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Another MDMA LTC fuck up...

Hey PillsandKills, regarding whether you learn to cope with DR or whether it genuinely gets better, it really does genuinely get better and resolve - however, the less the DR bothers you in the present, the less stressed you will be and the quicker you will return to normal. Funny how that is.

The DR is a weird symptom that I've been hearing about from many who have had adverse drug experiences. I had a friend who got it in childhood from weed and another person in the recovery thread has said the same thing.
 
There is a proven genetic predisposition to adverse MDMA reactions - not everyone is equal.


Citation please -- with the associated genes and polymorphisms that are PROVEN to cause a predisposition to adverse effects from MDMA

Or

Retraction please
 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2631647/

I should not have spoken so conclusively but it was just to get a point across - not everybody is equally vulnerable to neuropsychiatric disease and neuropsychiatric disease after drugs. But specifically I was referring to the short form of 5-HTTLPR, associated with increased adverse effects in MDMA users and increased adverse effects after tryptophan depletion.

The data on increased alterations of function in MDMA users with the short form is not incredibly conclusive but the research on increased alterations of function after tryptophan depletion in short allele carriers is better studied. There is some similarity between how MDMA users with a short allele function and how healthy volunteers function after tryptophan depletion with respect to the Affective Go/No-Go test.

"it is of interest to note the similarities of our current results to those seen in normal subjects after acute tryptophan depletion, a dietary manipulation that lowers availability of the precursor of 5-HT to the brain and temporarily reduces synthesis (19). Healthy volunteers under conditions of acute tryptophan depletion show the same behavior on the Affective Go/No-Go test as the ls and ss groups of Ecstasy users—they fail to reduce commission errors from shift to nonshift blocks (15).

Moreover, ss individuals who have never suffered from depression show the greatest mood change under acute tryptophan depletion, while ll individuals show little or no mood change (20), a result concordant with our finding that ss Ecstasy users were the group that scored highest on the Beck Depression Inventory. It is possible that possession of the s allele confers particular vulnerability to disturbances in emotional processing following 5-HT depletion, whether by acute tryptophan depletion or chronic Ecstasy use, perhaps due to low levels of tonic serotonergic neurotransmission.

This similarity with acute tryptophan depletion is intriguing, but it remains possible that the differences between the genetic subgroups among the Ecstasy users are caused by some other factor. Data from the Adult Impulsiveness, Venturesomeness and Empathy Scale did not provide evidence of personality differences between the genetic subgroups. In fact, our results suggest that the greater impulsivity in Ecstasy users found in other reports may be due to concomitant use of amphetamine.

However, Soar et al. (21) calculated that 34% of those in whom Ecstasy triggers a psychiatric disorder had a family history of psychopathology, and it may be that Ecstasy users carrying the s allele have a family history of depression.

In summary, we have identified a test of emotional processing that is overtly abnormal in chronic Ecstasy users with specific 5-HTTLPR genotypes carrying the s allele. These data are compatible with the finding of a trend toward higher depressive scores on the Beck Depression Inventory in Ecstasy users with the ss genotype. Since such effects may have been overlooked if we had not stratified our samples by this genotype, future studies examining the long-term effects of Ecstasy use should consider the potential for gene-environment interactions at the 5-HTTLPR locus."


If a population size of one matters, I have the short form. Haven't heard from anybody else having adverse effects anecdotally about short vs long alleles at 5-HTTLPR, just somebody who supposedly has an overactive form of MAO-A. I believe someone in neuroscience and pharmacology had posited that variation at HTR2A (which encodes for 5-HT2A) may predispose one to developing HPPD/sensory gating disorders (in addition to typical neuropsychiatric disease). There are however over 200 polymorphisms found so far with HTR2A.
 
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2631647/

I should not have spoken so conclusively but it was just to get a point across - not everybody is equally vulnerable to neuropsychiatric disease and neuropsychiatric disease after drugs. But specifically I was referring to the short form of 5-HTTLPR, associated with increased adverse effects in MDMA users and increased adverse effects after tryptophan depletion.


But the data doesn't say that.

The comission errors all fall within 1 SD of eachother regardless of ls or ss allele -- which means there is no difference.

The study authors used a SHITTY surrogate test and poorly correlated data to identify a possible association, (it's possible I'll get struck by lightning)


Furthermore the Go-NoGo test is highly biased

Does the Emotional Go/No-Go Task Really Measure Behavioral Inhibition? Convergence with Measures on a Non-Emotional Analog

It must be noted that any conclusions regarding the emotional go/no-go task drawn from the present results are limited by the lack of data on the current mood state of participants.

and

"However, unexplored gender and mood effects on performance suggest that the emotional go/no-go task will continue to be more of a research tool than part of a standard clinical battery for the time being."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2562664/

Basically, If you are in a bad mood, bored, or otherwise not "happy" the test is absolute crap.


