I have been too busy for BL lately, so you are fortunate I stumbled across this thread.
Before I join the naysayers, I will admit to wandering something very similar myself long ago.
In the first few months of recovery, I repeatedly asked myself what I could have done differently to avoid the severe consequences I was facing.
And I considered whether or not very small doses of MDMA in the first few days afterwards would have helped...
I now believe that 100mg benedryl caused an inhibition of CYP2D6, resulting in extra MDMA metabolite-based toxicity.
Some toxicity was already present, but the DPH made it exponentially worse.
But at the time...
I thought to myself, "What if the damage is caused by a sudden drop in serotonin? What if it is the SPEED of the change that is so damaging, as seen in acute benzo or alcohol withdrawal? A proper taper..."
In all my reading, which was extensive, I never found solid reason to support this theory.
The closest I got was a paper that showed 5 or 10mg doses of MDMA could cause UP-regulation of 5HT receptors. (don't ask me which subtype)
This is seen with other drugs, especially antagonists - small doses can up-regulate or increase the sensitivity of the relevant receptors.
Large doses will do the opposite.
But even that fell far short of asking the question - what can be done post-roll, with MDMA, to prevent toxicity. Anything?
After a lot more experience and knowledge, I can safely abandon such a reckless theory.
Had I taken more MDMA, even in tiny doses, I could have been FAR worse off.
That doesn't mean I wouldn't have experienced SOME positive effects...
I should note that I have found a few anecdotal reports on BL of people recovering from MDMA toxicity attempting to roll.
This is after many months of soul-destroying depression, not early on.
Although they never achieve any real euphoria, some reports conclude that real emotional benefits do occur - sometimes many hours, perhaps a whole day later!
So there is a delayed onset, and the emotions are certainly less than the high-grade empathic experience that they are accustomed to, but they might feel reconnected to some of their normal emotional function. One described crying for the first time in years.
A more specific example - Somedud reported a complete abolition of his anxiety.
Immediately, he began sleeping deeply (after 8 months of insomnia).
He no longer cared about the odd interactions with other people; he stopped obsessing about how different he was.
He just didn't feel the same anxiety anymore.
But he didn't 'roll' either.
It was quite odd for him to understand how this could happen.
If his serotonin axons were destroyed, why would MDMA have ANY benefits at all?
Some researchers point out that some measures of neuroimaging (SERT expression) depend on a variety of factors.
It is possible that many axons are still present, but simply do not appear on scans or even stains.
This likely indicates a lack of function, but not necessarily a complete axotomy.
One day, perhaps, serotonin will flow down that axon again...
The larger body of research strongly suggests that many of these axons will never regain function, regardless of whether or not 'axotomy' has occurred (cleaving from the cell body).
But other axons do compensate, at least partially.
Likely, so do other neurotransmitter systems.
It is very important to point out that ever since, Somedud has complained that he stopped his recovery process by doing this.
Even though he was glad to sleep and stop obsessing over what happened to him, he began making statements about not being able to read people AT ALL.
He didn't care that much anymore, but the level of social disconnect became severe. And long-lasting.
He later tried SSRI Lexapro, which caused a HUGE improvement after about 5 weeks.
He claimed to be 90% recovered and even amused at his previous state!
But this 'magic' would not last, either.
Within about 2 months of beginning the medication, he stopped.
The positive effects were lower and he felt even MORE disconnected from reality.
To the point of disphoria.
This is quite a story - why was the rapid improvement so temporary?
Most SSRI users take many months before they have to increase the dose.
And some will live years of their lives without stopping.
But other MDMA users have had similar reactions to SSRIs - a very rapid improvement followed by severe emotional blunting. Why?
This serves as further evidence of 'toxicity'.
Or at least compromised serotonin transmission.
I have digressed, but not without a purpose.
Somedud's story is an example as to WHY further serotonin activity does NOT fix the problem originally caused by MDMA.
Although there is at least a temporary and minor benefit.
I suspect someone suffering 'Suicide Tuesday' would also benefit, slightly, from a modest dose of MDMA.
But would they pay a higher price the next day?
That is the real question you are asking.
I think the answer is YES.
It it important to understand when the damage from MDMA occurs and why certain SSRIs can prevent this damage.
Every paper that shows neuroprotection from SSRI administration concludes that it MUST be administered THREE HOURS after the initial MDMA dose.
This is because most of the damage done by MDMA begins just after serotonin drops.
