5 ms·

> Once people convince themselves that the drug is the easy solution to their problems, they're on their way to low-level addiction. What's the difference betw

> Once people convince themselves that the drug is the easy solution to their problems, they're on their way to low-level addiction. What's the difference between this and being prescribed an antidepressant? I'd argue there is no difference except that self-medicating is much less likely to work.

jskajakzkjx 6y ago
MDMA induces tolerance and requires dose escalation for redosing after the acute effects wear off. It’s like benzos, heroin, or speed in that respect. At least it will stop working eventually so few people would compulsively redose every day, but I’ve seen people who did it every weekend and eventually had a very bad time. Antidepressants, on the other hand, are designed for daily use (and generally require sustained use to be effective). The dynamic where you want more so you keep increasing your dose to fight tolerance until you end up worse than you started is less of a risk. I don’t mean to attack MDMA. I think it’s great, and a lot of people could benefit from it. But I think this is a real issue if it’s easily available outside of a therapeutic context.
- loceng 6y ago
  NAC (N-acetyl cysteine) supplement anecdotally reduces the tolerance that builds. Time passing also reduces the tolerance - I initially was told to not do MDMA more than every 4 months maximum.
  - tonyhb 6y ago
    NAC is also a must if you drink alcohol and appreciate your liver.
  - jason0597 6y ago
    >I initially was told to not do MDMA more than every 4 months maximum. Does that mean you are now doing it more frequently than every 4 months? If so, how often are you taking it?
PragmaticPulp 6y ago
It's completely different. Antidepressants don't provide immediate relief. In fact, one of the major challenges with antidepressants is that they require time to work, some times as much as a month or more for full effect. They also don't directly induce "good" feelings, rather they work to dampen negative feedback loops and give the patient space to sort out their problems. Another challenge with antidepressant treatment is that patients frequently fail to associate their improvements with the medication. It's very common for patients to discontinue their medication because they think they don't need it any more, only to discover that the medication was part of their recovery all along. MDMA treatment, on the other hand, is solely about immediate effects. The patient feels the effects very quickly and there is no question about where those good feelings came from. The trap is that those drug-induced feelings are entirely unsustainable. MDMA is even notorious for extreme rebound effects, known as "suicide Tuesday". People who attempt to use MDMA frequently will quickly succumb to tolerance and dependence, becoming mentally far worse than when they started. The only reason it's being considered for therapy is that they're using lower doses relative to what most recreational users use, and the administration is limited to two therapy sessions under strict control. Users go into this with the expectation that they must use the drug as a tool to help their therapy work, not that they can use the drug as a go-to to fix their problems.

jskajakzkjx 6y ago

MDMA induces tolerance and requires dose escalation for redosing after the acute effects wear off. It’s like benzos, heroin, or speed in that respect. At least it will stop working eventually so few people would compulsively redose every day, but I’ve seen people who did it every weekend and eventually had a very bad time. Antidepressants, on the other hand, are designed for daily use (and generally require sustained use to be effective). The dynamic where you want more so you keep increasing your dose to fight tolerance until you end up worse than you started is less of a risk. I don’t mean to attack MDMA. I think it’s great, and a lot of people could benefit from it. But I think this is a real issue if it’s easily available outside of a therapeutic context.

loceng 6y ago
NAC (N-acetyl cysteine) supplement anecdotally reduces the tolerance that builds. Time passing also reduces the tolerance - I initially was told to not do MDMA more than every 4 months maximum.
- tonyhb 6y ago
  NAC is also a must if you drink alcohol and appreciate your liver.
- jason0597 6y ago
  >I initially was told to not do MDMA more than every 4 months maximum. Does that mean you are now doing it more frequently than every 4 months? If so, how often are you taking it?

PragmaticPulp 6y ago

It's completely different. Antidepressants don't provide immediate relief. In fact, one of the major challenges with antidepressants is that they require time to work, some times as much as a month or more for full effect. They also don't directly induce "good" feelings, rather they work to dampen negative feedback loops and give the patient space to sort out their problems. Another challenge with antidepressant treatment is that patients frequently fail to associate their improvements with the medication. It's very common for patients to discontinue their medication because they think they don't need it any more, only to discover that the medication was part of their recovery all along. MDMA treatment, on the other hand, is solely about immediate effects. The patient feels the effects very quickly and there is no question about where those good feelings came from. The trap is that those drug-induced feelings are entirely unsustainable. MDMA is even notorious for extreme rebound effects, known as "suicide Tuesday". People who attempt to use MDMA frequently will quickly succumb to tolerance and dependence, becoming mentally far worse than when they started. The only reason it's being considered for therapy is that they're using lower doses relative to what most recreational users use, and the administration is limited to two therapy sessions under strict control. Users go into this with the expectation that they must use the drug as a tool to help their therapy work, not that they can use the drug as a go-to to fix their problems.