I think I may have Neurotoxicity from MDMA

[onwardsupwards]

About four months ago I tried powdered MDMA for the first time, stupidly on top of Fluoxetine and Risperidone.

Ever since Iv'e been experiencing hot feelings on my skin without a temperature, worse when the heating is on or I'm wearing headphones, high levels of anxiety and depression, and an overall run-down feeling.

Initially my phych doc told me the MD wouldn't have had an effect and increased my dose of Risperidone to 8mg to help with the anxiety but this only gave me Akathisia so I came of it when I discovered it was causing the problem. I also came off of the Fluoxetine.

Last week I decided this must be down to some kind of neurotoxicity and my new phych doc agreed yesterday. Iv'e started a regimen of omega 3/6/9, magnesium, Vitamin C, and various other detoxifying activities to balance out my brain chemistry.

Is this likely to go away with time or will It last forever? Should I continue to try and get doctors to find the cause and hopefully help me get better?

 

[Solipsis]

It seems very unlikely that you are suffering from neurotoxicity in the normal sense, after one time using MDMA having organic damage to neurons..

MDMA is very well known to influence body temperature, which is I believe associated with serotonergic function (among other NTs probably) in the hypothalamus.
Fluoxetine, an SSRI, changes the NT household, specifically the balance of serotonin and how it affects different 5HT receptors.

If there was any acute 'toxicity' from your MDMA dose I would suspect that it destabilized the balance fluoxetine set.

Actual neurotoxicity may cause pruning of neurons or damage that might take a certain amount of time for neurogenesis to create new brain matter... in your case I would rather expect - basically as you concluded yourself - that it takes rebalancing of your brain chemistry. That your 'baseline' for certain functions, mainly serotonin-regulated ones, has been altered (temporarily). Unless for example your hypothalamus is damaged which seems rather unlikely, homeostasis would eventually rebalance everything given time. Exercising and eating well will be supportive of recovery but I personally doubt that you can administer any medicine to speed up the homeostatic process.

Terribly hard to say how long it will take to go away, but I never heard about something like that being permanent. I'd expect it to be a chronic thing, but that it will get better. Have faith..

I guess it would be helpful to know more about the feedback process that influences shifts of baselines or returns to baselines. Generally isn't such a baseline level (ones that determine how your mood and anxiety level is etc) primarily genetic to begin with? That would mean that if your environmental factors are positive, over time how your body expresses growth and development genetically will steer you back to your inborne baseline?

 

[Cotcha Yankinov]

Concerning specifically the hypothalamus and other midbrain structures - there is a study detailing the reinnervation of serotonin after MDMA in rats and squirrel monkeys - after neurotoxic binge administrations (extremely high dosages), after one year there is hyper reinnervation of serotonin, meaning it grew back denser and more heavily innervated by serotonin than before MDMA exposure. That being said, an fMRI study in abstinent human users showed that the hypothalamus has abnormal connectivity, so it's hard to say what predicament you're in.

Personally I don't think you have neurotoxicity. Both of the medications you were on would be protective. What's much more likely is that you're suffering side effects from your medications that could be even hormonal related that your MDMA experience "triggered", or you could still be facing side effects from the MDMA that are not permanent, such as brain bloodflow changes or production of serotonin changes (that can lost months), but the important thing to note is that they are not permanent.

I think if you give it time and exercise/eat healthy you will be just fine in a couple of months. Be aware that some of your symptoms might have to do with your medications or even having been on medication in the past if you withdraw and still have symptoms. It takes a long time for the serotonin system to normalize after SSRIs. But that doesn't mean there is any "damage".

Best of luck, any questions are welcome.

 

[onwardsupwards]

Thanks, this information is really reassuring.

I'll keep up with the exercise, diet and supplements and see how I feel within the next few months.

I guess it would be helpful to know more about the feedback process that influences shifts of baselines or returns to baselines. Generally isn't such a baseline level (ones that determine how your mood and anxiety level is etc) primarily genetic to begin with? That would mean that if your environmental factors are positive, over time how your body expresses growth and development genetically will steer you back to your inborne baseline?

Sorry I'm not quite sure what your'e asking.

 

[Solipsis]

Mostly wondering if given time your body will just follow its genetic blueprint to create its machinery leveled out like it used to be. Some epigenetic factors can change your body's genetic expression: outside causes that turn genes on or off etc.

Anyway I don't know enough so say anything conclusive about that.

 

[aced126]

Concerning specifically the hypothalamus and other midbrain structures - there is a study detailing the reinnervation of serotonin after MDMA in rats and squirrel monkeys - after neurotoxic binge administrations (extremely high dosages), after one year there is hyper reinnervation of serotonin, meaning it grew back denser and more heavily innervated by serotonin than before MDMA exposure. That being said, an fMRI study in abstinent human users showed that the hypothalamus has abnormal connectivity, so it's hard to say what predicament you're in.

Personally I don't think you have neurotoxicity. Both of the medications you were on would be protective. What's much more likely is that you're suffering side effects from your medications that could be even hormonal related that your MDMA experience "triggered", or you could still be facing side effects from the MDMA that are not permanent, such as brain bloodflow changes or production of serotonin changes (that can lost months), but the important thing to note is that they are not permanent.

I think if you give it time and exercise/eat healthy you will be just fine in a couple of months. Be aware that some of your symptoms might have to do with your medications or even having been on medication in the past if you withdraw and still have symptoms. It takes a long time for the serotonin system to normalize after SSRIs. But that doesn't mean there is any "damage".

Best of luck, any questions are welcome.

What would be physiologically observed as a result of this?

 

[Cotcha Yankinov]

Sorry I had an empty head moment and didn't mention that the midbrain handles basic autonomic functions like the thermostat function and if I recall correctly the thalamus is very important for sensory gating and might explain some abnormal sensations if the thalamus is overactive because serotonin is no longer inhibiting it,but I don't know what the consequence of hyper reinnervation/abnormal reinnervation would be - it would be helpful to know whether the serotonin gained is more excitatory or inhibitory. SSRIs are notorious for causing night sweats.

The cortex (outer layer) of the brain in one area remained de-innervated in this one study (probably because it's very far away from the serotonergic dorsal raphe nucleus cell bodies located near the brain stem and it's hard for serotonin to grow back across such a long distance) and humans have increased excitability of the cortex on fMRI studies - this is probably because the serotonin is no longer inhibiting the cortex. So in that brain region we see increased excitability. Hard to say what the serotonin is doing in the midbrain, that's definitely a serotonin2A question lol.

But if we assume our poster here has neurotoxicity I would assume he is still in the phase where the serotonin is growing back so maybe he doesn't have as much temperature control. Though I would much more likely assume a deficit of serotonin production due to tryptophan hydroxylase issues and fallout from that rather than neurotoxicity from one dose.

 

[onwardsupwards]

Just thought I'd post an update on how I'm doing:I've certainly come a long way since my original post. Unfortunately the hot feelings on my skin haven't completely subsided but they seem to be coming and going in waves. Also on withdrawal iv'e been feeling pretty much every symptom imaginable and I'm having to battle through most days. I do however think I'll recover, it will probably take me a long time too as I was on the Antidepressants and Anti-psychotics for quite a few years. I got a CT scan and they said there was no visible damage to my brain, which I guess can only be a good thing. I just hope going forward that even if there is some kind of change to the way my brain functions that I'll manage to return to a functioning life again and perhaps recover from other symptoms iv'e had to put up with on the drugs and live a better life after this.