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A Novel Neurochemical Model for Severe MDMA Addiction in susceptible individuals

RainbowMadFaerie

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Mar 15, 2010
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**posted in Ecstasy Discussion to get a wide audience with a cautionary tale, if it belongs in Advanced Drug Discussion, please move, mods!**

The following is entirely the result of my own notably peculiar experience with a profoundly different model of addiction than I have ever heard described, with a neurochemical model based on research into the effects of the drugs in question and as empirical of testing as is possible on one individual.

I also present A self-tested Method for Safely Using Non-Neurotoxic Triple-Releasers myself, as a suceptible individual. (YMMV!! these are still highly misunderstood potentially dangerous drugs, at your own risk!! I cannot stress that enough. If you have issues following this method, it is obviously wrong or not for you, please stop!!)

Unlike in classical addiction models which focus simply on reward expectation and response through DA pathways (especially in the Nucleus Accumbens but elsewhere as well), this particular addiction is primarily 5-HT functional depletion mediated. It is quite likely that susceptibility to such varies significantly across the population, with the obviously highest risk individuals being those with low 5-HT function to begin with, especially in areas of social function and impulse control. This often coincides with what appears to the individual to be shaky DA function, surges of intensity, pleasure, anger, etc. that are unpredictable and often result from experiences that essentially resemble panic attacks. The Autistic Spectrum individual is a very good example here, and this theory is promoted to explain my own especially severe battle with MDMA (and similar drugs eventually) addiction, why it led me to treat everyone around me as I did, and why it took more than two years of heavy abuse to admit something was wrong and even really scale back.

The standard neurochemical model of addiction is present to some degree at the core of this, but my specific reaction to the classic "guaranteed addictive" drugs shows much more must be present, because such DA releasers, Sigma agonist opioids, etc. simply produce a mildly enjoyable high that has no serious compulsion for further administration, with the pleasure diminishing as more is taken or more chronically. In short, it became easy to believe I could not be addicted because this cycle seemed unable to take hold in its classic form.

The impact of serotonin was simply not fully considered in these thoughts, and until recently despite quitting and recovering much from the MDMA kept being a problem when using non-toxic drugs that happen to be significantly serotonergic, especially serotonin releasers. It did not quite click until I found a paper discussing the reduction not only in serotonin release but specifically TPH release and serotonin synthesis following the administration of almost any significant serotonergic, mediated specifically through the 5-HT1A autoreceptor. This combined with the fact that MDMA also directly inactivates TPH meant that getting significant serotonin release absolutely required a serotonin releaser, and it would only work for a short while, because while DA re-regulation takes usually only a day or so, up to a week at the worst to settle, 5-HT regulation regularly takes 2 weeks, up to a month or more in our experiences with MDMA just to recover to the damaged baseline.

All of this together with a lack of knowledge made repeated administration about guaranteed, considering that, subjectively, our original (suppressed by chronic SRI use, but already low) serotonergic baseline was lets say a 100, MDMA damage took it rapidly to like 80...60...50...but compared to the release levels, even with damage present and downregulation of synthesis, I still experienced something like a 5,000 down from that 10,000 I experienced at first. This was still enough to make it possible to think reliably, to feel emotions properly, etc. and so it kept being intimately rewarding in a way psychedelics couldn't even quite kick. It took until the MDMA had eroded my baseline serotonergic function down as far as say 10 on this scale for us to really begin to get it. At that point, I'd also been taking such amounts and unclean pills that I likely did significant cumulative damage to both 5-HT terminals **and** DA terminals. At this point not only was I absolutely erratic in social situations, going from oblivious to unintentionally (or even intentionally, reactively) hurtful, pushing away almost any attempt to help. Needless to say somewhere around here I lost most of my close relationships.

This was what eventually made it better but not before it got worse. It was enough I finally realized something was way more wrong than any explanation I'd ever heard of addiction or even most MDMA damage reports. Serotonergic function that screwed up was a serious problem. It did not help that at the time I was not on the proper hormones, and as a transgirl, lack of Estrogen && presence of Testosterone leads to significantly less serotonin synthesis by a non-5-HT1A mediated pathway as well. Eventually, I realized well enough I began to space my MDMA experiences a month apart as often as possible, since even that was psychological torture at the time, knowing I couldn't be my emotional loving social self without it now but still not quite getting why, considering after those month breaks it finally started working again, but I improved none.

