The risk of chronic psychedelic and MDMA microdosing for valvular heart disease
Journal of Psychopharmacology August 12, 2023 Michael Tagen, Daniel Mantuani, Alex Holstein et al. 39 citations
Taking very low, repeated doses of psychedelics like LSD, psilocybin, mescaline, DMT, or MDMA may pose a risk of valvular heart disease because these substances activate the serotonin 5-HT2B receptor, which is linked to heart valve damage. All five compounds and some of their metabolites bind to this receptor with potency equal to or greater than their binding to the 5-HT2A receptor. Safety margins based on typical microdose blood levels are higher than those of known valvulopathogens, but risk is not absent. No animal or clinical studies properly designed to assess this risk exist for the psychedelics, though chronic full-dose MDMA use is associated with valvular heart disease. Further research is needed.