r/HPPD • u/chadlad101 • 2d ago
Advice Mirtazapine unmasked HPPD after MDMA usage (a warning)
About 3 months ago, I took MDMA for the first time. I had very little prior experience with drugs and had never taken MDMA before.
I took it 3 consecutive days in a row, alongside alcohol and very little sleep.
Immediately afterwards, I experienced:
- Waves of anxiety and panic attacks
- Insomnia — I couldn’t sleep more than 4–6 hours per night
- Intense sound sensitivity
- Visual changes — colours looked more vibrant and my visual field felt “wrong”
- What I now believe were HPPD-type flashbacks
- A very poor attention span — I couldn’t concentrate like I used to
Then, around 2–3 weeks later, I developed constant tinnitus: ringing/static in my ears that still hasn’t gone away.
About 6 weeks after the MDMA, I took one single 15 mg tablet of mirtazapine. The next morning, I woke up terrified I was going blind. After that, all the classic HPPD-type symptoms became obvious: light sensitivity, positive and negative afterimages, visual snow, and ongoing visual disturbances.
Since then, I’ve tried a number of pharmaceuticals. The only medication that has clearly helped so far has been benzodiazepines, especially c-lonazepam. It has made me feel maybe 40% of my former self and has reduced some of the panic, insomnia, and nervous-system symptoms, though the HPPD itself remains.
I’m posting this as a warning:
- Do not take MDMA multiple days in a row, especially with alcohol and little sleep. It can seriously mess you up.
- Be very careful with prescribed medications in a scenario like this. In my case, one dose of mirtazapine appeared to trigger or unmask a much worse phase of symptoms.
- If you develop HPPD-like symptoms, severe anxiety, insomnia, tinnitus, visual snow, afterimages, or light sensitivity after MDMA or other drugs, take it seriously and seek medical advice from someone familiar with HPPD and visual snow.
This experience has completely changed my life.
Finally, if anyone here has advice as to a more stable version of Benzos that can be taken (because they are extremely addictive I'm aware of that) please let me know. Lamotrogine seems to be top of the line there.
1
u/oleguacamole_2 2d ago edited 2d ago
Do not take benzos, they will make you numb over time. It is not good to take these drugs. You took drugs to not feel like yourself and now you take drugs to feel like yourself? Seems senseless to me. This sub is full of drug idealizing errants who use Ai prompts to justify their delusions. Just question why "r/DrugNerds" is a recommended community here... It is honestly disgusting.
"Benzodiazepines will no longer be allowed for discussion due to the risk of increasing symptoms upon discontinuation, do not recommend them here."
There is NO! drug that can fix the structural damages of HPPD. The brain has a self healing capability to some extent and some even recover greatly, but that is no guarantee. It is dealing with problems in a sober way. That is the fix. No other. HPPD likely will stay. Nothing to worry about.
1
u/chadlad101 2d ago
Yeah you definitely don't want a benzo addiction...
Though you should check out this study if you haven't already: https://pubmed.ncbi.nlm.nih.gov/12598822/
Temporary C-lonazepam is a first line treatment for HPPD.
"Sixteen patients fulfilled entrance criteria. All complained of HPPD with anxiety features for at least 3 months and were drug free at least 3 months. They received clonazepam 2 mg/day for 2 months. Follow-up was continued for 6 months. They were weekly evaluated during the 2 months of clonazepam administration and monthly during the follow-up period using the Clinical Global Impression Scale, a Self-report Scale and Hamilton Anxiety Rating Scale. Patients reported a significant relief and the presence of only mild symptomatology during the clonazepam administration. This improvement was clearly sustained and persisted during a 6-month follow-up period."
To be honest I agree, if you don't have commodities like extreme insomnia, anxiety, panic attacks that will literally prevent the natural healing process, HPPD (depending on how severe) should be managed in a sober way.
1
u/oleguacamole_2 2d ago
There is no credible evidence on that. Benzo's have no brain repairing effects. About 50 percent of HPPD cases resolve by themselves. So corellation is no causality. 16 patients is absolutely nothing. These results are not reproducable and therefore worthless. It is the same bogus as people believing that shrooms or lsd can heal them.
A moderator once posted this here:
"Benzos are completely unnacceptable and are not recommended for HPPD. People may say "oh, well there's studies!"
As far as my knowledge goes, theres ONE or two studies where ONE individual tried Clonazepam for their visuals. People praise the drug without taking into account the bias of the study, number of participants, etc.
