MDMA e Neurotransmissores

Portas da Percepção

hempadao 4 março, 2016

O metilenodioximetanfetamina (MDMA) é um psicodélico e empatógeno com usos muito surpreendentes, haja visto a sua eficiência no tratamento psicoterapêutico do transtorno de estresse pós-traumático (TEPT) e seu vasto uso como MD ou como bala com a finalidade de diversão, prazer intenso e expansão da consciência e da sensibilidade. Mas qual é o efeito do MDMA no nosso organismo e, mais particularmente, como ele se relaciona com nossos neurotransmissores?

por Fernando Beserra

 

Inicialmente, a neurofisiologia do MDMA afeta diretamente dois neurotransmissores: a serotonina e a dopamina. No caso da serotonina (5-hidroxitriptamina, 5HT) o MDMA provoca a inibição de sua recaptação (retorno ao neurônio pré-sináptico), aumentando sua disponibilidade na fenda sináptica (espaço de relação entre neurônios); igualmente, o MDMA aumenta a liberação de 5HT e de dopamina (MALBERG e BONSON, 2001).

O efeito psicofisiológico do MDMA é semelhante aos antidepressivos inibidores seletivos da receptação da serotonina (ISRS), como o Prozac (fluoxetina), no que se refere aos efeitos no neuroreceptores serotoninérgicos. Trata-se de uma ação atípica, pois o MDMA, ao mesmo tempo, aumenta a liberação de 5HT e evita sua recaptação às células pré-sinápticas. O efeito central, no que concerne à serotonina, é sobre os receptores de 5HT2, os mesmos receptores que se ligam aos psicodélicos indóis clássicos, como o LSD e a psilocibina. Há, no campo do debate entre psiconautas e pesquisadores de psicodélicos, a discussão sobre as propriedades psicodélicas do MDMA. Afinal, o MDMA produz efeitos psicodélicos?

Grande número de psiconautas e pesquisadores respondem que sim, mesmo que estes efeitos não sejam comparáveis aos psicodélicos clássicos como o LSD, em especial quanto a seus efeitos no campo da experiência transcendente, além de alterações mais importantes na senso-percepção.

O aumento da liberação de dopamina (DA) é posterior e secundário à liberação de 5HT e seus receptores, pois no caso de uso de MDMA em ratos geneticamente modificados, sem transportadores de 5HT, não há liberação de DA e os ratos não ficam como hiperatividade. A dopamina é um neurotransmissor ligado diretamente tanto à ação motora humana, nos núcleos da base (haja visto a sua importância no caso da doença de Parkinson e nos sintomas parkinsonianos possíveis no caso do uso de antipsicóticos que são antagonistas dopaminérgicos), quanto ao prazer (na via mesolímbica e mesocortical).

Restaria pergunta, a partir destas informações preliminares, se afinal o MDMA é neurotóxico em doses usuais de psiconautas, como se quer concluir a partir de alguns estudos. De acordo com Jullie Holland: “Como todas as medicinas potentes, o MDMA tem uma dose recomendada e uma dose tóxica. Não há nenhuma evidência de que uma única dose terapêutica (em torno de 120mg) cause qualquer dano ao sistema nervoso”.

Acerca da interação com outros fármacos, estudos recentes observaram que, de forma identifica ao LSD e outros psicodélicos, usuários que utilizavam antidepressivos inibidores seletivos de recaptação de serotonina como sertralina (zoloft) e paroxetina (paxil), tem efeitos menos pronunciados no uso do MDMA. Isso ocorre porque estes antidepressivos ocupam os mesmos espaços que o MDMA viria a ocupar na relação com os neuroreceptores. No caso do uso deste tipo de antidepressivo anterior ao MDMA, como a fluoxetina, o efeito do MDMA pode não ocorrer. Com efeito, em atuação conjunta com outras substâncias que aumentam a disponibilidade de serotonina, de acordo com as pesquisadoras Jessica Malberg e Katherine Bonson (2001), pode ocorrer a chamada Síndrome Serotoninérgica (SS). Um exemplo é no uso concomitante, por exemplo, do DXM, isto é, o dextromethorphan, um dos possíveis adulterantes do MDMA. Em ação recente da Associação Psicodélica do Brasil, não identificamos o DXM como adulterante de MD´s e balas. Em nossa avaliação observamos, além de MDMA, anfetamina, butilona ou metilona.

Outro fator importante é que o MDMA pode agir como um inibidor da monoaminoxidase (IMAO), mecanismo que já conhecem bem os pesquisadores e usuários da ayahuasca. No caso, como o MDMA já pode agir desta forma, o uso concomitante de outras substâncias que sejam IMAO podem levar ao quadro de crise hipertensiva, em especial IMAO A.

Finalmente, é importante lembrar que após a inundação serotoninérgica no sistema nervoso após o uso do MDMA, pode haver uma certa falta de 5HT. Exatamente por isso que alguns usuários de MDMA mais experientes recomendam o uso de alimentos com L-triptofano, como peixes e banana na alimentação do dia posterior, pois o L-triptofano é um precursor da serotonina no nosso sistema nervoso e, por lógica, o aumento de serotonina poderia reduzir os efeitos do pós-uso de MDMA, como alguma exaustão e tristeza.

Referências:

MALBERG, Jessica E,; BONSON, Katharine. How MDMA Works in the brain In: MDMA: a complete guide. Rochester/Vermont: Park Street Press, 2001.

HOLLAND, Julie. MDMA Myths and Rumors Dispelled In: MDMA: a complete guide. Rochester/Vermont: Park Street Press, 2001.

Mais posts sobre o assunto no Portas da Percepção:

BESERRA, Fernando Rocha. Psicoterapia com MDMA. Hempadão. Disponível em: – https://hempadao.com/pt/infumacao/portas-da-percepcao/3155-psicoterapia-com-mdma.html

BESERRA, Fernando Rocha. Ecstasy em debate. Hempadão, 2015. Disponível em: https://hempadao.com/pt/infumacao/portas-da-percepcao/2941-ecstasy-em-debate.html

BESERRA, Fernando Rocha. MDMA e psicopatia: um amor possível? Hempadão, 2015. Disponível em: https://hempadao.com/pt/infumacao/portas-da-percepcao/2977-mdma-e-psicopatia-um-amor-possivel.html

BESERRA, Fernando Rocha. MDMA e redução de danos. 2016. Disponível em: https://hempadao.com/pt/infumacao/portas-da-percepcao/3759-mdma-e-reducao-de-danos.html

BESERRA, Fernando Rocha. Legalidade e ilegalidade do MDMA: parte 1. 2015. Disponível em: https://hempadao.com/pt/infumacao/portas-da-percepcao/3679-legalidade-e-ilegalidade-do-mdma-ndash-parte-1.html

BESERRA, Fernando Rocha. Legalidade e ilegalidade do MDMA: parte 2. 2015. Disponível em: https://hempadao.com/pt/infumacao/portas-da-percepcao/3711-legalidade-e-ilegalidade-do-mdma-ndash-parte-ii.html

BESERRA, Fernando Rocha. MDMA e depressão. Hempadão, 2015. Disponível em: <https://hempadao.com/pt/infumacao/portas-da-percepcao/3310-mdma-e-depressao.html>.

BESERRA, Fernando Rocha. MDMA e depressão – parte 2. Hempadão, 2015. Disponível em: < https://hempadao.com/pt/infumacao/portas-da-percepcao/3329-mdma-e-depressao-parte-2.html>.



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