Why Microdosing MDMA Is A Bad Idea

Patrick Smith

It’s the advent of ecstasy.

MDMA is a rave-drug turned wonder-therapy. It has the potential to help people with PTSD, alleviate social anxiety, and save struggling relationships – and as most users will tell you, it makes you pretty good at dancing.

Having been recently approved for phase III clinical trials in the US, it looks like MDMA will soon be entering mainstream society as a legitimate therapeutic tool.

While this is a fantastic piece of news for PTSD sufferers and proponents of drug-policy reform, it might not make much difference to the average person. The MDMA-assisted psychotherapy being trialed by the Multidisciplinary Association for Psychedelic Studies would only become available to a select few – most likely those who could afford the treatment, or had serious medical reasons for needing it.

Unsurprisingly, the public will still want to get its share of the life-enhancing benefits being touted by researchers and therapists.

As the trend of microdosing illustrates, if people want to reap the benefits of a substance, they’ll find the most effective way to do it. Everyone from entrepreneurs to artists are microdosing psychedelics like LSD, psilocybin, and mescaline for spiritual, creative, and productive enhancement.

So could MDMA fall in among the usual microdosing suspects?

Have People Tried Microdosing with MDMA?

It’s certainly not become as popular as microdosing LSD or shrooms, but there is a growing number of people who are giving it a go.

Reports from Reddit users are mixed:

“I microdose very successfully on MDMA. I do it about once a week, sometimes a bit more, every four to five days. I take very, very tiny eyeballed doses, maybe milligrams, if I were to guess. It’s extraordinary; I’ve been doing it for years.”

“I tried microdosing with MDMA twice a week at 25mg for two-and-a-half weeks, wouldn’t recommend it at all. Even with vitamin supplements you will struggle to feel “normal,” sleep gets disrupted, mood disorders can be badly affected.”

One British student attempted to microdose MDMA for a week during her exams. The benefits were interesting… but weren’t worth the intense hangover she experienced for weeks after.

“I was more active, running around doing what I needed to do […] I was more social, I buzzed and felt I was glowing at pre-drinks, my high flowed into the night […] I got a first in that essay, though.

“I wouldn’t recommend it to anyone. The come down left me in my bed for weeks. I refused to see people, shut my phone off, and genuinely hid from the outside world.”

(The Tab)

It’s not just the extended hangover that should give you second thoughts about taking MDMA in a regular microdosing regimen…

Microdosing with MDMA Could be Deadly

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.[1] 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.[2]

What’s the Take-Home Message?

Although studies of MDMA’s toxicity have been looking at very frequent, very high-dose use of the drug, and we don’t know how microdoses would compare, we still can’t be sure if microdosing will be safe. Even for normal doses of MDMA (100mg or higher), it’s recommended to avoid taking it more than once every few months.

It’s best to assume that any chronic, long-term activation of the 5HT2B receptors on the heart could have health risks. MDMA is one of the strongest activators of the 5HT2B receptor, so it could still be having a significant effect at low doses.

Despite the reports of beneficial effects from microdosing MDMA, we don’t recommend trying it. Perhaps a therapeutic dose, in a comfortable surrounding and with appropriate support, is still the safest and most effective way of benefitting from ecstasy.


[1] Droogmans et al. (2007) Possible association between 3,4-MDMA abuse and valvular heart disease. Am J Cardiol, 1;100(9):1442-5. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/17950805

[2] Hutscheson et al. (2011) Serotonin receptors and heart valve disease – it was meant 2B. Pharacol Ther, 132(2):146-57. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/21440001


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