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Comment · Wed, March 6, 2013

Questions/discussion on MDMA neurotoxicity? Warning: long/controversial post

Original post in this thread

drpotatoe · 27 points

I’m curious, what is the definition of MDMA-induced neurotoxicity in layman’s terms? Is this damage permanent? Does neurotoxicity refer to complete neuronal death or just peripheral damage to the neuron?

Dr. Carhart-Harris wrote this in his AMA:

There's no known cell death with either drug (psilocybin vs. MDMA) but MDMA can damage serotonin cell fibres in large doses.

To clarify, I’m not looking for sources. I’m very aware of the underlying pharmacological science (MDMA metabolites are theorized to be neurotoxic). I own Ecstasy: The Complete Guide, I have B.S. in psychology (not pharmacology, but close enough), I participate in MAPS events, etc. etc., I’m just looking for a legitimate conversation on this topic between intellectuals aware of the science, without asking for sources. If we’re on this sub, we should be aware of the science, right?

What I’m about to say is controversial and will be attacked, but hear me out:

I believe that MDMA-induced neuroxicity is overhyped on reddit. Every pharmaceutical and recreational drug I am aware of is neurotoxic. Yes, I am aware of the animal/human studies conducted with MDMA that demonstrate (or do not demonstrate) the harms of…

What they were answering

drpotatoe · 2 points

This is awesome, thanks :) But I have a few questions:

1) Is MDMA itself neurotoxic, or is it a metabolite of MDMA that's the main cause of neurotoxicty? (I'm pretty sure I read on wikipedia that it was a metabolite).

2) Based on our knowledge of neurotoxicity, can we prevent or mitigate it with supplements or certain techniques (you don't have to link, I've seen your posts :))?

3) Although I completely agree with your concern about how fragile the serotonin system is, how come the behavioral side effects of MDMA are usually mild, if it's supposedly hitting such an important brain region? To clarify, I have read cases of MDMA induced sleep apnea (which is scary) and other weird case reports, but normally, it's mild memory problems that most people would brush away as insignificant. It'll probably take another 50 years to see the long-term health consequences, and I'll admit that the potential scares the shit out of me :O

4) Regarding what I commented below, do you believe that the psychoactive adulterants that are common in most molly and xtacy skew the human data so much that it almost can't be reliably correlated with pure MDMA used in a proper setting?

u/MisterYouAreSoDumb

Is MDMA itself neurotoxic, or is it a metabolite of MDMA that's the main cause of neurotoxicty? (I'm pretty sure I read on wikipedia that it was a metabolite).

Don't trust Wikipedia. That's the first rule of thumb.

It depends on the type of neurotoxicity you are speaking about. If you are referring to serotonin system damage, then yes, it's a metabolite to blame. The two I think are responsible for 90%+ are 2,5-Bis-(glutathion-S-yl)-alpha-methyldopamine and 2,4,5-trihydroxyamphetamine.

Based on our knowledge of neurotoxicity, can we prevent or mitigate it with supplements or certain techniques (you don't have to link, I've seen your posts :))?

Yes, you've read my posts. It can be done safely.

Although I completely agree with your concern about how fragile the serotonin system is, how come the behavioral side effects of MDMA are usually mild, if it's supposedly hitting such an important brain region?

If you call measurable memory issues, mood regulation issues, sleep issues, and structural changes to your hippocampus mild, then I think you need to step back and really think about it. These are measured in young people. Imagine what happens to those same people when they are 60, or even 80 years old!

it's mild memory problems that most people would brush away as insignificant.

Then I submit that those are not the type of people that value their brains. I for one do not want ANY damage to any of my neurological symptoms.

Regarding what I commented below, do you believe that the psychoactive adulterants that are common in most molly and xtacy skew the human data so much that it almost can't be reliably correlated with pure MDMA used in a proper setting?

No I do not. I did not work from the top down. I worked from the bottom up. I have researched the proven mechanisms for toxicity, then cross referenced that with human data regarding cognitive deficits. The mechanism exists, I promise you. I have left bias out of the equation. I in fact take MDMA. I am not an overzealous person set on proving toxicity to prove my point. I am only in it for the truth, to protect myself and others. MDMA can most definitely be neurotoxic, and show lasting cognitive deficits in human users. That damage can be mitigated by understanding the mechanisms that cause it.

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