2g of MDMA = still dizzy 2.5 years on (brain damage?)

[jonj3]

Hi all,

So, 2.5 years ago I did a very stupid thing (with no understanding at the time of how stupid it was…)

As way of background, I’m not a big MDMA user. I had previously taken it 5 or 6 times over several years, in very low doses, when given by friends on a night out.

For some bizarre reason, when heading away for a long weekend with friends, I decided buy 2 grams to take with me. It was a particularly stressful time at work and it was a crazy moment of madness.

I took 1g on the first night (split in approximately 1/6ths, over about 5 hours).

I took the 2nd gram on the second night (split in approximately 1/6ths, over about 3 hours).

Essentially all 2 grams were consumed within 35 hours or so.

The crystals were light brown in colour. I didn’t test it (I didn’t even know testing was possible).

Granted, I have no idea what they were cut with and what the MDMA concentration was, etc.

When I woke after the 2nd night out, I was extremely ill. So ill, that I had to leave and travel home.

When I got home, I laid flat on the sofa for days. I felt like I had lost my mind.

Every time I tried to stand, I was so dizzy that I had to lay back down again.

My brain was seriously overloaded - from both the terrible come down and all the dizzy signals it was receiving. I thought I had seriously damaged my brain (and still think that is likely which is the reason for asking your advice please).

Over the next few days, I heard squelching in my head. So loud that it even woke me several times during the night. (I have since learnt that this might be an inner ear issue/damage).

Over the next 30 days, the dizziness slowly subsided to around 10-15% of what it was. I have now been at this level of dizziness & confusion ever since.

Every 2-3 months, I have a re-occurrence of elevated levels of dizziness and confusion. One of the episodes has been up to approximately 2/3rds of the first incident. A couple have been 1/3rd of the intensity.

Life has become very hard for me over these last couple of years. Luckily I freelance remotely, which has helped me recover slowly at a distance, but I have plateaued and am not getting better than the ’10-15%’ level of dizziness/confusion.

I avoid social situations where I don’t know people. I especially avoid loud and crowed situations where at all possible.

My brain feels like it can no longer process information at the same rate. Either from brain damage/reduced cognitive function, or overload from dizzy brain signals, or both. This is especially noticeable when I meet colleagues face-to-face and am just not able to keep up with conversations I would have been fine with in the past.

I get tired very quickly. When I do need to be in stressful situations, I can only last for 2 or 3 hours, and then being unable to accomplish anything else for the rest of the day.

Life this last couple of years has just been ‘surviving’.

I have improved my lifestyle a reasonable amount. I gave up smoking almost immediately after the incident. I eat more healthy food. Exercise more than before (although not enough), etc.

Probably very irresponsibly, I find alcohol actually helps in the evening (e.g. a beer or two). It helps take the edge off it. My brain knows dizziness is associated with being drunk and so it treats the situation as ‘normal’. Of course, I don’t abuse this situation at all for fear of anything getting worse…

I had been working on the assumption that it was hopefully just an inner ear / balance issue, as if I sit down and concentrate on things (like writing this email) I still feel like I haven’t ‘lost it all’. However after meeting with various specialist dizziness consultants, had an MRI, had a full suite of balance tests, blood tests, etc they have drawn a blank.

Following reading some of the long-term brain damaging effects of MDMA on here and other good resourses (particularly large & sequential doses) I am now back to the more worrying conclusion that it is likely something brain related and more serious.

Given this is likely the case, what would you recommend I do please?

As such a length of time has passed since the incident (2.5 years) will any recovery have likely plateaued?

What can I do to either aid recovery further? Or help the symptoms (permanent low-level dizziness)?

Will the various supplements and / or enhancers people talk about have any effect this late on?

What type of specialist (neuro?) doctor could I go and see? I fear going to see a generic Neuro consultant will likely draw more blanks. I feel like they need to be specialists in an MDMA/other drug over-doses, but I can’t find anyone locally (I’m based in London, UK). Can anyone recommend anyone who is familiar with these situations please?

Would any treatments (e.g. neurofeedback) be worth trying?

Are there likely any prescription drugs which would help?

