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Long-term DPH effects survey
Answer as accurately and as honestly as possible. Rough estimates are fine for questions that ask for certain time periods.
Please do not participate in the survey if you have never taken DPH at a dose of
300mg or higher.
The purpose of this survey is to quantify the effects of high doses of DPH in the long term.
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* Indicates required question
What is your gender?
Male
Female
Prefer not to say
Other:
Clear selection
Do you have any
diagnosed medical conditions
or any family history of such conditions? Please list them if you do. Skip this question otherwise.
Your answer
Do you have any
professionally diagnosed
mental disorders? Check all that apply. Leave blank if you do not have any professionally diagnosed mental disorder.
ADHD/ADD
Autism spectrum disorder
Depersonalization/derealization disorder
Schizoaffective disorder
Bipolar disorder
Other:
Do you take any prescribed medication? Check all that apply. Leave blank if you do not take any prescribed medication.
Adderall
Antidepressants (Zoloft, Wellbutrin, Lexapro, etc.)
Benzodiazepines (Xanax, Klonopin, Valium, etc.)
Antipsychotics (Seroquel, Risperadol, Abilify, etc.)
Other:
Do you use any other psychoactive substances? Check all that apply. Leave blank if you do not use any other psychoactive substances.
Caffeine
Weed (Cannabis)
Nicotine
Kratom
Dextromethorphan
Nitrous oxide
Psilocybin mushrooms
LSD
DMT
Salvia
Methamphetamine
Cocaine
Any strong opiates (Heroin, Oxycodone, etc)
Other:
Do you use any nootropic substances? Check all that apply. Leave blank if you do not use nootropic substances.
Lion's Mane mushrooms
Huperzine A
Noopept
Alpha-GPC
Piracetam
Microdose psilocybin
Microdose LSD
Other:
Do you still use DPH, whether it be frequently or occasionally?
*
Yes, once or more per day.
Yes, once or more per week.
Yes, once or more per month.
Yes, once or more per year.
No, I have quit DPH completely.
How many times have you used DPH at a dose of
300mg or higher?
*
1
2 - 5
6 - 10
11 - 25
26 - 50
51 - 100
101 - 250
251 - 500
501 - 1000
1000+
What is the
highest
dose of DPH that you have ever taken?
Your answer
What doses do you/did you use
most frequently
on average?
*
100mg - 200mg ("fap dose")
200mg - 300mg
300mg - 500mg
500mg - 700mg
700mg - 900mg
900mg - 1,200mg
1,200mg - 1,500mg
1,500mg - 2,000mg
Other:
How long ago was your
first time
using DPH at a dose of
300mg or higher?
If you don't know try to give your best guess (i.e. 1 year ago, 3 months ago, etc.)
*
Your answer
How long ago was your
last time
taking a dose of
300mg or higher?
If you don't know try to give your best guess (i.e. 1 year ago, 3 months ago, etc.)
*
Your answer
Do you experience any of the following symptoms on a
regular basis
when you
are not
on DPH? Check all that apply. Leave blank if none apply. If you experience any symptoms not listed here, please enter them in "other."
Lack of appetite
Lack of libido
Muscle tremors
Difficulty moving, especially in hands
Short term memory loss
Long term memory loss
Short attention span/difficulty maintaining attention
Nausea/vomiting
Depression
Blurry vision
Organ pains
HPPD (Hallucinogen Persisting Perception Disorder)
DPH-like auditory hallucinations
DPH-like visual hallucinations
Difficulty speaking/articulating words
Difficulty writing or typing
Difficulty reading
Difficulty solving logical problems
Erectile dysfunction
Other:
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