5-Methoxy-N,N-Diisopropyltryptamine-Induced Flashbacks

Mr. A, a 35-year-old Japanese man without a previous psychiatric history, was seen with perceptual disturbances. One month before his evaluation, he had stopped using 5-MeO-DIPT because of a so-called bad trip—anxiety, palpitations, auditory oversensitiveness, and visual distortion—after six or seven times using between 15 mg and 30 mg of 5-MeO-DIPT over 5 months. He was bisexual and had used the drug to enhance intercourse with a male partner. A few days before his evaluation, after the announcement of his father’s diagnosis of a brain tumor, his 5-MeO-DIPT-induced phenomena of a “bad trip” returned, although he had not taken 5-MeO-DIPT.

There was no evidence of CNS infection or organic brain disease. Amphetamine was not detected in Mr. A’s urine. He was not clinically depressed. Schizophrenia-like symptoms, such as delusions or auditory hallucinations, were not present. He was given oral risperidone, 1 mg/day. Within 3 days, his perceptual disturbances remarkably decreased, and 7 days later, they had almost completely disappeared. Given his clinical features and history of drug ingestion, we made a diagnosis of hallucinogen-persisting perception disorder induced by 5-MeO-DIPT. Mr. A was discharged 1 month later. Although this medication was maintained for 4 months and then terminated, he has had no relapse.