Perampanel - possible treatment for HPPD/VSS?

[isness]

Perampanel - Wikipedia
Doesn't it make perfect sense to try a glutamate antagonist to treat HPPD or visual snow? It sounds like a lot of people on HPPDOnline, HPPD/Visual Snow subreddit think glutamate plays a big role in these disorders. I think it makes sense to look into AMPA antagonists since most NMDA antagonists have been explored. AMPA antagonists are somewhat new. There is one anecdote of someone 90% curing their HPPD with Perampanel. I'm really surprised no one has really looked into this any further.

A big reason this looks so appealing to me is because Piracetam is actually what gave me Visual Snow. Before Piracetam I only had some HPPD symptoms but not much static/snow. Piracetam is a modulator of the AMPA receptor. Piracetam has been known to worsen visual snow and have a strong effect on vision.

Another interesting tidbit. This similar drug (AMPA receptor antagonist) is known for effecting vision in a big way:
Fanapanel - Wikipedia
"side effects thought to be caused by blockade of AMPA receptors in the retina.[4] "

What if my AMPA receptors in my retina are on overdrive and just need to be turned off a bit? Am I possibly on to something? I think it would probably be hard to get Perampanel off label...

(1) A novel Medication which 90% cured my severe HPPD : HPPD (reddit.com)

Perampanel/Fycompa - a novel anti-epileptic drug that pretty much cured my HPPD. - Medications & Other Treatments - Hallucinogen Persisting Perception Disorder (HPPD) Support Forum (hppdonline.com)

https://www.hppdonline.com/topic/9154-ampa-hppd-and-treatment-options-some-glia-thrown-in-too/

/r/visualsnow/comments/pbicsh/study_from_2020_that_found_higher_levels_of/

 

[arrall]

I’m not sure if this would work, and the psychiatric side effects definitely do not seem worth it.
To the best of my knowledge, the only drug with evidence for treating VSS is lamotrigine.

 

[Neuroprotection]

Perampanel - Wikipedia
Doesn't it make perfect sense to try a glutamate antagonist to treat HPPD or visual snow? It sounds like a lot of people on HPPDOnline, HPPD/Visual Snow subreddit think glutamate plays a big role in these disorders. I think it makes sense to look into AMPA antagonists since most NMDA antagonists have been explored. AMPA antagonists are somewhat new. There is one anecdote of someone 90% curing their HPPD with Perampanel. I'm really surprised no one has really looked into this any further.

A big reason this looks so appealing to me is because Piracetam is actually what gave me Visual Snow. Before Piracetam I only had some HPPD symptoms but not much static/snow. Piracetam is a modulator of the AMPA receptor. Piracetam has been known to worsen visual snow and have a strong effect on vision.

Another interesting tidbit. This similar drug (AMPA receptor antagonist) is known for effecting vision in a big way:
Fanapanel - Wikipedia
"side effects thought to be caused by blockade of AMPA receptors in the retina.[4] "

What if my AMPA receptors in my retina are on overdrive and just need to be turned off a bit? Am I possibly on to something? I think it would probably be hard to get Perampanel off label...

(1) A novel Medication which 90% cured my severe HPPD : HPPD (reddit.com)

Perampanel/Fycompa - a novel anti-epileptic drug that pretty much cured my HPPD. - Medications & Other Treatments - Hallucinogen Persisting Perception Disorder (HPPD) Support Forum (hppdonline.com)

https://www.hppdonline.com/topic/9154-ampa-hppd-and-treatment-options-some-glia-thrown-in-too/

/r/visualsnow/comments/pbicsh/study_from_2020_that_found_higher_levels_of/

I definitely understand where you’re coming from and this is a drastic, but very logical approach. unfortunately, The true impact of AMPA receptor antagonism is not well understood in humans, yet on the other hand a whole host of psychiatric side-effects are known. nevertheless, I do still believe that AMPA Receptor antagonism, especially when achieved with shorter-acting drugs, that will hopefully be developed in the near future hold immense promise in treating a wide range of psychiatric and neurological disorders. AMPA receptor antagonists certainly show much better neuroprotective, anticonvulsant, anxiolytic and sedative/sleep promoting effects compared to the NMDA receptor antagonists. furthermore, whilst currently available AMPA antagonists, including the anti-epilepsy drugs perampanol and topiramate have occasionally been reported to trigger psychotic episodes or disconnection From reality, they only did so in vulnerable individuals and the effects were rapidly reversible. AMPA receptor antagonism presents some amazing therapeutic opportunities, however, research is still in its early stages and there are many side-effects, both known and unknown that come with this.

