• N&PD Moderators: Skorpio | thegreenhand

Overly High Serotonin Months After Taking MDMA? Please, I need help.

R

Restless Girl

Guest
Sorry if this is TMI, but I think it could help if I gave some background on me, and I really need some help trying to figure out what is going on.

I'm 24, female, 130 pounds, 5'7 and in pretty good shape, but I have ADD (apparently inattentive, not hyperactive but I wasn't diagnosed until college. I also have also had excoriation (skin picking) tendencies since I was very young. My ADD manifests itself in me being very sensation seeking. I am an extreme neophile, loving to try new things (like food), learning new things, and being unable to do a repetitive job. I had a huge sweet-tooth and a used to masturbate almost compulsively. I've always wanted to be normal because I think that would make me happier and better able to deal with my responsibilities, but I've also been pulled aside and called brilliantly creative by professors and teachers. I might have some borderline personality disorder and perhaps autistic tendencies. I was a child on the edge of having conduct disorder. In short though, I want to make it very clear that I am not someone trying to make the claim that I am "special" and trying to seek validation for that, more like I'm a girl who has always been unpleasantly on the edge of crazy because I almost certainly do have some kind of non-typical brain chemistry or wiring--but I don't know exactly what that is. I have struggled with fairly extreme depression in the past, but in the last couple of years after completing grad school, making a strong group of friends, and dabbling in meditation, I finally felt I was fully happy.


Before taking MDMA, I'd get buzzed after 1 beer, and practically drunk off of two beers, but at that point I'd typically find a bed and fall asleep if I'm not out in public. I was smoking a little weed almost every day for a few months since it became legal in California, just a couple of hits would be enough for me, and I think I had a normal enough reaction, though I guess I was a light-weight, and I think my tolerance was slowly building. I'd also been taking Adderall on and off again for the last couple of years, trying to keep my dose low and my tolerance low to avoid addiction and because I had some minor, but bad side-effects like nausea and increased carpal tunnel, and because frankly I don't think I could enjoy Adderall as a party drug whatsoever, and I only ever took it out of necessity. I've also done shrooms once, and after i got over the initial anxiety it gave me, I feel it was a mind-opening experience--though I felt nauseated the whole time and hung over as hell the next morning and none of my friends who did it with me may have felt such a strong reaction. I've also done acid, and I think my entire reaction to that was normal.

Now to my actual MDMA experience, my first (and definitely last experience) two months ago now. It sucked.

I had a quarter of an Adderall pill much earlier in the day, I had a beer, and I smoked a bit of weed. I was with my friends (male) and a girl who really annoys me, so I think maybe her presence contributed to my bad trip. I took a third of a Tesla pill (http://mixmag.net/read/warning-orange-tesla-pills-contain-very-high-mdma-content-news) and the first feeling I had was my ears getting warm. Everyone else was getting happy, but I just had hot ears. After a while, (maybe an hour, I don't remember clearly anymore) I felt mildly good, but it seemed to be that everyone else was doing a lot better, and the mild good feeling I felt quickly went away, so I took another third of a pill. I may have ended up taking another third of the pill later, so one whole pill. I was feeling cold then, though everyone assured me that the temperature was fine. All at once I felt hot and cold in waves with different parts of my body were hot and cold, and my heart was racing, and I had a vague hallucination or something for a second. I told my friends I needed to go to the hospital, and they got me to puke my guts out in the sink. Throwing up felt wonderful, because I had felt this weird sick to my stomach sticky seretonin feeling that it difficult to describe. Even after puking I asked to go to the hospital but my friends calmed me down and told me it was going to be alright, I just needed to go for a walk. I bundled up to the nines because I was cold again (after feeling too hot) and went on a walk with my friend. Finally, I felt some of the euphoria/love they say comes with MDMA, and my friend and I had a nice talk. We went back home, and I crashed.

The next day I felt hung-over as hell, but nothing terrible. I was happy. I still felt pretty loving actually. The day after that I felt fine enough and I took a quarter-dose of adderall. I still felt some flash-backs of the loving, but the next day I started to feel bad. I smoked and I got unbelievably paranoid and I was worried I was getting OCD. Then the next couple weeks when I had a big meal I'd get that sticky serotonin feeling in my stomach like a flashback to throwing up on MDMA and I'd want to throw up again, so I was worried I was losing my mind. I'd get weird shivers at night, heat-flashes, cold flashes, trembling, confusion, agitation, and insane nightmares to name a few of my symptoms. There were times I thought I needed to go to the emergency room. I had no appetite. Finally I went to the doctor two weeks later, told her what happened, and she ran some tests on me saying that physically, at least, I was fine. I didn't want to try and diagnose myself at that point because I have hypochondriac tendencies and I worried I give myself more symptoms just by knowing what was wrong, but the next week I went back and told her it might be serotonin syndrome and she agreed. She gave me xanax, as I asked for for my anxiety, and she said that I was basically going through something like withdrawal. She also told me to stop taking Adderall.

