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The Potential Negative Effects of MDMA and How to Counteract Them

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I recently added a comprehensive health effects, potential addiction, and tolerance as well as a legal issues section to everyone of my specific substance guides. I wanted to add this article to specifically include with the MDMA health section; since there was so much information and preventative tips, it was necessary to make it an article on its own. This was so all the information was in one simple place, so people no longer have to trawl through random forum posts. Once again, this article is not written by me, but the same friend of mine who wrote the previous article on “An Explanation of the Effect of Hallucinogens upon the Nervous System”.

Negative Effects on Health
Serotonin syndrome occurs when there is an excess of serotonergic activity in the central nervous system (CNS). Serotonin syndrome can often be overcome by resting 
in a cooler environment. However, occasionally it will turn into a medical emergency, which can be fatal. If dangerously excessive amounts of MDMA are taken, serotonin syndrome may occur.

  • Autonomic

Excessive sweating, high body temperature, high blood pressure, increased heart beat, pupillary dilatation, nausea, diarrhoea, shivering.

  • Neuromotor

Twitching, restlessness, tremor, in-coordination  rigidity, teeth chattering, reduced opening of jaw, seizures.

  • Cognitive-behavioural

Confusion, agitation, anxiety, persistent elevated/irritable mood, insomnia, hallucinations, headache.

Dehydration can occur when taking MDMA; this happens when not enough fluid is consumed to replenish that already lost. MDMA can cause excessive sweating, diarrhoea and hyperthermia on its own, which can exacerbate the dehydration. To prevent dehydration occurring, fluids should be drunk before thirst is felt. Thirst is the preliminary indicator of dehydration. As many ions/electrolytes (essential for many bodily functions) in the body are lost while on MDMA, the best fluids to drink are sports/energy drinks, or water with a tablespoon per litre of table salt added but normal water will always suffice regardless. This restores the electrolytes lost via sweating or diarrhoea.

It is also important to regulate the amount of fluid consumed. If too much is drunk, hyponatremia (water intoxication) can occur. This interferes with the sodium levels, making them lower than normal levels. Symptoms include include nausea and vomiting, headache, confusion, lethargy, fatigue, appetite loss, restlessness and irritability, muscle weakness, spasms, or cramps, seizures, and decreased consciousness or coma. To prevent this occurring, fluid must be drunk at the correct rate, ensuring you sip the water at a slow rate: 
During active e.g. dancing: between 250ml and 500ml every hour.
When inactive: around 250ml every hour.

MDMA interferes with the body’s ability to regulate temperature. This is because it causes vasoconstriction, where the blood vessels closest to the skin constrict, preventing the body from ridding itself of excess heat. Hyperthermia can occur, which is where the body overheats. This can be controlled by staying hydrated and taking breaks from physical activity. If hyperthermia occurs, cease physical activity immediately, and apply cool (but not freezing cold) flannels to the forehead, chest and groin. 

Improving the MDMA Experience
Taking supplements before/after taking MDMA is known as pre/post-loading. There are a number of supplements that can improve the MDMA experience and help with some of the negative effects and neurotoxicity.All these, apart from the SSRIs (prescription only) are cheap and freely available through Google, Amazon, and local health food stores.
5-HTP: This is the precursor to serotonin, and taking it after taking MDMA helps restore levels of serotonin in the body. Due to the depletion of serotonin after taking MDMA, a comedown is often felt the next day or upon ‘coming-down’. Symptoms are very similar to depression, and can include impaired attention, focus, and concentration, as well as drive and motivation, aches and pains, exhaustion, and feelings of sadness. Taking 5-HTP can help relieve these effects, by replenishing serotonin.
SSRIs: If you have access to SSRIs (specific serotonin reuptake inhibitors), these can be taken after a buzz to help restore serotonin levels also. However, taking them before an MDMA buzz appears to dull the buzz.
Magnesium: There is a nerve in the jaw called the trigeminal nerve, which is responsible for innervating the jaw. This nerve is especially sensitive to changing levels of (among other things) serotonin. This causes the jaw to clench and the teeth to grind, known as bruxism or “gurning”. Magnesium can be taken before MDMA, and acts as a muscle relaxant.
Vitamin C: Vitamin C has been proven to be effective when combating neurotoxicity of MDMA.

Pre/Post-Loading Recipe
One Hour Before
100mg of Magnesium
1000-2000mg of Vitamin C
After
200mg of 5-HTP

Another effect caused by MDMA is the release of anti-diuretic hormone (ADH). ADH is responsible for regulating urination. If more ADH is released, urination will become difficult. This, coupled with the vasoconstriction, makes urination almost impossible. If heat is applied to the genitals, especially when male, this helps reduce the vasoconstriction, and make urination easier.

MDMA can be taken safely without using any of these supplements, and most dangers generally come from overuse, over a long period of time, or unnecessary excessive doses. The information above can be used to seriously diminish the negative health effects and sometimes notoriously unavoidable comedown that is experienced for some in the days after taking MDMA.

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