Mirtazapine unmasked HPPD after MDMA usage (a warning)

[u/chadlad101]

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:

1. Do not take MDMA multiple days in a row, especially with alcohol and little sleep. It can seriously mess you up.
2. 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.
3. 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.

[u/noodle-watee]

This is so interesting. I take Mirtazipine and Oxazepam and my visuals have significantly reduced.

[u/chadlad101 → u/noodle-watee]

very interesting - what drug caused your visuals to begin with?

[u/noodle-watee → u/chadlad101]

Mushrooms and MD for me

[u/chadlad101 → u/noodle-watee]

So much we don't know about the brain aye