Hi there.
I'm still recovering from MDMA neurotoxicity and serotonin syndrome that occurred almost 17 months ago.
I did quite a lot of research and posting on BL - plenty of information in my post history.
Some of my earliest posts will give you more to worry about.
There is no medical or scientific consensus about the sensations you describe.
Drug users that describe sensations on their face and scalp are labeled 'psychotic' in some way or another.
Although it is agreed that most cases of amphetamine-induced psychosis is temporary. (MDMA is an amphetamine)
A year of drug abstinence is required before an official diagnosis of schizophrenia, or other mental illness, is made.
Even in cases of diagnosed psychotic disorders, reports of facial and bodily sensations (which are very common) are often ignored by medical personnel.
Some will admit that the sensations may be due to actual physical processes occurring in the nervous system.
And researchers have noted a connection between serotonin and a broad variety of bodily sensations, including on the bottom of hands and feet.
I found several such reports on BL during my research - involving a wide variety of serotonergic drugs.
It appears that sensation on the bottom of the hands and feet are directly influenced by serotonin in the brain.
So are the genitals - which is why MDMA causes such a drastic increase in sensation (and a long term loss after neurotoxicity).
In all my searching I never found a great explanation for why the sensations on the face and scalp take place.
It is known that the cranial nerves are wired directly to the brain without traveling to the spine.
And it is also known that serotonin directly influences regional blood flow in the brain.
In my opinion, altered rCBV - or Regional Cerebral Blood Volume - is the culprit you are looking for.
And fluctuations in serotonin are causing this to occur.
Serotonin is the 'serum' that 'tones' the intestines.
Bile is a chemical cousin to serotonin - both derived from dietary tryptophan, an amino acid found in protein.
While the primary function of serotonin is digestion...
In the brain it directly moderates blood distribution, glucose consumption, and is intertwined with the dopamine network in a most impressive manner.
It is through modulation of dopamine that MDMA achieves its greatest effects - including activation of the prefrontal cortex and release of prolactin and oxytocin from the pituitary gland.
The ongoing and continuous activity in the intestines provides the brain with constant fluctuations in serotonin activity.
In a healthy person, this is largely unnoticed.
But in people with mental illness bodily sensations are very common during digestion.
Likewise, people with severe digestive disorders (such as IBS or Chron's) experience what appears to doctors to be full blown psychosis.
And scientists have linked serotonin to migraines, cluster headaches, tinitus, visual disturbances, anorexia, severe depression, schizophrenia, bipolar disorder, IBS, and ulcers!
The list goes on.
The connection between your gut and your brain is pretty impressive.
The intestines are gifted with a larger blood supply and innervation than ANY organ in the body.
Indeed - they have their own nervous system often referred to as the 'second brain'.
This is the reason that so little is understood by medicine, much less people online.
You, and I, are asking for what is essentially a complete understanding of the interaction between two vast nervous systems!
Accepting this will allow you more freedom in what you are willing to believe.
The truth is that the long list of mental disorders I listed represents a LOT of poorly understood conditions of the central nervous system.
While features, symptoms, and some treatments are understood - we are a very long way from really having a command on these subjects.
Suffice it to say that you now have an idea of what it is like to feel 'psychotic'.
Welcome to the club.
Good news: MDMA research has shown that alterations to rCBV eventually correct themselves.
A drop in rCBV is common, with some MDMA users being unaware of any cognitive changes.
But increases in rCBV are directly associated with anxiety, depression, brain zaps, insomnia, and psychotic behavior.
It is a direct indication of neurotoxicity - beyond that seen in most users.
Big surprise - if the phenomena of 'brain zaps' (which is easily located on BL) does not convince people that the drug is damaging their brain, what can?
A similar and alarming phenomena has been reported by a minority of SSRI users that discontinue their medication.
The 'serum' that 'tones' that intestines is far reaching in its effects.
The paper I read involving repeated fMRIs on a group of current and former MDMA users showed that restoration of normal rCBV (in those with severe increases) is achieved around 12-18 months of abstinence. This finding overlaps that seen in psychiatric studies that illustrate a resolution of anxiety and depression between 1-2 years of recovery.
This information does not necessarily reflect what is happening to you.