But now it has been 2 months. Could I possibly have 2 months of withdrawal? I think my symptoms are slowly getting better, but at this point it is hard to tell. I feel like a changed person half the time. I'm still restless, I have trouble sleeping, I have feel trembly sometimes, I have no appetite, no sweet tooth, no real desire to pick my skin anymore (not that I want this again! But it used to make me feel very good, now I suspect it hurts like it is supposed to), no real sex-drive, and less focus than before, circular OCD-like thoughts, with symptoms getting worse at night. I have had like two hours where i felt irrationally depressed in the past couple months, but generally I have not been remotely depressed--which I guess is the normal side-effect to MDMA, but my agitation/anxiety is in some ways more distressing than depression. What could be going on with me? Should I take serotonin enhancing supplements try to deplete my seretonin levels? When I drink now I get trembly, and when I smoke I get paranoid--I've been a sober-Sally. I have been taking multivitamins and doing Yoga.

TLDR:
Basically, I took MDMA two months ago, had a bad trip, and now I think my remaining symptoms still seem reminiscent of too much serotonin than too little (agitation, lack of an appetite), but everything I have read says that my serotonin should be depleted by now and I should be tired and depressed if anything, which I most certainly am not. How could this be?
 
It sounds like MDMA has temporarily changed your brain chemistry. Sounds very similar to severe depressive symptoms, though probably different to how you've experienced it before.
Since you're susceptible to depression i would probably avoid MDMA in future. If your experience is anything like mine, i eventually needed SSRIs to sort out what MDMA worsened.
 
It sounds like MDMA has temporarily changed your brain chemistry. Sounds very similar to severe depressive symptoms, though probably different to how you've experienced it before.
Since you're susceptible to depression i would probably avoid MDMA in future. If your experience is anything like mine, i eventually needed SSRIs to sort out what MDMA worsened.

Thank you for taking the time to reply. I would never have considered what I am experiencing depression--I was severely depressed and suicidal a couple years ago with no energy and bad sleeping patterns, but I don’t have any kind of death wish right now. I just want to live healthy and happy--and be able to relax and focus. But was your experience like I described mine? Did you lose the ability to be fully relaxed? Did alcohol make your symptoms worse, make you feel trembly? How long did you wait before you started taking SSRIs? Were you also able to stop taking the SSRI’s after a while? I am desperate to do anything to make it better, but I also am very worried about taking a new drug and making it worse.
 
Thank you for taking the time to reply. I would never have considered what I am experiencing depression--I was severely depressed and suicidal a couple years ago with no energy and bad sleeping patterns, but I don’t have any kind of death wish right now. I just want to live healthy and happy--and be able to relax and focus. But was your experience like I described mine? Did you lose the ability to be fully relaxed? Did alcohol make your symptoms worse, make you feel trembly? How long did you wait before you started taking SSRIs? Were you also able to stop taking the SSRI’s after a while? I am desperate to do anything to make it better, but I also am very worried about taking a new drug and making it worse.

My suggestion would be to still wait and see, 2 months isn't a very long time to allow yourself to heal up abit. But for me even 18 months after an MDMA experience i still experience severe jaw clenching and certain anxiety symptoms i never had before using it, and it was only a couple times 3 months apart, very carefully done & with supplements.
I also cannot smoke weed anymore due to paranoia after MDMA changed my brain chemistry. My symptoms were abit different to yours, i can still relax but it definitely changed me in some way.

If you've tried all the natural methods of relieving symptoms & still don't feel normal after say 3-6 months, then maybe look at trying SSRIs. Or ask your doctor about it.
 
Single doses of MDMA, even if they're fairly large, generally don't have a massive long term effect on serotonin levels or serotonin nerve fucntion, despite the popular rumor.

If you've taken MDMA just once and had a bad trip, and a doctor has checked you out and said you're fine, you're very likely just as healthy, physically speaking, as you were before doing MDMA. Mentally speaking however, any bad trip can be considered a traumatic and intense experience, and those are expected to be a source of stress, confusion, and general upset for a while until you can integrate them into your life and move forward.