This led to losing the place I had been living with my ex at the time, well, effectively, our relationship crumbled about the time I had to ask her to police my usage. Very bad idea borne out of 5-HT social stupidity. At this point I couldn't take care of myself well at all, and a friend luckily was willing to take me in, providing I provided most of the actual responsibility side of things. She at the time was having it a bit worse, and that I actually was able to help likely seriously saved me, ability to have compassion work properly, to be responsible to any degree even brokenly without it, and how hard it was helped show how useless it had become to me. If I used it at this point, I was useless for a month. The decreased social stress made it easier to get by but it took a while to finally listen to reason and give it up altogether.

This was of course made worse by the one piece of this that it seems is specifically poorly distributed, namely the decrease in 5-HT synthesis caused by any 5-HT1A autoreceptor agonist, commonly known as the major portion of SRI discontinuation syndrome I would suspect. This meant even when I finally found a non-toxic triple releaser, without the understanding of what it does to serotonin syntheis I never had 5-HTP at the right times, and started into a similar, if less potent addictive spiral. It happened late 2011 with an unscheduled triple releaser quite badly for about a month. My wife and I were in constant panic attacks punctuated by periods of hyperfunctionality and periods of buying more, and did not understand it was even so broken reliably because of this. Eventually such serotonergic depletion damages the ability to associate memory. Much data is still recorded, but no meaning or other association is recorded.

At its worst, you find what happened with us and MXE, which depleted serotonin function again, causing the chronic use addictive pattern, and also seems to specifically act to shut down the memory circuits that 5-HT7 mediates, as 5-HT7 agonists reversed this state, along with serotonin itself (the initial burst of each dose of MXE, thus reinforcing it), but little if anything else. The worst of it, which happened daily for a while, left me unable to remember anything really outside of the current time, especially associatively, learned skills still worked fine, and I had access to a lot of information, but little context, and no experiential memory.

This plus the short period information stays in working memory made for some seriously dangerous behaviour. I would often find I'd gone through all of it (IV of course, just to make it more obviously bad I guess, heh), have no idea how, often had managed to accidentally something in the process (never that though, too much practice), and had I had an unlimited supply I may have ended up dying of personal neglect had I been left alone. Perhaps this is a bit of a tangent but it illustrates how bad serotonergic depletion can be when any other functional impairment shows, and I would conjecture some deficiency in such memory is a major part of the MDMA addiction I suffered as well, with the similar rising edge experience being stored properly in associative memory but little else, always reinforcing that it must be a good thing, irrationally.

Similarly dangerous behaviour in the long-run, what MXE caused short-term and MDMA in general, since it had made me unable to handle the potential of working even let alone actually getting a job, unable to sanely use the drugs that actually help my baseline condition significantly safely until I found out about the synthesis issue, and even on one awful DXM binge landed me in jail (this was during the time I'd become convinced shoplifting was a wonderful way to pay for my struggling family while on EDD, since the other roommate moved out of the place I went to, and the other two were all who had really stuck with me && needed my support), specifically I had gotten too good at it for my own good, and was convinced I still was despite being on so much DXM I did everything in plain sight. All of this was made to seem a better idea in general due to the still-recovering at the time damage from the MDMA I hadn't even quite quit then.

Now that I finally have been off it long enough, and have found this information though, I have managed for the past month, historically a record, and with long high-dose sessions to successfully use a non-toxic triple releaser with 5-HTP and some common sense to turn this into applying for and likely getting an interview for my first management position, having a wonderful day with my ex and enjoying each other's company properly again, and just in general finally being able to see clearly enough to get my life together. Stress-test style experiences carried out after my past experience have shown that with little margin for error, this substance used this way does not produce any marked acute or pronounced functional deficit no matter how much (within reason, no OD test has been performed for obvious reasons) or how often, nor has it produced significant tolerance, which is to be expected with such a drug if it is properly non-toxic, in the case of someone with low general release to begin with.

