09/24/2026
Prevalence-focused revision
The study is the largest retrospective cohort to date on hallucinogen persisting perception disorder (HPPD), using TriNetX electronic health records to compare 25,778 HPPD patients with population controls and psychedelic-using controls. Importantly, it does not provide a true general-population prevalence estimate for HPPD; the 25,778 figure is a clinical cohort count, not a population prevalence.
Prevalence of comorbid conditions before HPPD diagnosis:
· Depressive episodes: 29.2%
· Anxiety disorders: 26.2%
· Chronic pain: 15.9%
· Headache syndromes: 14.7%
· Post-viral fatigue: 12.3%
· Fibromyalgia: 6.7%
· ADHD: 6.6%
Anxiety and functional somatic syndromes were significantly more prevalent in HPPD patients than in psychedelic-using controls. Among psychedelic users, pre-existing anxiety (OR 1.5) and post-viral fatigue (OR 1.9) predicted later HPPD diagnosis.
After diagnosis, HPPD was associated with higher subsequent prevalence/risk of functional somatic syndromes (OR 2.0) and psychiatric disorders (OR 1.4) compared with psychedelic-using controls. Neurodegenerative disorders were recorded in 2.3% of HPPD patients vs. 1.2% of population controls.
Bottom line: In this clinical cohort, HPPD co-occurs with a high prevalence of anxiety, depression, pain, headache, fatigue, and functional somatic syndromes. However, because the study relies on EHR diagnoses and a selected clinical sample, the true prevalence of HPPD in the general population or among all psychedelic users remains unknown.
An that’s a problem…
Hallucinogen persisting perception disorder (HPPD) is characterised by episodes of altered perception linked to past psychoactive drug use, accompanied by distress and functional impairment. To date, clinical characterisation has been limited in scale. Using TriNetX, a global federated health resear...