Rather it serves as an example of what to expect when real brain damage does occur in an MDMA user.
To further the overlap, a similar 1-2 year recovery process is observed in SSRI users that develop major depression and sexual dysfunction following discontinuation.
In both groups, there are exceptions that go beyond 4 years or even develop 'permanent' life-long changes, but the trend is towards recovery in 12-18 months. I have personally observed, also in both groups, that attempts to interfere by taking more medications/drugs is the greatest cause of delayed or absent recovery.
I highly recommend a drug-abstinent lifestyle - and to avoid taking prescription medication handed out by doctors who falsely believe they have a command of the bodies most complex neurotransmitter.
In my experience on BL I have found that those reporting brain zaps, or tingling on their scalps, in the first few days post MDMA tend to recover more quickly than the 12-18 month group.
Disturbances in sleep are VERY common.
Typically it takes 4-12 weeks for members of this group to return to normal.
If you go beyond three months with sensations still occurring, or if you develop severe anxiety, you may belong to the second group that requires 1-2 years. Considering the modest history with MDMA that you describe this is VERY unlikely.
However, I only reached 30 tabs lifetime before a catastrophic reaction, serotonin syndrome, occurred.
The cause of my downfall was the habit of redosing every time I rolled.
A mountain of data on rodents and primates indicates that repeated doses of MDMA causes more and more damage to higher brain serotonin nerves. Every time you take more MDMA, more serotonin is depleted - which allows more toxic metabolites of dopamine to enter the serotonin transporter and receptor site. What follows is the spilling of mitochondria from cell membranes, and the subsequent formation of lipid peroxide!
The exact dose that causes detectable damage is not known in humans, and likely varies from person to person.
But it can be concluded with certainty that repeated exposure, especially on consecutive days, causes real 'brain damage' in human MDMA users.
If you often took more than one dose you may be in for a longer recovery.
But chances are that you will emerge from this state within weeks.
Even if you are destined to suffer, the odds are overwhelmingly in your favor - even heavy repeated users 'recover' eventually.
Can hemorrhaging occur?
Well, yes.
Strokes have claimed the lives of many MDMA, meth, cocaine, and other stim users.
The leading cause of death from MDMA is hyponatremia - or water intoxication.
An imbalance of water/electrolytes can be caused by VERY high levels of anti-diuretic hormone released by the pituitary.
Normal MDMA use causes ADH release, making it difficult to urinate.
But in acute reactions, SIADH, very elevated levels can occur.
Drinking lots of water is not necessary for hyponatremia to occur.
And the water imbalance can put pressure on the brain - leading to migraine, tinitus, and stroke!
Strokes have also been documented in former MDMA users that are abstinent.
Although it is uncommon, this should still be of little surprise since restoration of rCBV must be achieved.
I have no doubt that I have suffered multiple small strokes throughout the last year and a half.
Good news: They are not always debilitating.
Hemorrhaging is a particularly dangerous type of stroke because they put pressure against neurons, causing cell death.
Ischemia is more common, and is often caused by a blockage in an artery of the neck or inside the brain itself.
Much like a heart-attack, plaque in the artery wall can cause this to happen and high cholesterol and carbohydrate diets contribute to the inflammatory process inside the blood vessels.
But TIAs, or temporary ischemic attacks, represent a minor type of stroke that often resolves by the time the patient reaches the ER.
For reasons unknown, a disruption of rCBV occurs causing a temproary loss of blood (and oxygen) to brain cells.
The brain's glial cells respond by inducing a process known as angiogensis, in an attempt to restore normal blood flow.
If this is done quickly enough wide-spread neuronal death is avoided.
This technical explanation would offer little comfort to somebody actually experiencing a TIA.
I recall some of the greatest anxiety occurring during those events - and the greatest change afterwards.
During several of them, my entire right arm ached and I felt pins and needles on both palms and feet!
Twice I experienced complete loss of sensation down my right arm (except for STRONG pins and needles) and significant loss of motor control.
In both cases it took HOURS of anxiety and head-pressure for this to occur.
And once it happened, it took only minutes for the pain and numbness in my arm to resolve.
The next day I would test my motor function and sensation repeatedly and find NO remaining issues.
