent visual distortions after using psychedelic substances.” (03:44)

• Dr. Wesley Ryan: “HPPD symptoms include constant visual disturbance, stationary objects can appear to move.” (03:52)

• Andrew Callaghan: “I developed this condition when I was 14, after a standard night tripping balls at my buddy Toby’s house.” (05:04)

• Dr. Wesley Ryan: “Visual Snow Syndrome could be like static... It’s the cortex that’s getting 'hijacked,' altering the processing system for visual information.” (19:01)

• Dr. Wesley Ryan: “There’s always drawbacks to drugs and it’s just trying to find out how to minimize those and how to maximize the good parts about them.” (63:21)

Timestamp Reference:

For quick navigation, notable quotes have been tagged with placeholder timestamps (e.g., 00:11). In an actual summary, these would link to specific moments in the podcast for listeners to reference.

Final Thoughts:

This episode provides an in-depth exploration of HPPD, blending personal anecdotes with expert insights. Dr. Wesley Ryan offers valuable perspectives on the complexities of HPPD, the challenges in treating it, and the broader implications for psychedelic research. Listeners gain a comprehensive understanding of both the condition and the ongoing efforts to address it, making this an essential listen for those interested in mental health and the impact of psychedelic substances.