Firstly, doesn't DMT also work as a 5HT1A agonist? If so this might explain any increases in NGF, because 5HT1A activates Gi, which then increases NGF.
So while DMT might be activating 5HT2A, it's also activating 5HT1A.
Furthermore, 5HT2A is supposed to increase arachidonic acid (AA) levels. This is pretty important because AA in a very potent inflammatory mediator.
The upshot off all of this is: How selective is the drug you're talking about? The less selective the drug, the more complex the response.
On the cannabinoid thing, here's a pretty good looking review.
http://www.ncbi.nlm.nih.gov/entrez/..._uids=16375685&query_hl=2&itool=pubmed_docsum
The effects of MDMA are pretty complex, but MDMA mediated neurotoxicity is more to do with the physiological changes it causes, rather than any toxicity of MDMA itself.
I try and describe it like this:
'Jumping out of a plane doesn't kill you, hitting the ground does.'
Likewise, taking MDMA doesn't cause brain damage, but the breakdown products produced as a result of excessive serotonin catabolism does.
MDMA doesn't necessarily cause brain damage, as long as the breakdown products are dealt with properly.
This fits in with another 'big theme' in cellular biology: Oxidative stress
Using oxygen to release energy from food (aerobic respiration) is far more efficient than other methods (anaerobic respiration). The downside is that using oxygen produces highly toxic by-products called free radicals.
This is also why antioxidants are important, as they work by 'mopping up' radicals.
What MDMA does is cause an unregulated increase in 5HT, activating 5HT2A, desensitising 5HT2C and causing dopamine release.
The problem comes when the 5HT is reabsorbed and broken down. Basically there's too much to breakdown, you get loads of free radicals being produced, which causes cellular damage.
Any attempt at neuroprotection involves either reducing reuptake or getting rid of radicals.
To my knowledge, methamphetamine does the same thing, but at dopamine transporter rather than the serotonin transporter, but the concept is very similar.
As for Olney's lesions, I've read the wikipedia entry on it and it stikes me as odd, because I thought NMDA antagoninsts were supposed to be neuroprotective and had been considered for preventing damage caused by excititoxicity caused during stroke.
http://en.wikipedia.org/wiki/Olney's_lesions