MDMA is a synthetic compound, known illicitly as ecstasy, used in supervised therapy for severe trauma; microdosing means repeating amounts too small to be felt, for steadier mood, easier social connection, and more motivation. That practice has essentially never been tested. Small amounts still raise blood pressure and heart rate, briefly blunt memory, and can be dangerous alongside common antidepressants. Lasting benefits remain reported rather than demonstrated. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Resting blood pressure | 105–120 / 65–78 mmHg | Detects the compound's most consistent physiological effect |
| Resting heart rate | 50–65 bpm | Tracks arousal load and recovery between doses |
| Serum sodium | 138–142 mmol/L | Screens for the water retention that produces hyponatremia |
| ALT | 10–26 U/L in men, 9–22 U/L in women | Earliest signal of strain on the liver, which clears this compound |
| GGT | Under 20 U/L in men, under 15 U/L in women | Liver and oxidative stress, and alcohol co-exposure |
| eGFR (estimated glomerular filtration rate) | Above 90 mL/min/1.73 m² | Kidney function governs both sodium handling and metabolite clearance |
| hs-CRP | Under 0.8 mg/L | Background marker of body-wide inflammation, not drug-specific |
| Echocardiogram (ultrasound of the heart) | No more than trace mitral, aortic, or tricuspid regurgitation; no leaflet thickening | The only way to detect valve changes from chronic serotonin-receptor stimulation |
| CYP2D6 genotype | Normal metabolizer phenotype | Determines whether a nominal microdose gives microdose-level exposure |
Cadence: Blood pressure and heart rate before and roughly two hours after each of the first four doses, then weekly for three months, then monthly; serum sodium, liver enzymes, and kidney function at 3 and 6 months, then every 6 months; hs-CRP every 6 to 12 months; echocardiography at baseline and every 12 months for anyone dosing more often than monthly beyond a year, or sooner if a new murmur, exertional breathlessness, or unexplained fatigue appears.