I experienced a rather strong visual and spatial HPPD for over six months, as a result of MDMA-induced serotonin syndrome.
I researched MDMA quite a lot but was surprised how little is written about HPPD - regardless of the drug causing it!
What seems clear is that serotonergic drugs tend to cause it most often, with LSD producing the most well known and longest lasting visual alterations.
About 20% of people that take acid will report HPPD, often in the form of visual snow and halos.
As the months go by most will describe an improvement in these features, although color blindness may onset during this time.
I have spoken to more than one LSD user that claimed the snow started clearing up just as certain colors began looking identical.
And for some people this color blindness becomes permanent.
The vast majority do recover from other visual changes, and it is surprising to hear that most life-long HPPD victims do NOT have a problem with their new perception of life. They seem to accept it rather well and depression/anxiety is NOT a long-term issue at all.
I know one LSD user that used it in the 70s.
To this day he cannot read text on a monitor very easily.
But he never complains about it and he is rather successful as an ER nurse.
Ironically his daughter, who is now 21, took SEVEN hits in one night....about two years ago.
Her visuals took a year and a half to calm down, and she will very likely be color blind to blues and purples, maybe even greens.
But she still talks about LSD like she loves the shit!
Her dad is rather upset with the example he set...
I describe LSD because it really is the most likely cause of long-term visual HPPD.
It seems to target the visual cortex more powerfully than any other serotonin agonist or releasing agent.
After all, visual hallucinations are a leading feature of the acid trip experience.
I have some in my freezer and have never taken it!
Damned MDMA...
My point here is that you will very likely experience a near-complete restoration of normal vision.
And even if you don't, you will indeed accept it completely one day.
It will just fade into the background of normal life and your brain will begin to filter it out automatically.
But it may take a few years.
I am 17 months since my serotonin syndrome episode.
For the first 3-4 months I felt like a 90 year old man!
The entire world looked a little more distant, a little grey...like everything was behind a sheet of glass or playing on a screen.
I would have said that my eyes were 'set back in my skull'.
The visual cortex is a VERY complex brain structure, commanding a great deal of blood and glucose.
It is also exceedingly rich in serotonin receptors, which mediate blood flow directly.
A strong enough agonism of the 5HT-2a and 2c receptors will cause down-regulation.
With MDMA at least, there is a compensatory up regulation of 2b receptors in the visual cortex - but this requires substantial neurotoxicity.
Perhaps this is the brain trying to maintain bloodflow to the region.
Over time 2b is down-regulated, and hopefully some of the 2a and 2c receptors return.
But the truth is that very little research can be done on the cause of HPPD, because it is an experience that requires human description.
How can we know if a primate has HPPD?
And studying a human brain through PET scans using radioactive ligands is a very new science.
Doctors do NOT have information much less medication that can treat the re-organization of serotonin nerves in your visual cortex.
There is nothing they can do.
Piracetam might improve your vision, temporarily.
I remember colors becoming SO vivid and textures SO alive when I first started taking it!
The greyness would vanish from the world before my eyes.
And I was literally transformed in a matter of hours.
After two or three days of taking it, my vision would stabilize.
No longer did I experience wonder and surprise by what I was again able to see.
Rather I simply coasted...feeling and seeing normally.
But each time I stopped taking the stuff, my vision got worse again.
It took really coming off of the stuff for several months before my vision reached a bottom.
Then around month 7-8 I realized that I could live with the minor changes I had for the rest of my life.
Anxiety did not interact with my vision any longer, even when it was bad.
By 13 months I had days where my vision and my bodily sensation just peaked on its own.
Almost orgasmic...tingles, bright colors....eyes actually hurt at grocery stores!
But this would come and go, just like all other features of recovery.
Now I am considerably more stable emotionally, but I have suffered some cognitive decline since passing the 1 year mark.
And my vision still seems like an aged man's eyes have replaced mine - some days.
But sure enough, they seem to brighten up a little every few weeks.
So I am evidence that the visual cortical and serotonin connection is a constantly fluctuating relationship.
You cannot make ANY judgments about your long-term outcome until you have SPENT a long long period of time living with it.
By the way, serotonin is the 'serum' that 'tones' (or contracts) the smooth muscle surrounding the intestines.
Bile is a chemical cousin of serotonin and both are derived from dietary tryptophan, an amino acid found in protein.
Its primary purpose is to digest food.
But in the brain it represents the most dense and intricate of all neurotransmitter systems!
It has powerful effects upon micro-vasculature, glucose consumption, and dopamine inhibition...
Only time, and exercise, will make a difference.
I STRONGLY recommend against medication of any kind.
There is NO substitute for the re sprouting of receptors and axons in your serotonin system.
I cannot caution you enough - doctors don't know a DAMN thing about serotonin or HPPD.
Very sporadic benzo use is the only thing you should consider.
And any regular use will have real consequences.
If you are determined to medicate the problem, at least try the Piracetam and see what happens.
And don't forget my warning - any improvement on it is temporary.
Working out is your best bet because it sprouts new serotonin axons.
And it grows new capillaries.
So get to work, and don't stop.
No matter what happens to your vision, your anxiety will taper down.
Your brain will not allow it to be any other way.
There is considerable evidence that the worst long term cases of psychosis and depression are actually caused by the medications given to the patients!
The brain is a truly remarkable organ, so patience may reveal a great reward for you.
Do not interfere with the complex process going on in your mind.
Simply support it.
Take care of your intestines with proper diet.
And exercise every single day.
Good luck.