I guess all of this is caused by anxiety...
HI there, a short answer for those who won't be reading too far - the brain is extremely neuroplastic, constantly wiring and re-wiring, and can develop and recover from these symptoms without any drugs ever being involved. I had a lot of visual disturbances similar to HPPD since I was a kid. I think many people here have primarily HPPD, and should probably cast aside that it came from a certain drug at all. The important thing is to influence our brain's neuroplasticity in a desirable fashion, and there are a ton of different things that can do that.
The most effective way in my opinion is mindfulness practice.
We know that these syndromes can happen in people with no history of drug use, and we also know that they happen from taking drugs with extremely different mechanisms of action from MDMA/substituted amphetamines, drugs like psychedelics, dissosociatives, other monoamine releasers like cocaine, and even Benadryl. So I certainly wouldn't chalk it up to "serotonin neurotoxicity" - I think that belief leads to a lot of anxiety that perpetuates the symptoms.
That isn't to say that what is going on isn't biological in nature, but anxiety
is biological in nature. The brain is extremely neuroplastic, constantly wiring and re-wiring. Trimming old connections and growing new ones. The trick to recovery is to influence this process in a way that results in a happy, healthy brain. All brains are neuroplastic. Hell, there is a paper showing an increase in brain volume and reduction in insomnia in elderly patients after just
8 weeks of mindfulness meditation practice. Don't even get me started on the reactive re-sprouting of serotonin neurons after they've been experimentally damaged in animals whose brains are much less neuroplastic than humans.
There are kids who have had half of their brains removed when they are young because there is epilepsy selectively on that side. Some of these people, you wouldn't even know that they were missing almost half their brain. That's the power of neuroplasticity. But the tendency towards negative thoughts, anxiety and insomnia, that is slowing down the neuroplastic processes from fixing the brain.
As far as a theory for these syndromes.. Some people might have a temporary serotonin signaling shortage after serotonin receptors are temporarily desensitized (a natural process when serotonin signaling increases), and some neuroplastic changes might occur during that shortage, and that shortage would at most last only a month or two. Some people may be more resistant to developing that serotonin shortage in the first place, or they may not be affected by that serotonin shortage as much. Sleep is really important for serotonin recovery, and genes can effect how well a person sleeps when someone does have this temporary serotonin shortage.
See dietary tryptophan depletion exacerbating depression symptoms selectively in people with two short forms of a serotonin related gene called 5-HTTLPR. It is known that people with one or two short forms at the 5-HTTLPR are more vulnerable to the negative effects of serotonin depletion via depletion of the dietary precursor (protein) tryptophan, the adverse effects of MDMA use, and the adverse effects of cocaine use (cocaine once again, not neurotoxic).
If anyone here has insomnia - I suggest focusing on treating that in particular. It took me several months of mindfulness practice to gain any proficiency, then once I started sleeping better and applying mindfulness meditation throughout the day, it was an upward spiral. Years later and I still have so much to learn. There are many similar stories of miracle recovery with mindfulness. I know it seems that things like this could not possible be helped with a "psychological" technique, and back when I could barely understand basic sentences and had physical symptoms, and horrible visual symptoms I probably would've told you to go screw yourselves if you told me it wasn't "permanent brain damage", but mindfulness has potent biological effects. Even Cognitive Behavioral Therapy can cause all sorts of changes in brain volume of different brain regions.
Mindfulness, mindfulness, mindfulness. I suggest you all throw yourselves into it wholeheartedly, and understand that it's similar to exercise. I think I made the mistake of expecting to be buff after 3 months of working out, if you will. You can see reports of things like chronic treatment resistant cases of HPPD that miraculously resolve with a certain med (
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3736944/ - spontaneous recovery of 13 year treatment resistant HPPD in an architect upon treatment with Lamotrigine), but I don't think those silver bullets are the ones worth chasing. I'd much rather see you guys work out and exercise than use steroids, if you will. Even if exercise is harder and takes longer, you will come back stronger.
Some people recover so well with mindfulness that they are happier than they ever were, and return to using all sorts of drugs, including MDMA regularly. Not that I recommend that