Sorry for all the questions. Any advice would be very much appreciated please.

Also please don’t worry about hitting me with worrying/unsettling facts. I feel that a proper understanding is better to try and beat this.

I of course understand the complete stupidity of what I did, and have regretted it every day since then.

Yours

Jon

 

[Nambo]

Welcome Jon. My personal view is that it is some sort of brain damage. I think with time there will be some sort of 'recovery' and generally an adaptation to your new reality. 2.5 years in I'm sure that adaptation is starting to entrench itself. Obviously healthy living can only be beneficial but will it help to return you to your previous state, who knows. If there is a bright side to this you could have a plethora of other horrific symptoms so in a way you are lucky that this is all you have based on the amount you consumed. I know one is looking for the magic answer / remedy but in reality I don't believe it exists. A very sensitive area of the brain has been subjected to an large dose of an unknown and undoubtedly toxic substance. How it has rewired itself or been altered / damaged is truly anyone's guess.

 

[Jabberwocky]

Following reading some of the long-term brain damaging effects of MDMA on here and other good resourses (particularly large & sequential doses) I am now back to the more worrying conclusion that it is likely something brain related and more serious.

Jon

Jon, there is ZERO evidence of brain damage in humans from MDMA -- possibly altered serotonergic function? yes -- actual brain damage? no.

Considering your large dose, there is a possibility that some sort of axonal changes occurred due to your substance use.

Google HPA axis dysregulation.

 

[cyberius]

Welcome Jon. My personal view is that it is some sort of brain damage. I think with time there will be some sort of 'recovery' and generally an adaptation to your new reality. 2.5 years in I'm sure that adaptation is starting to entrench itself. Obviously healthy living can only be beneficial but will it help to return you to your previous state, who knows. If there is a bright side to this you could have a plethora of other horrific symptoms so in a way you are lucky that this is all you have based on the amount you consumed. I know one is looking for the magic answer / remedy but in reality I don't believe it exists. A very sensitive area of the brain has been subjected to an large dose of an unknown and undoubtedly toxic substance. How it has rewired itself or been altered / damaged is truly anyone's guess.

These dark and useless posts have no place here, and I discourage posting anything like this in the future.

Look into supplementation to increase serotonin levels, this should be done before everything else as it can provide immediate relief. I use St Johns Wort, and I can vouch for it working to alleviate serotonin related ailments.

Seek medical attention, from a psychologist. They can refer you to a neurologist or other specialists. In very few cases of mdma abuse the damage is permenant, but in many, professional intervention is necessary. You've knocked off the equilibrium of your neurochemicals and there's no way anybody can tell you what damage has been done here.

 

[Cotcha Yankinov]

Three general causes of dizziness upon standing that I would examine are

1. Issues of cardiovascular function (chronic deconditioning)
2. Issues of neurological regulation of blood pressure (orthostatic intolerance/postural orthostatic tachycardia syndrome, aka POTS)
3. Musculoskeletal compression of arteries (the anterior neck muscles, especially scalenes/SCM, are known to compress the relevant arteries which not only supply the brain but also express the baroreceptors responsible for maintaining blood pressure)

In the first category, its prudent to mention that amphetamines/stress are a well known cause of chronic deconditioning, which manifests primarily as orthostatic hypotension (low blood pressure upon standing, although hypotension can of course extend to sitting and laying down). I personally have had issues with low blood pressure since using too much ecstasy that have vastly improved with conditioning, but it took much more than just a couple months of cardio 3 times a week and I still have a ways to go. For a while it was so severe I would get incredibly lightheaded just going from laying down to sitting up. I've got fake front teeth from passing out Standing and sitting was very difficult.. Unfortunately that meant that I was horizontal most of the time, and this meant I was just getting more and more deconditioned.

So what may have at first been hypotension due to other causes (due to acute effects of a drug/experience) could now be primarily cardiovascular insufficiency/deconditioning. The other thing to consider if money is not an issue would be issues of the heart that could be ruled out with an echocardiogram (have you had an echocardiogram?).