Of note: the Go-NoGo test assessment paper was published 2 years AFTER the 5-HTTLPR study.

 
But the data doesn't say that.
The comission errors all fall within 1 SD of eachother regardless of ls or ss allele -- which means there is no difference.
The study authors used a SHITTY surrogate test and poorly correlated data to identify a possible association, (it's possible I'll get struck by lightning)

I think you've been continually overstating the importance of reaching 2 sigma when we are looking for ie genes that could have a small effect on risk, this isn't particle physics. For example, we might be looking for a gene that increases the risk of adverse effects occurrence in 1/10 people with the gene, and it might only have a small effect on that 1/10 person. Nobody is suggesting these neuropsychiatric disease related genes are deterministic, and after all, people with a short form 5-HTTLPR only have increased risk of MDD after stress.

But I'm not sure if you even read the results section of the study that I posted, and bothered to look at the Beck depression inventory measures they took as well..

"Repeated-measures analysis of variance (ANOVA) was used to examine data from the Affective Go/No-Go test. There was a highly significant shift-by-genetic-subgroup interaction for commission errors in the Ecstasy users (F=6.81, df=2, 64, p<0.003) but not in the comparison subjects (F=0.16, df=2, 55, p=0.85).

In the ll subgroup of the Ecstasy users, and in all genetic subgroups in the comparison group, commission errors declined as expected from shift to nonshift blocks. However, the ls and ss subgroups of Ecstasy users did not make the expected reduction in errors from shift to nonshift blocks (Figure 1).

~ The Ecstasy users scored significantly higher on the Beck Depression Inventory than comparison subjects within the ss (Ecstasy group mean=11.8, SD=9.6; comparison group mean=3.9, SD=3.2) (z=2.4, p<0.02) and ls (Ecstasy group mean=8.1, SD=5.5; comparison group mean=5.2, SD=5.6) (z=2.4, p<0.02) genotype subgroups, but the difference in the ll subgroup was not significant (Ecstasy group mean=7.5, SD=6.0; comparison group mean=5.3, SD=3.1) (z=1.0, p=0.32).

Second, each individual was categorized as either not depressed or depressed on the basis of the accepted cutoff point of 9 on the Beck Depression Inventory. The proportions of individuals categorized as depressed or not depressed showed a strong tendency to differ in the Ecstasy users when classified by 5-HTTLPR genotype (χ2=5.95, df=2, p<0.06)—there were more individuals categorized as depressed in the ss subgroup of Ecstasy users. The proportions of depressed versus nondepressed individuals did not show this tendency to differ as a function of 5-HTTLPR genotype in the comparison group (χ2=0.55, df=2, p=0.76)."

Furthermore the Go-NoGo test is highly biased
Does the Emotional Go/No-Go Task Really Measure Behavioral Inhibition? Convergence with Measures on a Non-Emotional Analog
It must be noted that any conclusions regarding the emotional go/no-go task drawn from the present results are limited by the lack of data on the current mood state of participants.
and
"However, unexplored gender and mood effects on performance suggest that the emotional go/no-go task will continue to be more of a research tool than part of a standard clinical battery for the time being."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2562664/

First off, if the MDMA users with a short form have a higher incidence of depression (they did score higher on the Beck inventory), then I don't know why you would discount the findings of a study showing that same group didn't have the normal reduction of commission errors from shift blocks to non-shift blocks (the same thing we see in normal volunteers after tryptophan depletion) in a study that is examining the effect of 5-HTTLPR on MDMA user's mood and function.

...But let me quote the abstract of the study you posted, because you seem to just be reading the provocative title and then misleading people about the actual content therein;

"This study tested the convergence of behavioral inhibition measures across emotional and non-emotional versions of the same go/no-go task in 85 college students. The two tasks differed only in the stimuli used for trial cues (i.e., circles versus facial expressions). Moderate correlations (r = .51 to r = .56) between commission errors across the emotional and non-emotional tasks support the construct validity of behavioral inhibition. Further, parametric manipulation of preceding context had comparable effects on performance on the two tasks.

Responses were slower and more variable, commission errors were more numerous, and perceptual sensitivity was lower on the emotional than the non-emotional task. A bias for happy faces on the emotional task resulted in faster responses and more commission errors for happy than sad faces despite marginally greater sensitivity for the latter. These results suggest that the basic neuropsychological constructs of the original go/no-go task were preserved in the emotional adaptation."

(from Discussion) "These results support the use of the emotional go/no-go task to test the emotional biasing of behavioral inhibition."