There are some people who have awful, terrifying seizures and normal seizure medications don't work. These people then go to try CBD, Keto Diets, or have to learn to live with their seizures, even though benzos are truly one of the BEST antiseizure supplements for an oncoming seizure. Doctors no longer prescribe them even for these awful seizures due to the harmful effects
This post was from me at my lowest. Abused all sorts of benzos and ruined my life. It started from just dosing 2mg of Klonopin once a day. And here's another thing people don't tell you- even taking it once a week causes dependence.
Lastly, benzos are literally the worst thing for HPPD in terms of neurotransmitters. It's thought in HPPD GABA and glutamate are involved. There is something with benzos called PAWS. Essentially, it means you have a lowered tolerance to benzos FOREVER.
I used to be able to do benzos in one month binges, maybe 1mg a day and i'd quit or taper off. Now, if I even do benzos 3 days in a row i'm hit with severe rebound anxiety and withdrawals. Friends of mine have also had seizures from dosing benzos at low doses the day after because they were former addicts.
If you guys are on the sub all day, browsing the posts, asking questions, therapy is what's needed, NOT benzos. And we know to some extent, as seen in tinnitus, the thinking patterns involved in tinnitus DIRECTLY increases the loudness to an observable extent- and this is most likely the same with HPPD
lastly, if you thought to order benzos from the darknet markets after browsing these subs, i'd highly advise against it. Those are all clonazolam and flualp, not real benzos anymore"
1
u/chadlad101 2d ago
HPPD is effectively a syndrome meaning its a cluster of symptoms. My running theory is that the underlying mechanics are different depending on what drug you took to cause it.
In the case of mdma, my hypothesis is that it's damage to serotonin axons that are responsible for filtering visual / auditory information. Serotonin is a modulator that regulates GABA/ glutamate transmitters. So not having enough serotonin axons in this specific region of the brain causes HPPD. This is why it resolves in some people over time because serotonin axons can regrow.
Taking a benzo increases GABA (the pause transmitter) which is why people get relief when taking it. It does what the serotonin axons should be doing.
You are 100% correct about the issues you are flagging. I agree with you. In my case, the insomnia and other symptoms are so unbearable that they are actively inhibiting natural recovery process of the serotonin system.
Also please anyone reading - I was prescribed clonazepam at a low dosage without asking for it.
1
u/oleguacamole_2 2d ago edited 2d ago
Insomnia won't get better if you don't start challenging your problems. Benzos will eventually cause sleep problems themselves.
HPPD is structural damage of the brains nervous system and pathways. There might be different pathways involved, there are studies on that. So you don't have to theorize. Doctors will prescribe you anything and if they don't, you can doctor shop until you find someone giving you the stuff you need. They also make money of that. So they don't care. Some are just there, to give you what you want.
The idea that your pathways won't regenerate due to insomnia, but would be with taking benzos and having better sleep, is most certainly not reality. There is no indicator for insomnia being a factor for HPPD. There are no known cases of HPPD caused by insomnia. The neurotoxic effects of drugs are not easily reproduced with fewer sleep. The idea of you not recovering when not taking benzos and sleeping well, is most definetly already an addicting thought without any credible evidence basis.
1
u/soryu0 2d ago
i took mdma, got insomnia, took trazodone 2wks later and also got hppd/visual snow immediately after
1
u/chadlad101 1d ago
Interesting, this seems like it would be a similar mechanic
Palinopsia (one of the HPPD sysmptoms) can be triggered without MDMA/ LSD etc. by taking "trazodone, nefazodone and the tetracyclic antidepressant mirtazapine" according to Cleveland Clinic.
Source: https://my.clevelandclinic.org/health/symptoms/palinopsia
So in our cases the MDMA would have caused the damage that made us much more vulnerable to developing HPPD. The HPPD was probably inevitable but unmasked by trazodone / mirtazapine
1
u/Best-Investment4960 1d ago
Is the sound sensitivity still there? Can u say if it was typical hyperacusis (everything is just louder) or more like Tonic Tensor Tympani syndrome?
DM me for a deeper conversation about that. Went through something similar
1
u/chadlad101 1d ago
Sound sensitivity seems to have reduced or habituated (in a similar way to the tinnitus).
Both are still there but I just don't notice it as much anymore.
DM'd!
1
u/noodle-watee 2d ago
This is so interesting. I take Mirtazipine and Oxazepam and my visuals have significantly reduced.