A second topic came up in this episode - cardiac valve disease with use of 5HT2 receptor agonists . You also discussed this before, I believe in episode #17 with Andrew Chadeayne. The pharmaceutical pulled from the market was Fenfluramine, half of the combination Fen-PHEN (Fenfluramine-Phenteramine). Ryan mentioned the risk was up to 30%. the data is somewhat confusing on this one. The initial concern came from 24 case reports of valve damage after millions of prescriptions. Subsequent surveillance found several hundred cases. The incidence was low but relative risk was quite high - up to 20x that of people who did not take fenfluramine. There was one later study that showed as high as 23% of people on fenfluramine has some aortic regurgitation. This did not require long term usage. This could be of concern for daily microdosers of 5HT2B agonists. It took years before it became apparent with fenfluramine. I would worry that it would be very hard to detect as routine microdosing is not common and not in the open.
Nick, Excellent episode. After listening I had a question I was hoping you or Ryan could answer. As the 5HT2B receptor functions at least partly via with influx of calcium, do calcium channel blockers change efficacy of psychedelics? Calcium channel blockers are a very common medication for hypertension. It seems many do cross the blood brain barrier. A brief google search did yield papers on ca channel blockers and psychosis in mental health. I did not find any direct papers on psychedelics and calcium channel blockers. Thanks.
Biochemistry & Molecular Biology of Serotonin Receptors, Tryptamines & Psychedelics | Ryan Gumpper | #102
A second topic came up in this episode - cardiac valve disease with use of 5HT2 receptor agonists . You also discussed this before, I believe in episode #17 with Andrew Chadeayne. The pharmaceutical pulled from the market was Fenfluramine, half of the combination Fen-PHEN (Fenfluramine-Phenteramine). Ryan mentioned the risk was up to 30%. the data is somewhat confusing on this one. The initial concern came from 24 case reports of valve damage after millions of prescriptions. Subsequent surveillance found several hundred cases. The incidence was low but relative risk was quite high - up to 20x that of people who did not take fenfluramine. There was one later study that showed as high as 23% of people on fenfluramine has some aortic regurgitation. This did not require long term usage. This could be of concern for daily microdosers of 5HT2B agonists. It took years before it became apparent with fenfluramine. I would worry that it would be very hard to detect as routine microdosing is not common and not in the open.
Nick, Excellent episode. After listening I had a question I was hoping you or Ryan could answer. As the 5HT2B receptor functions at least partly via with influx of calcium, do calcium channel blockers change efficacy of psychedelics? Calcium channel blockers are a very common medication for hypertension. It seems many do cross the blood brain barrier. A brief google search did yield papers on ca channel blockers and psychosis in mental health. I did not find any direct papers on psychedelics and calcium channel blockers. Thanks.
Sorry - note above refers to episode #71 (not #17)