Basically, If you are in a bad mood, bored, or otherwise not "happy" the test is absolute crap.

Here it was found that tryptophan depletion in healthy volunteers causes function on an affective go/no go test to be similar to that of MDMA users with a short form but there weren't effects on mood https://www.ncbi.nlm.nih.gov/pubmed/11351939 -

"A robust reduction in total tryptophan was achieved in the test group. Subjects receiving the placebo drink showed the expected effect of shift on the affective shifting task, that is, more errors in the more difficult shift versus the non-shift condition. The tryptophan-depleted group made a similar number of errors in the shift trials but failed to reduce the number of errors in the non-shift trials. The tryptophan-depleted group showed a significant impairment on the delayed pattern recognition task. No significant effects on the subjective mood measures were found.

Tryptophan depletion abolished the normal tendency to improve error scores on non-shift trials in response to affective cues on a go/no-go task."

Mind you that only people with the short form show issues with mood after tryptophan depletion.
The test itself wouldn't be as useful if it wasn't somewhat sensitive to the neuropsychiatric status of the person. One example is that people with depression react faster to sad faces than happy faces. In that situation you aren't going to say "Well they rated themselves higher on a depression inventory so toss the results".

Or in this particular case, you aren't going to discount the mood of the person being tested because if the acute mood could be related to 5-HTTLPR's modulation of adverse effects of MDMA then that is relevant. So you're not going to 100% separate function and mood...

There are similarities between the performance of MDMA users with a short form and healthy volunteers after tryptophan depletion "TRP depletion increased response times for happy but not sad targets in an affective go/no-go task and slowed responding in a visual discrimination and reversal learning task." - https://www.ncbi.nlm.nih.gov/pubmed/12185399/

Such a test has also been combined with neuroimaging https://www.ncbi.nlm.nih.gov/pubmed/12090812/

Overactive MAO-A would reduce the effects of serotonin releasers like MDMA.

I believe we've already discussed this topic but just a reminder; I'm not proposing that the adverse effects are due to an acute excess of serotonin, but rather a deficit of serotonergic signaling on the comedown... Which would be worse in somebody with moreso functional MAO.
 
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I think you've been continually overstating the importance of reaching 2 sigma.

No, you don't understand statistics. the responses across all the groups fell within 1 SD of eachother -- what that means is that they are EASILY FROM THE SAME DISTRIBUTION -- menaing there is no difference!!!


I believe we've already discussed this topic but just a reminder; I'm not proposing that the adverse effects are due to an acute excess of serotonin, but rather a deficit of serotonergic signaling on the comedown... Which would be worse in somebody with moreso functional MAO.

If someone has ahighly functional MAO

They will be used to low serotonin -- duh -- high MAO eliminates circulating serotonin more quickly


I think you are confusing a higly active MAO (meaning the oxidase works overtime - clearing serotonin more quickly) -- with an MAOI
 
No, you don't understand statistics. the responses across all the groups fell within 1 SD of eachother -- what that means is that they are EASILY FROM THE SAME DISTRIBUTION -- menaing there is no difference!!!

I still think you're missing the main point about MDMA users homozygous for the short allele not reducing commission errors on non-shift blocks but this effect not necessarily needing to be enormous given that not everyone has adverse effects after MDMA and not everyone abuses it https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2631647/figure/F1/

Just a reminder that these are the same findings that we see with tryptophan depletion in healthy volunteers.

I understand that its within one SD and that if the number of commission errors on the nonshift blocks of the MDMA users dropped that data would be insignificant, but this is the mean

If someone has ahighly functional MAO

They will be used to low serotonin -- duh -- high MAO eliminates circulating serotonin more quickly

I think you are confusing a higly active MAO (meaning the oxidase works overtime - clearing serotonin more quickly) -- with an MAOI

....You're completely misunderstanding this particular theory of adverse effects. The theory is that a deficit of serotonergic signaling on the comedown would be worsened by a more active form of MAO-A. There are some correlations between overactive MAO-A forms and neuropsychiatric disease as well, so I don't have complete faith in the body's ability to compensate homeostatically for overactive MAO-A.

If MAO-A is quickly breaking down the 5-HT that has accumulated in the cytosol after VMAT2 inhibition then there will be little vesicular 5-HT available for natural impulse driven 5-HT efflux.
 
I still think you're missing the main point about MDMA users homozygous for the short allele not reducing commission errors on non-shift blocks but this effect not necessarily needing to be enormous given that not everyone has adverse effects after MDMA and not everyone abuses it https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2631647/figure/F1/

Just a reminder that these are the same findings that we see with tryptophan depletion in healthy volunteers.