It is the exhaustion of available serotonin that allows MDMA metabolites - specifically a dopamine metabolite - to enter the SERT and receptor site.
Once there, they cause mitochondria to spill out of cell membranes and form peroxide radicals!
In order to prevent most of the toxicity, one must intervene at this critical moment in time.
At 3 hours post dose, most people are just starting to come down.
Just a small amount of cannabis is all that is required to bring the 'roll' back.
And many users, if not most, are already considering the next dose of MDMA.
This is where the real damage actually occurs.
Too many young people think that the MDMA research is flawed or inadequate.
They fail to see that REDOSING is really the greatest cause of 'toxicity'.
Every subsequent dose of MDMA that is taken further reduces serotonin levels to zero, and increases the presence of nasty metabolites.
Experienced rollers agree - taking more than a modest 'bump' results in a speedy and unpleasant feeling and causes a worse comedown.
There may be a TEMPORARY benefit in taking a bump.
Perhaps the ONSET of the toxic cascade can be postponed, modestly.
But serotonin will still be depleted further, and metabolites increased.
The same conclusion should be made about the next day, even with tiny doses.
(although this has not been studied)
MDMA is a serotonin releaser - causing the SERT (transporter protein) to reverse itself and pump serotonin into the synapse.
As long as you are causing this to happen, toxicity is only going to get worse.
While anything that releases serotonin also causes agonism, MDMA is primarily a releaser and a DAMNED potent one.
In acute MDMA reactions, a serotonin antagonist can be used if supportive care does not stabilize the patient.
This literally shuts down activity at the receptors, and carries its own risks.
But SSRIs, which are known to have high affinity for the 5HT receptors, are agonists.
They certainly carry their own risks, especially with long-term use as antidepressants...
But they have a higher affinity for the receptor site than MDMA or its nasty metabolites.
So taking one of these agonists, at the proper TIME, will prevent toxicity.
This is proven with many animal studies, that show no neurotoxicity if the competitive agonist is administered within three hours of MDMA.
This effect is not observed the next day.
But all research has its limits...
Typically such studies involve a single massive dose that would normally ensure easily detected neurotoxic changes.
It is arguable that ALL MDMA use, even among recreational humans taking reasonable doses, that SOME level of 'neurotoxicity' is occurring.
Some research by 'pro-MDMA' researchers, such as Halpern, actually support this idea.
Even in moderate MDMA users that do NOT heavily consume other drugs, detectable cognitive changes are present...
This would mean that every single 'roll' is the result of a controlled neurodegenerative experience.
Every meaningful dose of MDMA depletes serotonin and introduces metabolites that cause oxidative stress.
And the 're-organization' of the serotonin network, which 'ascends' towards the frontal lobes and PFC (right behind the forehead).
This REWIRING effect is tolerable in most users, and even HEAVY users tend to adapt to the cognitive changes that are occurring.
But science strongly suggests that a loss of serotonin and endocrine function occur as use continues, regardless of the subjective reports.
But there is also a variety among users that suggests some people experience more 'rewiring' than others.
It is the extent that makes the difference on BL.
The shorter answer would have been - NO.
Taking small doses of MDMA the next day probably offers NO neuroprotection whatsoever.
If microdoses of MDMA could offer protection, it would have to occur just after the roll.
And even this is highly doubtful, because MDMA is primarily a releaser not an agonist.
Competitive serotonin agonists or antagonists are necessary to overcome the serotonin releaser, MDMA.
Perhaps they have some value the next day, but research clearly shows that they posses the ability to completely block all detectable toxicity (even with ridiculous MDMA doses) if administered promptly.
The only other methods of harm reduction that hold REAL value are...
Controlling the initial dose of MDMA, making sure to not exceed 2mg/kg or about 200mg MAX for a heavy person.
Not redosing, as this further depletes serotonin and increases toxicity with little additional euphoria...
And maintaining proper core body temperature.
Extra MDMA, in any dose, does not fit into this equation.
Nice idea though.
I can remember feeling tempted to take more on several occasions the next day.
I did it three times.
The first two were SO unbelievably shitty - I told myself NEVER AGAIN.
The experience itself was tolerable or even fun, but the comedown/recovery was HORRIBLE.
It would have been better to get heavy metal poisoning.
And I cannot imagine taking a SMALL dose of MDMA could somehow have turned out a truly positive result.
Any additional MDMA was going to feel dirty.
Shit dirty.
And the third time I took more on the day after...
Well, that is how I ended up here.
FBC
