Psychedelics and valvular heart disease

[Rifle]

I searched the forum but found no discussion of this. There appears to be a possibility of increased risk though as per these 2 articles (I'm don't have access to the second article):

Serotonergic Drugs and Valvular Heart Disease

The serotonin (5-HT) releasers (±)-fenfluramine and (+)-fenfluramine were withdrawn from clinical use due to increased risk of valvular heart disease. One prevailing hypothesis (i.e., the “5-HT hypothesis”) suggests that fenfluramine-induced ...

www.ncbi.nlm.nih.gov

http://www.nejm.org/doi/full/10.1056/NEJMp068265

I'm surprised I couldn't find a discussion of the likely risks of DMT wrt to the findings of these studies. Do we know if DMT has the agonism described? Is there any likely appreciable risk at any reasonable dosing level/frequency? Heart disease is the number one cause of death in the USA.

 

[Amygdala]

Hello,
1) Never take medical advice from strangers on the Internet, even if they are med pros.

2) I am an ICU nurse that specializes in cabgs and valve surgeries, and I still heed #1

3) to my knowledge, the primary threat of dmt in this case would be tachycardia from anxiety/experience intensity and the resulting initial hypertension. Hypertension places excess stress on mechanical/bio synthetic valves. Any alpha or beta adrenergic agonism would occur secondary to the drug itself

4) you can talk to yr dr about this. If yr hesitant to mention drugs, you can ask if you can go bungee jumping or sky diving, as these experiences would approximate the potential cardiovascular and cortisol stress of dmt.

Be safe,
Amygdala

 

[Rifle]

These papers only addressed the long-term effect of chronic use. I have no concern about acute physical effects and little about chronic effects, but given the literature it seems the potential risks of chronic use are worth discussing. However, from the information available I'd guess that very few people use psychedelics frequently enough for this to be a concern.

 

[corpus callosum]

Valvular heart disease is recognised as a consequence of excessive stimulation (usually prolonged and sustained)of the 5HT2b subtype of receptor. This promotes division of certain cells which form the valve ring and eventually leads to fibrosis.

A neuroendocrine tumour which produces excessive serotonin and the Carcinoid Syndrome is well recognised to cause this.Fenfluramine the appetite suppressant also does so (or more correctly its metabolite), as do certain Parkinsons drugs like pergolide and entacapone, and others such as cabergoline (the latter is also safely used to suppress lactation in women choosing not to breast-feed, but the course of treatment here is less than 5 days).MDMA is also a culprit when used excessively frequently with big doses.

The key risk factors seem to be excessive and/or prolonged stimulation of 5HT2b so unless one is a real serotoninergic-hallucinogen hog, or on concurrent agonists of this receptor, the risk is not significant.

In Uganda they love to eat the matoke banana which is similair to plantain; this is well recognised to cause cardiac (including valvular) fibrosis due to its very large serotonin content.Again, this is due to frequent high-dose exposure of the cardiac 5HT2b receptors to serotonin.

 

[Rifle]

Thanks for the response corpus, very informative.

 

[ॐ]

Hey guys,

Sorry to post in such an old thread, but I've been wondering about the risks of this as well lately.
From what I understand, and the comments in this thread, it seems the risks are negligeable as long as you don't really abuse the serotonergic psychedelics.

How frequent is too frequent though? I'm still exploring lots of different compounds, and have been tripping once every two weeks for the past year or so, with no real intents of slowing down.
I use psychedelics responsibly, taking care of dosage/set/setting and with good intent. I find tripping this often helps wonders in warding off my depression, and keeps me motivated to live a healthy life, stay away from harmful addictions, etc.

The substance I am using the most at the moment (and probably for a long time to come) is LSD.
I tend to change things up a bit with mushrooms every now and then, and am still exploring lots of new territory inbetween as well, including 2C-E, novel lysergamides and tryptamines, and DOx compounds like DOC, DOM (I know these are particularly heavy on 5-HT2B agonism, though I will not be using them frequently at all).

So, will use of LSD or mushrooms every 2 weeks for years on end put me at risk for developing heart disease?
Any info on the reversibility of the damage done? Is damage cumulative, irreperable? Does any damage only occur after a period of heavy abuse, or does any period of heavy agonism cause small amounts of damage that add up after a while?

How much is too much? Once every week, or really only heavy use like multiple times a week, which would be non-productive anyway due to tolerance?

Would just like to make sure whether or not I have to dial down my use to protect my heart health.

 

[Emptiness]

Is there not some way to have your heart tested? Are you approaching old age or just worried about death? It is hard to get an exact estimate but generally a lot would be dosing every day. Once a week or two would seem safe to me, but if I had a heart condition and I wanted to trip really bad constantly I would be paying a cardio doc and getting test once a month or so to be on the safe side. The test include where you run on a treadmill and get monitored too i think.

"Despite the lack of evidence, it’s still best to be cautious. We know that psychedelics can activate a receptor in the heart that is a risk factor for heart disease. So it’s probably sensible to avoid taking psychedelics every day or for extended periods.

This is why we advise microdosing for no longer than 90 days, with two rest days between every dose day. It’s also sensible to avoid microdosing if you have a pre-existing heart condition."

The Latest Research on Microdosing and Heart Risk - Third Wave

Third Wave looks into the potential heart associated with using large doses of psychedelics and whether there is a heart risk for microdosing too.

thethirdwave.co

https://www.reddit.com/r/Drugs/comments/2my3zp/heart_damage_and_psychedelics

I would think once I get to 80 or 90 years of age I would worry less about it as I know my time is soon approaching. But maybe I would be too senile to even want to do psychedelics.