I would recommend you stick to trying lamotrigine after consulting with a qualified and trustworthy doctor. if that fails, maybe you could try a selective 5HT2A antagonist such as Pimavancerin. this is a drug initially developed to treat hallucinations in Parkinson’s disease, but if I remember correctly, it didn’t do that well in clinical trials because it targeted the wrong receptor. however, in HPP D and all the serotonergic psychedelic related disorders, this drug might perform much better. finally, if you can’t get hold of that, why not try short-term cyproheptadine, But be sure to only use this on days you intend to get a very early night and to sleep for a long time because it’s a very powerful sedative according to what I’ve read and heard. aside from being an extremely strong antihistamine (H1 antagonist), it also possesses strong antagonism at the 5HT2 serotonin receptor family, in particular 5HT2A and 5HT2C. By opposing the actions of psychedelics, these two drugs might reverse psychedelic related plasticity in the retina or visual cortex.

Hope this helps, please let me know how you’re getting on.

 

[isness]

I definitely understand where you’re coming from and this is a drastic, but very logical approach. unfortunately, The true impact of AMPA receptor antagonism is not well understood in humans, yet on the other hand a whole host of psychiatric side-effects are known. nevertheless, I do still believe that AMPA Receptor antagonism, especially when achieved with shorter-acting drugs, that will hopefully be developed in the near future hold immense promise in treating a wide range of psychiatric and neurological disorders. AMPA receptor antagonists certainly show much better neuroprotective, anticonvulsant, anxiolytic and sedative/sleep promoting effects compared to the NMDA receptor antagonists. furthermore, whilst currently available AMPA antagonists, including the anti-epilepsy drugs perampanol and topiramate have occasionally been reported to trigger psychotic episodes or disconnection From reality, they only did so in vulnerable individuals and the effects were rapidly reversible. AMPA receptor antagonism presents some amazing therapeutic opportunities, however, research is still in its early stages and there are many side-effects, both known and unknown that come with this.

I would recommend you stick to trying lamotrigine after consulting with a qualified and trustworthy doctor. if that fails, maybe you could try a selective 5HT2A antagonist such as Pimavancerin. this is a drug initially developed to treat hallucinations in Parkinson’s disease, but if I remember correctly, it didn’t do that well in clinical trials because it targeted the wrong receptor. however, in HPP D and all the serotonergic psychedelic related disorders, this drug might perform much better. finally, if you can’t get hold of that, why not try short-term cyproheptadine, But be sure to only use this on days you intend to get a very early night and to sleep for a long time because it’s a very powerful sedative according to what I’ve read and heard. aside from being an extremely strong antihistamine (H1 antagonist), it also possesses strong antagonism at the 5HT2 serotonin receptor family, in particular 5HT2A and 5HT2C. By opposing the actions of psychedelics, these two drugs might reverse psychedelic related plasticity in the retina or visual cortex.

Hope this helps, please let me know how you’re getting on.

This is really helpful. Thank you. Im looking into Pimavancerin and it seems amazing, its just expensive. I hope that price comes down sometime soon. I'm curious why its not targeted towards people with schizophrenia? Would it not help them? Is cyproheptadine the second most selective 5ht2a antagonist? There is just so many other actions going on I think even D2 antagonism.

 

[Neuroprotection]

This is really helpful. Thank you. Im looking into Pimavancerin and it seems amazing, its just expensive. I hope that price comes down sometime soon. I'm curious why its not targeted towards people with schizophrenia? Would it not help them? Is cyproheptadine the second most selective 5ht2a antagonist? There is just so many other actions going on I think even D2 antagonism.

