Ecstasy and your Brain: Don't believe the promoters
> 2/11/2006 10:32:18 PM

    Ecstasy (MDMA) has been abused since the early 1980’s. It was first heavily abused by “club kids” who were raving at all night dance clubs in New York City. It has been a regular “designer drug” that is often used with ketamine “boosting” and is promoted amongst its users as a feel good drug that enhances the abusers sense of well being (empathogen) and opens up emotional channels that have been previously shut down. These effects are mediated by the drugs profound serotonergic central nervous system effects.

    All the above sounds appealing right? Well that is what Ecstasy promoters would have you believe like the Multidisciplinary Association for Psychedelic Studies  a truly “in touch” organization that advocates the use of Ecstasy in psychotherapy as well as in the treatment on PTSD. They also want to see Marijuana legalized. There are other more scientific types like Julie Holland M.D. from my beloved Bellevue Hospital that are encouraging that Ecstasy be researched as a psychiatric treatment. It seems that one of the back doors that promoters of Marijuana and Ecstasy use these days is to pull at the heart strings of the FDA by trying to establish their favorite drugs as being good in the treatment of “cancer patients pain” both physical and psychological. Now these promoters are plying their strategies to include PTSD patients. Leave us not forget that John Halpern M.D. a psychiatrist at the prestigious Harvard University/McLean Hospital, is looking to examine the effect of MDMA on anxiety and depression in end-stage cancer patients.  This research is an apparent déjà vu to the LSD days of Professor Timothy Leary at Harvard which left an indelible stain on this otherwise dignified institution.

Then there are the “field researchers” like:

Mr. A whose case history is presented by Christos Kouimtsidis, Fabrizio Schifano et al, in this months Psychosomatics 47:86-87, February 2006 because of his Lifetime Intake of 40,000 Ecstasy Tablets

Case Report Mr. A, 37 years old, used ecstasy between the ages of 21 and 30. For the first 2 years, he took 5 tablets every weekend, escalating to an average daily use of 3.5 tablets for the next 3 years, and further escalation to an average of 25 tablets daily over the next 4 years. An estimate of lifetime consumption yielded a total intake of more than 40,000 tablets. At the time of his presentation, Mr. A reported current cannabis consumption, together with a previous history of polydrug misuse (i.e., solvents, benzodiazepines, amphetamines, LSD, cocaine, heroin). After three episodes of "collapsing" at parties, Mr. A finally stopped his ecstasy use. For a few months, he felt as if he was still under the influence of ecstasy and suffered several episodes of "tunnel vision." He eventually developed severe panic attacks, recurrent anxiety, depression, muscle rigidity (particularly at the neck and jaw levels), functional hallucinations, and paranoid ideation. His family and before-drug-use psychiatric history were negative. The Mini-Mental State Exam revealed disorientation to time, poor concentration, and short-term memory difficulties. Decrease in level of cannabis intake led both to disappearance of his paranoid ideas and hallucinations and reduction of his panic attacks, but remaining symptomatology persisted. Administration of the Wechsler Memory Scale (3rd Edition)3 suggested the existence of global memory-function impairment, with no subtest score being above the 10th percentile. Assessment of daily functioning skills identified major behavioral consequences of his memory loss (i.e., repeating activities several times). Although Mr. A was able to fully understand the instructions given, his concentration and attention were so impaired that he was unable to follow the sequence of the tasks required. A structural MRI brain scan revealed no focal cerebral lesions; specifically, both temporal lobes showed normal symmetrical hippocampal areas. The structural areas of the "Dealy-Brion" system were normal. There was no evidence to suggest atrophy. Mr. A was then prescribed olanzapine 10 mg and admitted to a brain-injury unit, where there was some improvement of his memory skills as a result of the use of compensatory strategies.

Granted 40,000 hits of Ecstasy is a sizable amount and I can hear the “promoters” cackling that this is an anomaly and means nothing when you are conducting serious research into helping cancer patients and PTSD sufferers. Well gang Mr. A maybe an unusually exuberant Ecstasy user but he is also brain damaged from his irrational exuberance and was driven by the effects of this drug to use in this manner. Mr. A is not alone, anecdotally, I have treated patients whose use of ecstasy over many years, in order to rave at clubs, have ingested 500-1000 doses of Ecstasy and they are suffering from the neuro-cognitive deficits described in the previous case report.

Leave us not minimize the credible research below that has adequately defined the dangers of Ecstasy. The promoters point to the reseach conducted by one researcher George Ricaurte M.D. from Johns Hopkins University who mixed up vials of MDMA and Methamphetamine and published an article in Nature that had to be subsequently retracted. The “promoters” discredit all Ecstasy research by beating this dead horse and cast aspersions on any subsequent research that might negatively reflect upon Ecstasy’s true effects.

Well here is some research that the “promoters” will have to digest with their daily Vitamin X elixir, oh by the way, none of the following research supports the thesis that Ecstasy (MDMA) is good for the BRAIN:

  1. Cortical Serotonin Transporter Density and Verbal Memory in Individuals Who Stopped Using 3,4-Methylenedioxymethamphetamine (MDMA or "Ecstasy")
  2. Association of a Functional Polymorphism in the Serotonin Transporter Gene With Abnormal Emotional Processing in Ecstasy Users

  3. A Voxel-Based PET Investigation of the Long-Term Effects of "Ecstasy" Consumption on Brain Serotonin Transporters

  4. Ecstasy: Pharmacodynamic and Pharmacokinetic Interactions

  5. Consumer & Family Information: Ecstasy

  6. Ecstasy in the Brain

  7. Electrophysiological Evidence of Serotonergic Impairment in Long-Term MDMA ("Ecstasy") Users

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