Comment · Tue, April 9, 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
DownWithLucy · 2 points
Thank you, this is very interesting. I always thought that 5% MDA is below threshold with a normal MDMA dose, but 18% is entirely different and might explain some of the odd hallucinations that, now that I think about it, happened more frequently when the redose was larger.
u/MisterYouAreSoDumb
Yeah, re-dosing and body temperature can bring that level up to significant amounts. Since it's almost 100% correlated with 5-HT system damage, that is where my MDA theory came into light. I am 99% sure that MDA is the main cause of MDMA induced neurotoxicity. The O-methylated metabolites are still hepatotoxic, but cannot cross the blood brain barrier.
It also fits with the fact that MDA is much more neurotoxic than MDMA. It immediately gets metabolized by CYP2D6 and ring-hydroxylated, so it's damage is much worse. Whereas MDMA must first go through CYP3A4.