To me, your experience seems typical of someone who just took a dose that was beyond what they could comfortably toelrate. There's lots of pills going around now that are dosed quite high with pure MDMA - I've seen pilltesting sites that claim 200 to 300mg of MDMA per pill, which is probably around 3-4 doses worth in one pill! It's a welcome change from the days of low-dose and random piperazine pills, but at the same time, it causes a lot of situations like the one you experienced: the come-up is so intense people will panic and feel so strange, on edge, nauseous etc that they can't have any fun in the state they're in. They may get to a state where they calm down and can enjoy the drug somewhat, later in the night, and then almost everyone reports feeling rather washed-out the next few days. The solution to this is having people take half a pill or less, there's campaigns all in Europe to encourage this, because that's all you need to have a good time, usually, and you can't "un-take" a drug that you've ingested, you can always take more.

The good news about this is the effect of a MDMA overdose is usually more mentally injuring than physically injuring. As I mentioned before you don't have to worry about serotonin levels (MDMA is actually way more complex than just serotonin release) or nerve damage if it's just one dose, even if it was a whopper. I'm assuming you're young and fairly healthy - then you can tolerate a lot more abuse than a MDMA overdose, let me tell you that. (I don't actually think your "brain chemistry" is changed either; it's a known fact that emotionally intense events - "oh my god I've taken too many drugs I'm going to die I feel awful" - are tricky to deal with and not something the average person can just sleep off!)

The way I'd recommend you treat this is by staying off any stimulants for a while (no coffee, Adderall etc) and trying to get back into a normal pattern of life, reminding yourself that you are physically just fine and many people have had the same experience you've had and lived to tell the tale. What you'll want to do is the same thing anything someone should do after a traumatic experience or crisis, try to bring your life back to normality and find things to do to keep your mind off of ruminating about past events. Avoid any stressful experiences and try to give yourself a little mental vacation - go for a walk in the park, learn to play chess or Go, visit the library and read a book, hang out with a friend, see a movie, listen to music, meditate. Do anything that keeps you busy and you find mentally pleasing. Try to eat relatively balanced, healthy food and avoid anything too greasy, and decrease your portion sizes if you feel nauseous often. Get plenty of sleep too. Basically, you want to do your best to start your mind thinking positively about the present and future rather than being mentally centered around the intense, scary experience you had. It shouldn't take too long before you start feeling better and then you can resume taking your morning Adderall as prescribed.

As for medication, just because a pill got you into this mess, doesn't mean more pills will get you out. SSRIs seem unnecessary at this state, they are not really something you can take for the short-term, (the rule of thumb is they typically take 2-3 weeks for depression and you need to take them on a continuing basis) and anyway, your issue is not one related to "serotonin levels" per se anyway.

Taking Xanax or other benzodiazepines for anxiety attacks is permissible as long as they're only for actual emergencies and you're not refilling the prescription. They're really meant to be used for periods of time ~2weeks or less. Dependency on benzodiazepines can really mess with you if you have anxiety, you should be wary of overusing them.
 
Single doses of MDMA, even if they're fairly large, generally don't have a massive long term effect on serotonin levels or serotonin nerve fucntion, despite the popular rumor.

If you've taken MDMA just once and had a bad trip, and a doctor has checked you out and said you're fine, you're very likely just as healthy, physically speaking, as you were before doing MDMA. Mentally speaking however, any bad trip can be considered a traumatic and intense experience, and those are expected to be a source of stress, confusion, and general upset for a while until you can integrate them into your life and move forward.

To me, your experience seems typical of someone who just took a dose that was beyond what they could comfortably toelrate. There's lots of pills going around now that are dosed quite high with pure MDMA - I've seen pilltesting sites that claim 200 to 300mg of MDMA per pill, which is probably around 3-4 doses worth in one pill! It's a welcome change from the days of low-dose and random piperazine pills, but at the same time, it causes a lot of situations like the one you experienced: the come-up is so intense people will panic and feel so strange, on edge, nauseous etc that they can't have any fun in the state they're in. They may get to a state where they calm down and can enjoy the drug somewhat, later in the night, and then almost everyone reports feeling rather washed-out the next few days. The solution to this is having people take half a pill or less, there's campaigns all in Europe to encourage this, because that's all you need to have a good time, usually, and you can't "un-take" a drug that you've ingested, you can always take more.

The good news about this is the effect of a MDMA overdose is usually more mentally injuring than physically injuring. As I mentioned before you don't have to worry about serotonin levels (MDMA is actually way more complex than just serotonin release) or nerve damage if it's just one dose, even if it was a whopper. I'm assuming you're young and fairly healthy - then you can tolerate a lot more abuse than a MDMA overdose, let me tell you that. (I don't actually think your "brain chemistry" is changed either; it's a known fact that emotionally intense events - "oh my god I've taken too many drugs I'm going to die I feel awful" - are tricky to deal with and not something the average person can just sleep off!)