Issues with neurological regulation of blood pressure can also be examined, autonomic testing can be pursued to rule out something like POTS. The University of Washington offers autonomic testing for example, and they might be able to point you in the direction of autonomic testing closer to home. Both me and my sister have had blood pressure issues after bunk ecstasy but its not quite clear whether or not we have autonomic issues - my sister may have some autonomic dysfunction (not quite POTS but more towards orthostatic intolerance) while the UW thought that my dysfunction could be "mild or early", although when my doctor interpreted the results, she was under the impression that it was just severe deconditioning.

Needless to say, the treatment for orthostatic intolerance is aerobic conditioning, which can put it into remission. So regardless of whether you have chronic deconditioning or issues with autonomic function (or both), cardio is your best bet. Get yourself some whey protein and make sure you're eating enough carbs/protein before cardio, and eat a lot of protein after cardio so you can get the maximum benefit from whatever effort you put forth. If you can only do 5-10 minutes of light jogging - that's just dandy. It was like that for a long time for myself until I worked myself up to above 20 minutes.

The final thing to consider is musculoskeletal compression of the arteries. I would find stretches for the anterior scalene, sternocleidomastoid and medial scalene on youtube, and see if doing any of the various stretches makes you dizzy. You could pursue massage and myofascial release of the muscles in addition to botox of the scalenes, which often provides great relief of headaches if you have headaches as well. There have been case reports of people fainting just from tilting their head to the side and increased issues with low blood pressure/headaches after cardio due to excessive activation of the scalenes. The scalenes are assisted inhalation muscles, meaning that they generally kick in when breathing through the chest forcefully (anxiety breathing). I wouldn't be surprised if some people get excess scalene tone from a stressful drug experience. I've definitely had loads of fun with the anterior neck.

The baroreceptors located in the arteries of the neck are finicky, it would be a good idea to make sure your anterior neck is sorted out, especially if you have forward head posture.


My questions are

1. Do you have headaches or otherwise musculoskeletal/spine pain? Any issues with your facial muscles or neuropathy, pins and needles in the hands etc?
2. Have you had an echocardiogram?
3. Do you have panic attacks wherein you breathe rapidly and get pins and needles all over?

Hang in there, I had really bad low blood pressure for a couple years before I really stuck with a cardio regimen long enough with appropriate diet to make a difference. It definitely wasn't just like "10 cardio sessions and then back to normal".

 

[Nambo]

Actually Cyberius is right. There is nothing wrong with you mate. You are totally fine, take some supplements and speak to a psychologist. It's all in your head, you'll be right and dandy.

 

[ADubbs]

Yeah its damage... Hate to be a dick but it's the truth. Not much you can do but treat the symptoms and try and keep a positive outlook....Which I'm failing at.

 

[Cotcha Yankinov]

Woah woah woah guys, no need to catastrophize to "damage" as an explanation just yet, it could be something as simple as the arteries in the neck which express baroreceptors that signal dizziness are getting compressed and cranky.

I'm still not quite clear on what exactly the OP means by dizziness, if he/she does imply some level of hypotension (if not measured as hypotension in the periphery it could still be compression of arteries that run to the brain) and then accompanying issues or if they are just talking about the feeling of dizziness you would get after spinning around.

I'd like to hear if they OP has any problems with anything in the dyslexia spectrum, issues with mixing up letters and words, numbers (positive and negative), or left and right. There is a vestibular theory of dyslexia, wherein inner ear issues -> dizziness and then the cognitive fallouts develop when people have a hard time with balance and focusing vision. Some people could be more vulnerable than others to the neurological component that develops after inner ear dysfunction/dizziness.

And I believe the OP has mentioned inner ear issues, "Over the next few days, I heard squelching in my head. So loud that it even woke me several times during the night. (I have since learnt that this might be an inner ear issue/damage)."

 

[Jabberwocky]

In very few cases of mdma abuse the damage is permenant, .

I'd like to see evidence for this statement.

(hint: there is none, it's pure speculation)

 

[Cotcha Yankinov]

I don't think Cyberius is meaning "damage" as "conclusive objective evidence of neuronal injury" etc

 

[Nambo]

I'd like to see evidence for this statement.

