Comment · Thu, December 20, 2012
Would micro-dosing MDMA on a daily basis be viable from a psychotherapy standpoint (anxiety, social lubrication, etc.) or does it's method of action and neurotoxicity prevent such use?
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Direct reply to the original post in this thread.
u/MisterYouAreSoDumb
This is a question that is hard to answer, given our current knowledge. There have been many anecdotes that small below-threshold doses of MDMA actually potentiate a full dose of MDMA. The mechanism for which is not understood. Hypercium (Saint John's Wort) also has been shown to up-regulate serotonin receptors, even though it's a mild SSRI and MAOI at higher doses. We are still not positive how it does this.
Could below-threshold doses of MDMA actually up-regulate 5-HT receptors? It's possible. However, I do not believe 5-HT down-regulation to be the primary cause of MDMA tolerance. Hypercium does little to potentiate an MDMA dose, even though it does up-regulate 5-HT receptors. NMDA receptor modulators have been shown to potentiate MDMA much more. This leads me to believe that tolerance is more closely related to glutamate excitotoxicity than to 5-HT system changes. Memantine has been shown to reverse MDMA tolerance, and NMDA modulators like piracetam potentiate MDMA's effects much more than drugs that work on the 5-HT system.
So is it possible that below-threshold doses of MDMA could be useful in various treatments? I think it's possible. However, I would not suggest it until we know more.