BACKGROUND: Hallucinogen persisting perception disorder (HPPD) is a relatively unknown complication of ecstasy use. As a result, the diagnosis is often missed. The prevalence of HPPD is probably low. Few patients seek medical help; HPPD is however widely discussed by drug users on internet fora. CASE DESCRIPTION: We describe a 23-year-old male with HPPD after ecstasy use. Besides visual complaints, including seeing little spots ('visual snow'), the patient suffered from anxiety and depressive symptoms. We treated him with citalopram with good results. CONCLUSION: In patients with HPPD combined with anxiety or depressive complaints, citalopram could be a good treatment option. Further research into treatment is necessary.