A case report was just published about a guy who took 40,000 MDMA pills over the course of nine years. That's nearly 4,500 Ecstasy tablets a year. That's an overall average of 12.18 pills per day. Funny enough, he's had some lasting side-effects, none of which sound particularly pleasant.
The man, known as Mr A in the report in the scientific journal Psychosomatics, started using ecstasy at 21. For the first two years his use was an average of five pills per weekend. Gradually this escalated until he was taking around three and a half pills a day. At the peak, the man was taking an estimated 25 pills every day for four years.
Surely the brain would have dumped all of its stored seratonin after the first pill or so? After that, he may as well have just been drinking Red Bull or swallowing diet pills. My brain hurts just thinking about it. At any rate, "Mr. A" says that he continued to feel the comedown effects for months after he stopped taking the E, similar to side-effects felt by lifelong alcoholics.
While this is (obviously) an extreme case whose findings can't necessarily translate to occasional users, it's remarkable that this guy even survived. There have been deaths linked to MDMA use, but most of those are the results of water poisoning or impurities in the drug, as opposed to pure overdose. Meanwhile, the USA continues to research the use of MDMA in treating Post-Traumatic Stress Disorder.
There is no clear evidence that some people suffer allergic reactions to ecstasy. However, around 10% of Western users do lack a key liver enzyme CYP2D6 needed to break down MDMA. This may make them more sensitive to the effects and more prone to accidental overdose.
"He came to us after deciding that he couldn't go on any more," said Dr Christos Kouimtsidis, the consultant psychiatrist at St George's Medical School in Tooting who treated him for five months. "He was having trouble functioning in everyday life."
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