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In recent years, the trend of microdosing psychedelics has gained popularity, with enthusiasts touting a wide range of potential benefits, from enhanced creativity to improved mood and focus. However, a recent scientific review published in the Journal of Psychopharmacology has raised concerns about the potential health risks associated with long-term microdosing of psychedelics. In particular, researchers have expressed worry about the possible connection between chronic microdosing and a heart condition known as valvular heart disease (VHD).
Microdosing involves taking small, sub-perceptual doses of psychedelic substances like LSD, psilocybin (found in magic mushrooms), mescaline (found in certain cacti), and DMT on a regular or semi-regular basis. Advocates of microdosing claim that it can lead to improved mental well-being, increased productivity, and heightened creativity, all while avoiding the intense hallucinogenic effects associated with higher doses of these substances.
Valvular heart disease, or VHD, is a condition that affects the heart valves, which play a crucial role in maintaining proper blood flow through the heart. VHD can range from mild to severe and may lead to symptoms such as chest pain, shortness of breath, and fatigue. In severe cases, VHD can result in heart failure, requiring surgical intervention to repair or replace damaged heart valves.
The concern raised by scientists stems from the interaction between these microdosed psychedelics and a specific receptor in the body known as 5-HT2B. This receptor is primarily associated with the neurotransmitter serotonin and plays a role in regulating various physiological processes, including those in the heart.
The scientific review focused on the potential activation of the 5-HT2B receptor by microdosed psychedelics. When this receptor is persistently activated, it has been linked to the development of VHD. Therefore, the researchers sought to determine whether microdosing, which often involves prolonged and regular use, could pose a risk by stimulating these receptors over time.
The review examined four commonly used psychedelics, namely LSD, psilocin, mescaline, and DMT, along with MDMA (3,4-methylenedioxymethamphetamine). These substances are all known to interact with the 5-HT2B receptor to varying degrees.
LSD was found to have a potential risk for VHD due to its similarity in potency between the 5-HT2B and the main target receptor, 5-HT2A. While there is some safety margin, individual variations in how the body processes the drug and variations in dosing schedules may not provide adequate protection.
Psilocin (the active metabolite of psilocybin) was found to bind much more potently to 5-HT2B than to 5-HT2A and also acts as an agonist at 5-HT2B, indicating a relatively higher risk compared to LSD when used for microdosing.
Mescaline’s low potency made it challenging to draw definitive conclusions regarding its actions at the 5-HT2B receptor. However, based on binding affinity and total plasma concentrations, it appeared to have a minimal safety margin, suggesting potential risk.
DMT also exhibited a minimal safety margin, but its extremely short half-life may reduce the risk compared to other substances.
MDMA, often associated with partying and club scenes, had the highest demonstrated risk among the compounds studied. Both MDMA and its metabolite MDA are potent 5-HT2B agonists with minimal safety margins for reported microdoses. Furthermore, cases of VHD have been observed in long-term users of full doses of MDMA, confirming its risk.
With the exception of MDMA, no studies had been conducted with the specific aim of investigating this potential health risk in a thorough and scientifically valid manner, the researchers said. Therefore, while there may be general safety concerns about these substances, there is a lack of concrete scientific evidence to confirm or refute the existence of a direct link between chronic use of these psychedelics and valvular heart disease.
The researchers noted that there are numerous lesser-known psychedelics used for microdosing, each with its own distinct safety profile. Unfortunately, little is known about these substances, making it challenging to assess their risk regarding VHD. Moreover, different microdosing schedules, such as every other day or every third day dosing, are common among microdosers. While these schedules may theoretically lower the risk of VHD compared to daily dosing, the exact extent of risk reduction remains unclear.
Interestingly, despite the growing popularity of microdosing, there have been no widespread reports of individuals developing VHD. However, the researchers cautioned that this could be due to the recent emergence of microdosing as a trend, with relatively few people consistently microdosing for a long enough period for VHD symptoms to develop.
“We conclude that VHD is a potential risk with chronic psychedelic microdosing, but further studies are necessary to better define this risk,” the research team wrote.
The paper, “The risk of chronic psychedelic and MDMA microdosing for valvular heart disease“, was authored by Michael Tagen, Daniel Mantuani, Liron van Heerden, Alex Holstein, Linda E. Klumpers, and Richard Knowles.
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