The way I'd recommend you treat this is by staying off any stimulants for a while (no coffee, Adderall etc) and trying to get back into a normal pattern of life, reminding yourself that you are physically just fine and many people have had the same experience you've had and lived to tell the tale. What you'll want to do is the same thing anything someone should do after a traumatic experience or crisis, try to bring your life back to normality and find things to do to keep your mind off of ruminating about past events. Avoid any stressful experiences and try to give yourself a little mental vacation - go for a walk in the park, learn to play chess or Go, visit the library and read a book, hang out with a friend, see a movie, listen to music, meditate. Do anything that keeps you busy and you find mentally pleasing. Try to eat relatively balanced, healthy food and avoid anything too greasy, and decrease your portion sizes if you feel nauseous often. Get plenty of sleep too. Basically, you want to do your best to start your mind thinking positively about the present and future rather than being mentally centered around the intense, scary experience you had. It shouldn't take too long before you start feeling better and then you can resume taking your morning Adderall as prescribed.

As for medication, just because a pill got you into this mess, doesn't mean more pills will get you out. SSRIs seem unnecessary at this state, they are not really something you can take for the short-term, (the rule of thumb is they typically take 2-3 weeks for depression and you need to take them on a continuing basis) and anyway, your issue is not one related to "serotonin levels" per se anyway.

Taking Xanax or other benzodiazepines for anxiety attacks is permissible as long as they're only for actual emergencies and you're not refilling the prescription. They're really meant to be used for periods of time ~2weeks or less. Dependency on benzodiazepines can really mess with you if you have anxiety, you should be wary of overusing them.


If you are lead to believe that only one MDMA trip doesn't affect Serotonin and its building blocks, pre-synaptic reslease, time it spends within the synaptic cleft, and then post-synaptic reuptake as little as you claim, you are truly misinformed.

MDMA has an extreme effect on the entire Serotonergic system within the brain (the brain only contains roughly 10-15% of all Serotonin in the body).
Although it doesn't affect Serotonin in the other organs where it is also found such as the gastrointestinal system etc.

SSRI's do in fact assist with post-MDMA symptoms, but only true first generation SSRI's that is solely functional with Serotonin and only Serotonin. Not atypical antidepressants with more than just Serotonergic actions and work on more neurotransmitters for example antagonism or agonism of norepinephrine, adrenaline, histamine etc.

Kindly read up on (not Wikipedia please, real academic sources) the pharmacology and pharmacokinetics of MDMA.

Hereunder is one study of hundreds you may peruse on the same website (also discard studies done on rats, it is only wasting your time and it can't be compared to a bigger mammalian's physiology and MDMA's pharmacokinetics on humans)

https://www.google.co.za/url?sa=t&s...ggaMAE&usg=AFQjCNEl-R7fDkhkaeEp6uhh6ZxWJtXk8g
 
Why you getting so choked? Am I too positive, not enough doom-and-gloom?

PubMed study you linked said:
A high proportion of the case reports of serious MDMA toxicity include the observation that the patients were jaundiced.

If you're taking so much MDMA you get jaundice, I think you're beyond hope... that's not typical of "normal" PiHKAL-type doses :)

It's important to distinguish single. acute overdoses of MDx from continued chronic overuse of the same, too. Long term overuse has proven to be way more nasty in terms of recovery time than single doses. Remember - for the longest time MDMA was used successfully in controlled doses and clinical settings without leading to wanton serotonin dysregulation.

Also, keep in mind that MDMA does a lot more than just serotonin release, its stimulating effect is actually dependent on norepinephrine release, and it does release dopamine too. Its all 3 monoamines in combination that make MDx so special actually :)

Rat studies are not worth discarding wholesale, btw. They're useful model organisms.
 
Why you getting so choked? Am I too positive, not enough doom-and-gloom?



If you're taking so much MDMA you get jaundice, I think you're beyond hope... that's not typical of "normal" PiHKAL-type doses :)

It's important to distinguish single. acute overdoses of MDx from continued chronic overuse of the same, too. Long term overuse has proven to be way more nasty in terms of recovery time than single doses. Remember - for the longest time MDMA was used successfully in controlled doses and clinical settings without leading to wanton serotonin dysregulation.

Also, keep in mind that MDMA does a lot more than just serotonin release, its stimulating effect is actually dependent on norepinephrine release, and it does release dopamine too. Its all 3 monoamines in combination that make MDx so special actually :)

Rat studies are not worth discarding wholesale, btw. They're useful model organisms.


Meh, rat studies are a starting point but when placebo affective double-blind, peer-reviewed academic studies are available that was performed on willing human beings, I would disregard the former completely.

If it is brand new research chemicals and rodent studies are the only published data thus far, well yes then obviously...
 
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