I understand that its within one SD and that if the number of commission errors on the nonshift blocks of the MDMA users dropped that data would be insignificant, but this is the mean

No all of the 1 SD error bars overlap eachother. The mean values are extremely close as well.

....You're completely misunderstanding this particular theory of adverse effects. The theory is that a deficit of serotonergic signaling on the comedown would be worsened by a more active form of MAO-A. There are some correlations between overactive MAO-A forms and neuropsychiatric disease as well, so I don't have complete faith in the body's ability to compensate homeostatically for overactive MAO-A.

If MAO-A is quickly breaking down the 5-HT that has accumulated in the cytosol after VMAT2 inhibition then there will be little vesicular 5-HT available for natural impulse driven 5-HT efflux.

MAO-A acts on extra-cellular serotonin.

MDMA is a re-uptake inhibitor, MAO-A being more active would simply attenuate the length of increased extracelluar serotonin -- it wouldn't have anything to do with less serotonin in the synaptic vesicle -- it doesn't cause serotonin synthesis to be inhibited (MDMA does but not significantly at recreational doses -- as exhibited by the easy ability to roll again on day 2)

serotonin would be replenished by synthesis quite quickly, as serotonin synthesis never actually stops
 
No all of the 1 SD error bars overlap eachother. The mean values are extremely close as well.

The upper ceiling of the error bar on the control's non-shift block is actually even with the shift block's mean errors. That would mean that in order for the controls to exhibit the phenomenon in question seen with tryptophan depletion and the homozygous short allele MDMA users group (the opposite of a reduction of commission errors on non-shift blocks compared to their performance on shift blocks), the mean of commission errors on shift blocks would have to drop and then mean of commission errors on non-shift blocks would have to rise. Even if the mean of commission errors on non-shift blocks in the controls rose to the error bar, they still wouldn't be exhibiting the same phenomenon as the SS MDMA using group.

But once again, we're talking about the mean here, we're not looking for an absolutely catastrophic effect that is occurring in every single one of these light-moderate users.. After all, many people report MDMA use with no issues. And again, this evidence is a bit empirical because these results are in accordance with the studies on go/no-go tests with tryptophan depletion, and short form carriers are the ones known to have issues after tryptophan depletion. You can say that "they could have come from the same group", but the data shows that they aren't the same, there are differences, even if they are relatively subtle (as opposed to reaching 5 sigma for a physics discovery..)

MAO-A acts on extra-cellular serotonin.

MAO is expressed inside of neurons as well, and under circumstances of VMAT2 inhibition MAO is going to be playing a bit different role than usual. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693914/ "Degradation of cytosolic DA by MAO and COMT as well as sequestration into vesicles via VMAT2 is even more important.

Neuronal reuptake by DAT is followed by sequestration into the synaptic storage vesicles by VMAT2. DA still accumulating in the cytosol, as a consequence of leakage from synaptic vesicles, is degraded by monoamine oxidase."

Note that MAO-B is expressed within serotonergic cells as well, and MAO-B inhibition is found to be protective against MDMA induced cell degeneration https://www.ncbi.nlm.nih.gov/pubmed/17881526

MDMA is a re-uptake inhibitor, MAO-A being more active would simply attenuate the length of increased extracelluar serotonin -- it wouldn't have anything to do with less serotonin in the synaptic vesicle -- it doesn't cause serotonin synthesis to be inhibited (MDMA does but not significantly at recreational doses -- as exhibited by the easy ability to roll again on day 2)

serotonin would be replenished by synthesis quite quickly, as serotonin synthesis never actually stops

MDMA acts primarily as a serotonin releasing agent (VMAT2 inhibitor-TAAR1 agonist), not a reuptake inhibitor... It is a substrate as well - the only reason why is somewhat selective for 5-HT is that it has higher affinity for SERT than other transporters like NET/DAT. But my point is that MAO is breaking down monoamines inside the cytosol, and there is an accumulation of neurotransmitters inside the cytosol with VMAT2 inhibition. Normally VMAT2 packages up the NTs in the cytosol and sequesters them inside of vesicles, but if the NTs are broken down before they get a chance to be sequestered in vesicles, there could be little vesicular 5-HT during some time period. This time period is when abnormal neuroplastic changes/signaling cascades could occur. There would also be co-occurring post-synaptic downregulation and desensitization.

You keep talking about how you can use for days on end and experience no diminishing effects - not everybody is like that.. I realize you going to say "Then its NOT real MDMA" or something but I think its more likely that individual biology could result in different extents of diminishing effects. After all, some people are vulnerable to loss of magic while some are not. It could be possible that some people are consistently sensitive to the "amphetamine" portion of MDMA as well, and sensitization to the behavioral effects of amphetamine is well noted. There is also the matter of direct agonism at 5-HT2A.
 
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