Updated: Jun 14, 2021
As the popularity of MDMA-assisted therapy is growing in both research and practice, some of my clients have been asking whether microdosing MDMA would be beneficial. While microdosing psilocybin and LSD are widely used by psychedelic medicine enthusiasts and are generally considered not only safe but therapeutic, microdosing MDMA is not quite the same. MDMA is an amphetamine and regardless of dosage, it has a strong effect on the body and cardiovascular health, not to mention the addictive potential. While occasional large doses of MDMA in a therapeutic and controlled setting is proving beneficial, there are no long-term studies performed on the effects of microdosing MDMA over a period of time. Third Wave recently published an article on this topic warning "There is a lot of evidence to suggest that frequent MDMA use can be very bad for you. MDMA is not like classic psychedelics; it’s an amphetamine, a stimulant, and will be doing very different things to your body than a tab of LSD. One well-known study looked at 29 recreational users of ecstasy, who typically took high doses more than twice a week. The study found that 28% of these people were suffering from defects in their heart valves, which could lead to serious heart problems. None of the control subjects had any similar defects. It’s thought that the reason MDMA is so toxic at frequent high doses is because of its effects on a specific receptor in the heart. High concentrations of the 5HT2B receptor are found on the heart – and when these are activated by MDMA, it sets in motion a signaling pathway that can cause defects in the heart valves if kept active for too long. " Take away? MDMA microdosing can potentially do more harm than good. Until further research is performed on this topic demonstrating safety, I recommend against microdosing MDMA.