My father-in-law who is an experienced ER nurse, assured me that visiting a hospital would only cost me money.
He told me to visit rehabilitation centers to see what 'real' strokes look like.
There is very little that can be done medically when strokes are suspected.
But here is some basic advice...
Cutting down on sources of inflammation is the number one step you can take.
I recommend a BABY dose of aspirin every day.
This is about 80mg.
Aspirin is made from the bark of a tree and is a blood thinner.
Taking a larger dose can possibly increase the risk of stroke and interfere with a few medications available in a hospital setting.
Brushing the teeth twice a day, and flossing on a regular basis, reduces markers of inflammation throughout the intestines and blood stream. I brushed mine FOUR times a day or more during the first few months of recovery.
Although the difference was minor, I did perceive a meaningful alleviation of head-pressure - so I highly recommend that you start brushing with flouride toothpaste several time a day. And don't forget the floss.
The body treats plaque in the mouth like an infection.
And research has shown surprising data - that brushing twice per day, regardless of other lifestyle choices (including diet), significantly reduced the risk of heart-attack and STROKE.
So start taking care of your mouth.
And your intestines...
Eat a variety of lean proteins, as this will provide plenty of tryptophan.
Taking supplements is not necessary and may be harmful.
Reduce carbohydrate intake, especially high-glycemic carbs like french fries, cakes, and breads.
Low glycemic carbs take longer to metabolize into sugar and cause less inflammation - a good example is sweet potatoes or brown rice.
Carbs also increase serotonin activity in the brain - NOT what you want right now.
Fried foods directly increase markers of inflammation are are considered the central cause of cardiac disease and stroke in western cultures!
You should be eating bananas every single day.
Although they contain lots of sugar, they also provide serotonin and b-vitamins - along with potassium (which improves metabolism).
Lots of fruit, veggies, and water needs to be included.
This is a time to eat healthy for once in your life.
The benefits cannot be overstated.
The same goes for exercise, which is perhaps the most effective tool for recovery and prevention of strokes.
Thats right, getting your blood pumping will decrease the risk of stroke.
It is the ONLY treatment known for serious strokes - and it is begun the next day.
Daily cardio is enforced upon elderly victims of stroke across the world because it WORKS.
After six months the extent of recovery is typically reached - but immediate therapy is necessary for this benefit.
Exercise also increases the release of STEM CELLS into the brain.
More importantly, it releases a serotonin growth factor - BNDF.
Brain Derived Neutrophic Factor is a protein that enhances the plasticity of existing serotonin neurons and encourages the resprouting of others!
In both MDMA and SSRI victims I recommend exercise, both lifting and cardio, as the ONLY tool for recovery.
Nothing in diet, lifestyle, or medication will approach the healing power of exercise.
The body serves to heal the mind.
The only supplement I recommend is turmeric extract.
It is one of the most powerful anti-inflammatory agents available and may be tied to the lower rates of several diseases in Eastern cultures. It is also a very mild SSRI.
Take it with black pepper for real absorption.
It works for headaches, by the way.
B-vitamins and magnesium are both VERY important to the synthesis of neurotransmitters.
And magnesium is central to a GREAT number of metabolic processes.
It is also neuro protective against strokes and is seen to be reduced in psychotic disorders.
There is one other supplement that has the most profound effect - Piracetam.
It is cheap and available online and is quite safe.
It causes an increase in blood flow to the corpus collosum and it perferentially increases serotonin and dopamine in the Prefrontal Cortex.
And decreases them in the hypothalamus.
Considering the amount of 'damage' I suffered from MDMA, the effectiveness of Piracetam at restoring healthy brain function is a clear indication that the hypothalamus (site of hyper-innervation after MDMA toxicity) is key to the process of recovery.
It caused a real transformation in how I felt and it fueled a very long binge on researching my problem.
But it is NOT a cure, despite its effectiveness.
Every time I stopped taking it I would degenerate into anxiety and depression once again.
It would happen slowly, but surely.
And I have been forced to conclude that the brain must be allowed to suffer for a VERY long period of time.
There is no drug, or treatment, that will substitute for this process.
Aside from intense and regular exercise....
Something I am about to go do right now.
You should too.
Good luck.
FBC
It also help against psychogenic headache.