Comment · Mon, April 8, 2013
Man 'took 40,000 ecstasy tablets' - Doctors have revealed details of the biggest recorded user of ecstasy - a man estimated to have taken 40,000 ecstasy pills in his life.
What they were answering
Mentran · 14 points
Why no redosing?
u/MisterYouAreSoDumb
The metabolism characteristics of the drug mean that the first dose inhibits the main metabolic pathway, CYP2D6. This means that any subsequent doses are more likely to use the secondary metabolic pathway, CYP3A4. The CYP3A4 pathway N-demthylates MDMA to MDA. MDA is SIGNIFICANTLY more neurotoxic than MDMA, due to it's O-demethylated and ring-hydroxylated metabolites HHA and THA. Also, re-dosing leads to body temperature increases, which are closely correlated with 5-HT system damage.
Basically the re-dose is metabolized differently, and causes the toxic metabolites to be created in much higher amounts. Single dose MDMA should only lead to ~5% being metabolized to MDA. Multiple doses can lead to as much a 18% MDA. Body temperature is a key modulator of this effect.