(hint: there is none, it's pure speculation)

Well that's a relief. I am feeling totally better now.

 

[Jabberwocky]

I don't think Cyberius is meaning "damage" as "conclusive objective evidence of neuronal injury" etc

Well then he shouldn't post a statement that says there is.

 

[socrilus]

I don't get why people argue over the word "damage" so much tbh.

Even if its not damage there are still changes that occured otherwise how would you even be feeling the LTC in the first place. If you felt normal how would the thought of "damage" even come up to begin with??? Thats the flaw I find with the psychological theory that its all in ones head. I agree with cotcha that there is a middle ground. Something has happened after all (whether or not its strict damage) to cause the psych changes right?

@Shugenja

I see you mention HPA dysregulation a lot. Even if it is recoverable how come you don't consider this at the very least an injury of some sort? And then the gene theories Cotcha mentions aren't they in some way connected to HPA axis in the first place?

 

[Jabberwocky]

Even if its not damage there are still changes that occured otherwise how would you even be feeling the LTC in the first place.
@Shugenja

I see you mention HPA dysregulation a lot. Even if it is recoverable how come you don't consider this at the very least an injury of some sort? And then the gene theories Cotcha mentions aren't they in some way connected to HPA axis in the first place?

Mood disorders are known to be inherited. -- It is more likely it is a mood disorder than somehting that happened from MDMA. (FYI -- about 1 MILLION pills are dropped per week in the UK alone (500,000 -2,000,000)) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2631647/

Mood disorders are a bitch.

I claim that the overwhelming majority of LTC is unknown or UNDISCLOSED mood disorders (anxiety, depression, bi-polar disease)


@ socrilus

would you consider hyponatremia an injury or an electrolyte imbalance?

HPA dysregulation is just that -- DYSREGULATION -- not a morphological or structural injury

 

[socrilus]

Mood disorders are known to be inherited. -- It is more likely it is a mood disorder than somehting that happened from MDMA. (FYI -- about 1 MILLION pills are dropped per week in the UK alone (500,000 -2,000,000)) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2631647/

Mood disorders are a bitch.

I claim that the overwhelming majority of LTC is unknown or UNDISCLOSED mood disorders (anxiety, depression, bi-polar disease)


@ socrilus

would you consider hyponatremia an injury or an electrolyte imbalance?

HPA dysregulation is just that -- DYSREGULATION -- not a morphological or structural injury

Ok fine call it whatever but either way isn't it still an adverse effect? I'm not saying its some permanant damage thing.

 

[Cotcha Yankinov]

Mood disorders are known to be inherited. -- It is more likely it is a mood disorder than somehting that happened from MDMA.
I claim that the overwhelming majority of LTC is unknown or UNDISCLOSED mood disorders (anxiety, depression, bi-polar disease)

There is an environmental component to developing a neuropsychiatric disease. See for example increased risk of MDD in people with a short form of 5-HTTLPR only after stress - a gene-environment interaction. It would be ridiculous to suggest that 100% of these "LTC sufferers (not saying OP is one) would have developed their syndromes/HPPD etc without the use of ecstasy and other substances.

There are probably a fair number of now chronic schizophrenics who would not have developed full blown schizophrenia had their mothers not been stressed during pregnancy.

So things like LTCs, HPPD and persistent altered states of consciousness/psychosis just happen to coincide with psychoactive drug use? And amphetamine doesn't worsen and speed along the progression of chronic schizophrenia?

My point is that the drug in question is surely playing some role.

 

[Jabberwocky]

My point is that the drug in question is surely playing some role.

may be playing some role.

I have never argued that the experience did not elicit an abnormal response

If you read my posts -- I equate it with PTSD.

Surely, PTSD isn't brain damage -- simply a transient imbalance.


But it isn't MDMA/MDXX -- it is the response (mainly emotionally based) of the individual to the life-altering experience

When the UNIVERSE looks at you and tells you your life is completely bollocksed up and utterly cocked-up and crap -- it tends to hit you like a freight train

 

[HPPDOFF]

OP.
I am very sorry you have to put up with this, I too am if experiencing off balance and a little dizzy after taking 300mg of MDMA one night. With regards to advice, all I can give you is exercise heavily, weightlifting and cardio, 3/4 times a week. This might restore a bit of equilibrium to your body, plus the untold benefits it has on the brain.

