Can it be eliminated altogether?
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I’ve always considered myself lucky since I don't experience the typical MDMA hangover. The day after rolling, I don’t feel depressed like many report; I feel affectionate, open, relaxed, and daring—almost as if I were still high. However, two days after, I’ve been known to cry over some stupid things, including, but not limited to, “I have too much work to go to the park,” “I don’t like this hotel as much as our last one,” and “my relationship might end one day.”
MDMA ups the activity in your serotonin system, which creates all the pleasant feelings it’s known for, as well as the not-so-pleasant effects like muscle tension and overheating, says James Giordano, professor of neurology and biochemistry at Georgetown University Medical Center. As it wears off, your brain runs low on serotonin, which can lead to depression, irritability, and fatigue. “If you deplete that system, you wear that system down,” Giordano adds. “It takes a while for your body to make more serotonin, and the effect of serotonin depletion is a tremendous crash.”
In addition to the “blue Mondays” immediately following weekends of raving, some people describe “suicide Tuesdays” or “Tuesday blues” with a two-day delay. This happens because MDMA increases serotonin levels for a long period of time, especially if you take it more than once over the course of a night, Giordano says, before it drops. This is known as a “latent crash.”
People who are consuming other drugs (like antidepressants) or foods such as ginger, cumin, or grapefruit, which affect the breakdown of MDMA, may experience serotonin release for longer than others. In addition, some have more resilient serotonin systems, and some are less sensitive to MDMA in general, so they’re less likely to experience a major crash at all.
How you use the drug also makes a difference. If you re-dose, you’re essentially “stacking half-lives,” Giordano says. The half-life is the amount of time it takes for your body to break down the concentration of a drug by 50 percent. For example, if MDMA’s half-life in your body is seven hours and you take 100 mg at 11 pm, half of it will likely leave your system by 6 am. But if you take 50 mg at 11 pm and 50 mg at 1 am, you’ll still have half the second dose in your system at 8 am. On top of that, re-dosing (taking more after the first dose kicks in) will release more serotonin overall than taking one dose because not all of each dose binds to your receptors, and taking it twice gives it two chances to bind. Giordano says that re-dosing can be a main culprit in the latent crash (however, taking a large amount at once carries its own risks, like an elevated heart rate and excessively high body temperature, known as hyperpyrexia).
Not much can be done to alleviate an MDMA hangover, Giordano says, though rest, hydration, and nutrition can help. Foods with high tryptophan content, like turkey and dairy products, can help replenish serotonin supply, though the body may take a while to absorb it. Alcohol and other drugs can can mess with the central nervous system and prevent the liver’s clearance of MDMA, prolonging the hangover.
As a side note, my feeling of still being slightly high the next day is not just a feeling. My body may really still be releasing high amounts of serotonin, Giordano tells me. That also means my judgment may be impaired, so he doesn’t recommend making big decisions the day after rolling. (That could explain why I decided to give up my apartment and travel the world the day following a week in Ibiza, so I guess I’m lucky that’s worked out.)
Most post-MDMA symptoms will go away after a few days, but some can be dangerous—like a fever or a fluttering in the chest. These are signs of serotonin syndrome, which can be fatal if left untreated.
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