Such tolerance is likely to stay mild and within sane ranges given high-dose and chronic experience results showing little actual tolerance to the effects, even throughout a waking period, with of course the caveat that everything fails at ~30+h to produce coherent consciousness reliably, but that's more of a standard brain function issue. Significant periods without have been experienced as well to search for slow-onset rebound effects, but the only thing noticed is a gradual decline of positive effects over the following days, suggesting it or some metabolite sticks around for a while if anything, and little negative rebound effect.

Something of its apparent safety may lie in its peak duration of only 2h or so, such might be short enough that the more rapidly re-regulating circuits don't upregulate as badly, or it could have to do with receptor affinity. Until I have the money to test, I am unsure what substance unfortunately this significantly serotonergic, moderately dopaminergic/adrenergic substance even is. All I can say for sure is it is a serotonin releaser because it causes depleted serotonergic function with chronic administration without 5-HTP administration, unlike an SRI, over the course of a day. This is also the very first time I've ever had a triple releaser function in the classic sense of providing 20 years of insight into my life in a day, and it just keeps doing it, whenever I choose to take it in that direction. Experience with this drug at this point has been roughly a month, more will follow if the unlikely happens and negatives occur aside from mild anorexia (lol). By now, everything I'd tried in the past had shown issues, and the toxic ones had left me a mess considering the general dosage I've been taking of this drug at least some deficit should be obvious, but the opposite appears to be true, with each day of use significantly increasing my overall function due to insight into my life and how it might go a lot better, and quite specifically how I might do better with those around me again and in general. This is why, specifically, I wish to detail this. It seems to provide a course to safely treating PTSD, which growing up trans and spectrummy (Asperger's technically), as well as generally weird is about impossible to avoid, plus the MDMA downward spiral experience itself. I haven't posted about my addiction until now for such reasons, and I am hoping this information is useful to someone else as well.

Neurochemical Summary:
* MDMA damages TPH, also generally decreases 5-HT production. Susceptible individuals find this to make it hard to not desire, eventually to the point of making irrational choices due to inability to percieve reality properly. This is why it can cause such a bizarre and powerful addiction that takes eventually years to kick since it is also neurotoxic, as well as the things it is often found with.
* Non-toxic triple releasers still pose some threat of this issue because they downregulate TPH production. Its likely as simple as 5-HTP with them.

General Summary:
* MDMA and other neurotoxic drugs == bad news period
* Non-toxic triple releasers still potentially dangerous this way if 5-HTP supplementation during use is not engaged in, time-release suggested for obvious reasons. Might help after as well, but is likely more of an issue during.
* Autistic Spectrum individuals, especially those pretreated with SRIs are likely particularly susceptible due to low serotonergic function and predisposition to panic to begin with
* PTSD is similarly indicated, as the serotonin reduction will make panic attacks more likely there too, and it makes the drug so compelling.
* Effective PTSD treatment seems possible and safely reliable even with heavy use of at least this one non-toxic triple-releaser with 5-HTP present, otherwise it does not succeed at the intended effect.

Speculation about specific differences in such individuals, such as myself:
* perhaps 5-HT1A autoreceptor-mediated synthesis downregulation is far more sensitive, either b/c of presensitization to other drugs that has led to lower thresholds for downregulation or because levels never came up far enough
* general 5-HT release/synthesis was through most of this especially low due to hormonal imbalance, a major issue already for many transwomen, in this case **along** with average sigma activation, as I have an abnormal response to bioidentical progesterone, i.e. none, but synthetic progestins help significantly in that way, this leading to low, bursty DA/NE release as well.
* autistic spectrum types seem to have low or unreliable function on these three neurotransmitters in general, release being sporadic and intense often, with baseline not so great, especially after puberty in my case, possibly commonly.

I would appreciate any and all constructive criticism here, as I am trying to understand and specifically **avoid** ever falling into again a problem that I had that it seems very few people have actually had and written about, specifically the depth and the general neurochemical motivation for the MDMA addiction, which seems different than even most of those I have read about, which caused my seeking help to take a lot longer.
 
Autistic Spectrum individuals, especially those pretreated with SRIs are likely particularly susceptible due to low serotonergic function and predisposition to panic to begin with
Is there evidence Autistic Spectrum individuals have a low serotonergic function?
 
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