You’re welcome, nice to know my advice has helped someone. regarding 5HT2A antagonists, I believe several others are available, including ketancerin though I think it is slightly less selective and has affinity for other serotonin receptors. however, I believe it has been tested on humans and can block the effects of psychedelics like LSD if administered beforehand. maybe if it’s cheaper, it would be worth trying it.
Regarding cyproheptadine, yes, it has a reputation for being a so-called dirty drug, meaning it binds to many receptors and possibly complicating its pharmacology. however, this drug has been known for many years and its main effects are strong antihistamine, Antiserotonergic(In particular 5HT2A and 2C) and mild anticholinergic. though I wouldn’t recommend using cyproheptadine regularly, I wonder if trying it out could be a cheap and effective proof of concept. this means, if cyproheptadine works for you, it is highly likely that the antiserotonergic effect is involved in which case, it may be worth spending money and pursuing the more selective 5HT2A antagonists.
Personally, I would recommend against antidepressants like mirtazapine or myancerin which are quite potent 5HT2A antagonists. This is because they have an extremely dirty pharmacology which unfortunately involves Alpha2 adrenergic antagonism along with powerful antihistamine effects. this produces contradictory effects, A combination of sedation/confusion with anxiety and stimulation. on the other hand, the main effects produced by cyproheptadine and the receptors it blocks produces complementary effects In my opinion. for example, the strong antihistamine effect of cyproheptadine is therapeutic for promoting sleep/Fighting against wakefulness and suppressing anxiety, whilst its 5HT2A antagonism promotes the onset and maintenance of deep sleep while simultaneously producing anxiolytic, Calming and fear suppression effects. finally, the mild but significant and admittedly unwanted anticholinergic affect of cyproheptadine at least compliments the sedative and anti allergic affects.

Please do let me know how you get on, and if you choose to try any of my suggestions or any others you may come up with.

I wish you all the best with your recovery.

 

[MorningStarN1]

Perampanel - Wikipedia
Doesn't it make perfect sense to try a glutamate antagonist to treat HPPD or visual snow? It sounds like a lot of people on HPPDOnline, HPPD/Visual Snow subreddit think glutamate plays a big role in these disorders. I think it makes sense to look into AMPA antagonists since most NMDA antagonists have been explored. AMPA antagonists are somewhat new. There is one anecdote of someone 90% curing their HPPD with Perampanel. I'm really surprised no one has really looked into this any further.

A big reason this looks so appealing to me is because Piracetam is actually what gave me Visual Snow. Before Piracetam I only had some HPPD symptoms but not much static/snow. Piracetam is a modulator of the AMPA receptor. Piracetam has been known to worsen visual snow and have a strong effect on vision.

Another interesting tidbit. This similar drug (AMPA receptor antagonist) is known for effecting vision in a big way:
Fanapanel - Wikipedia
"side effects thought to be caused by blockade of AMPA receptors in the retina.[4] "

What if my AMPA receptors in my retina are on overdrive and just need to be turned off a bit? Am I possibly on to something? I think it would probably be hard to get Perampanel off label...

(1) A novel Medication which 90% cured my severe HPPD : HPPD (reddit.com)

Perampanel/Fycompa - a novel anti-epileptic drug that pretty much cured my HPPD. - Medications & Other Treatments - Hallucinogen Persisting Perception Disorder (HPPD) Support Forum (hppdonline.com)

https://www.hppdonline.com/topic/9154-ampa-hppd-and-treatment-options-some-glia-thrown-in-too/

/r/visualsnow/comments/pbicsh/study_from_2020_that_found_higher_levels_of/

Fycompa is probably coming soon to Brazilian market. I'll give it a try. I can get any medication without a prescription so I'm open to try anything to get rid of the damn visual snow. I was 11 or 12 when it manifested and I'm 34 now. I learned to live with it. Any other suggestions for N=1? I'm ok to try anything.

 

[isness]

Fycompa is probably coming soon to Brazilian market. I'll give it a try. I can get any medication without a prescription so I'm open to try anything to get rid of the damn visual snow. I was 11 or 12 when it manifested and I'm 34 now. I learned to live with it. Any other suggestions for N=1? I'm ok to try anything.

I haven't been able to find perampanel on the dark web.

The three drugs on the top of my list are that and pimavanserin and tetrabenazine

 

[MorningStarN1]

Those 2 are not available in Brazil too. I can get my hands on any available medication on Brazilian market. If those three are available in India perhaps it worths a trip to India, there almost any drug is OTC.

 

[isness]

Those 2 are not available in Brazil too. I can get my hands on any available medication on Brazilian market. If those three are available in India perhaps it worths a trip to India, there almost any drug is OTC.

What do you mean not available "in Brazil"? Your pharmacy can order it. They'll obviously ship it over seas.

 

[MorningStarN1]

What do you mean not available "in Brazil"? Your pharmacy can order it. They'll obviously ship it over seas.

My family has 2 pharmacies. Brazilian customs do not allow any medication to be shipped without ANVISA( local FDA) authorization which I obviously can't get.

 

[isness]

My family has 2 pharmacies. Brazilian customs do not allow any medication to be shipped without ANVISA( local FDA) authorization which I obviously can't get.

One of those Two pharmacies will order it for you if you get a prescription.