People on this board is quick to dismiss the damages and the potential risks of MDMA. And why not?

If someone goes to the beach, swim in the sea and has no troubles, they may believe that the swimming in the sea is a safe thing to do, this evidence is supported by the fact that their friends also swim in the sea and have never experienced any kind of problems. Yet we all know the sea can be dangerous, even if people take precautions. People who have had no adverse reactions to themselves or the people they know have a much more relaxed view of something and are quick to dismiss the negatives of something they enjoy.

Someone who takes MDMA monthly with no adverse side effects or 'damages' are of course going to claim that it is safe. But that doesn't mean it doesn't have the power to damage another. There is great evidence of this happening, but of course it's government propaganda, right?

in my example, I can no longer look around my surroundings, my vision skips, nothing is smooth, it makes tasks very difficult to complete, searching for something is impossible because my eyes are all over the place. People could come up with a variety of possibilities, which may dismiss that I havent done any 'damage' to my eyes. But this is damage to me, regardless. My eyes were perfect now they are not.

 

[Cotcha Yankinov]

Surely, PTSD isn't brain damage -- simply a transient imbalance.

I don't think somebody with chronic PTSD would agree that the "imbalance" is "transient" by any normal use of the word transient - the key point with long term potentiation is that it can be persistent. Just as LTP related hypertrophy of the amygdala can persist in PTSD, LTD related atrophy can also persist in other regions with other disorders if they are not treated/if they don't remit - I'm not saying that ie SSRIs can't reverse hippocampal atrophy seen in chronic MDD or that anti-psychotics can't reduce some of the various atrophy seen in chronic schizophrenia but there is some degree of inertia to these neuroplastic changes, and the inertia is facilitated by biological change, not just a feedback loop of impulse flow across the neurons without some component of neuroplastic change.

But it isn't MDMA/MDXX -- it is the response (mainly emotionally based) of the individual to the life-altering experience

When the UNIVERSE looks at you and tells you your life is completely bollocksed up and utterly cocked-up and crap -- it tends to hit you like a freight train

So when schizophrenics show enhanced dopamine release with amphetamine challenge compared to controls, it is because of the way they respond to it emotionally, and the way that they respond to amphetamine emotionally has nothing to do with their schizophrenic biology?

Don't get all Deepak Chopra on me, I have no doubts that consciousness plays a role in modulating "Newtonian" biology but cause and effect is still in play - a substituted amphetamine is not a cause to be taken lightly. See for example 5-HT2A mediated reduction of parvalbumin expression in parvalbumin positive GABA interneurons, and dysfunction of these particular GABA interneurons is thought to play a role in schizophrenia, bipolar, and HPPD.

Similar reduction of expression of GAD67 in these interneurons is seen in schizophrenia/bipolar and animals given MDMA - its certainly possible that people have a predisposition to developing this LTC syndrome thing or HPPD, but I am not convinced that this is a reaction people have entirely under their control.

Recall that serotonin releasing agents cause serotonin to efflux out of the pre-synaptic terminals and bind post-synaptically (mediating genetic changes and changes in protein expression etc) without much regard for what "endogenous" neural activity is doing. You could have serotonin efflux causing binding onto 5-HT2A and then reduction of parvalbumin expression all with no conscious control over your parvalbumin positive GABA interneuron's change in genetic expression.

 

[Jabberwocky]

I don't think somebody with chronic PTSD would agree that the "imbalance" is "transient" by any normal use of the word transient - the key point with long term potentiation is that it can be persistent..

LTP does not happen from a single dose or even a few doses of a substance.

The self-reinforcing aspect of HPA axis dysregulation can beome persistent.

That however, is not due to the initial impetus, RATHER A FAILURE TO TREAT!

Diabetic neuropathy is not caused by transient high blood sugar ( else we would all suffer from it, as blood sugar can spike above 200 after a high sugar large dessert, even in healthy people)-- it is caused by failure to treat diabetes