Ecstasy users' brains show toxic effects

By Terrapinzflyer · Dec 9, 2011 · Updated Dec 9, 2011 · ·
  1. Terrapinzflyer
    Female Ecstasy users show long-lasting signs of toxicity in their brains, an imaging study shows.

    The neurotransmitter serotonin, a critical signaling molecule, has roles in regulating mood, appetite, sleep, learning and memory.

    In Monday's issue of the Archives of General Psychiatry, U.S. researchers used PET scans to look at levels of certain serotonin receptors in different regions of the brain in 15 women who had used Ecstasy compared with 10 who had never taken it.

    The study is important, said study author Dr. Ronald Cowan, a psychiatry professor at Vanderbilt University in Nashville, because the drug is now being tested as a treatment for post-traumatic stress disorder and anxiety associated with cancer.

    "Our studies suggest that if you use Ecstasy recreationally, the more you use, the more brain changes you get,” Cowan said. Investigators will need to know the dose at which Ecstasy becomes toxic before it is used as a treatment, the study’s authors cautioned.

    In the study, they found Ecstasy use produces chronic serotonin neurotoxicity in humans.

    Since previous studies suggest that the use of birth control, estrogen level and age affect serotonin receptors, the researchers took those factors into consideration in the analysis. But the authors acknowledged they may not have fully accounted for those variables.

    "Given the broad role that serotonin plays in human brain function, the possibility for therapeutic [3,4-methylenedioxymethamphetamine] use, and the widespread recreational popularity of this drug, our results have critical implications for human MDMA users," the investigators concluded.

    To be eligible for the study, Ecstasy users couldn't take it in the 90 days before the imaging study. When hair samples were analyzed to test for drug use, one woman was excluded from the study because of a positive cocaine result.

    Participants were aged 18 to 25.

    The study focused on healthy women and the findings may not apply to men or those with anxiety or depression, the researchers said.

    The research was funded by the U.S. National Institute on Drug Abuse, the U.S. National Institute of Mental Health, and the U.S. National Center for Research Resources.

    CBC News Posted
    Dec 5, 2011

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  1. Terrapinzflyer
  2. mersann
    Okay, set possible issues with the study aside -- what implications would such lowered serotonin receptors levels have? Monkeys having been administered absurd doses of MDMA (as mentioned in the study) seem to keep on living, and I just wonder what things an MDMA user could perform worse, or what effects would it have on his/her mental health?

    This is obviously not with regard to the study in particular, but with regard to all studies that research Serotonin toxicity resulting from MDMA use.
  3. can-I-bust
    was it street ecstasy they where using? if so I hope they accounted for impurities that could be present in any street substance.
  4. Terrapinzflyer
    ^^ Well, it's pretty much a given it was "Street ecstasy" - they weren't using subjects from MAPS clinical trials.

    While I've only had time to skim the paper, I found the controls used to be a little unclear. It seem to be implied that at least some, if not all of the control group had used some drugs- but unclear which drugs, how much, or how often. Likewise it is implied that the ecstasy user group were poly-drug users, but no indication which drugs, how much, or how often. Nor did I see any indication that any questioning was done as to whether the subjects had tested their ecstasy in any way, nor if they were even knowledgeable.

    The small sample group, the relatively young ages, and the odd exclusiveness to female users also worry me.
  5. mersann
    There's a table on page 4 that includes data on this.
  6. Basoodler
    I don't think 75 percent of people who use X "on the street" even know what the active compound should be. Also there is a large portion of street X that is not MDMA or is a mixture containing MDMA. I think it would be more accurate to use the chemicals sold on the street to study a public risk. Because pure MDMA is more a rarity these days... Perhaps it would be of value if the researchers tested and identified what everyone was ingesting. Maybe they did?

    I guess I don't see the value of the study because even if they tested pure MDMA it would not reflect what most X users are eating. If it was street bought then who is accounting for what nasty pipe or amphet may be in those pills? It's not like they are testing something like cocain that is cut with stuff like creatine or baking soda. This is a total mixed bag that has been misrepresented so much that you have no idea what the active compound is
  7. mersann
    Absolutely, and even though they do have some data on the other drugs consumed, the rest of the criticism Terrapinzflyer mentioned, especially being so selective with regard to participants, still holds. I've seen a couple of studies around here that claimed MDMA is neurotoxic and the next group repeated the setup and did not have the same results (and I don't mean the study where the guy injected monkeys with Meth, the one that was retracted because he confused the vials). I kind of expect this to happen this time round as well.
  8. Synesthesiac
    Read this article recently from the daily mail which cites a study [here]. It's a study carried out on the effects of MDMA on female volunteers.

    Quote from the daily mail article:

    Quote from the scientific paper they cite:

    Evidence for Chronically Altered Serotonin Function in the Cerebral Cortex of Female 3,4-Methylenedioxymethamphetamine Polydrug Users
    Am I expecting the usual now, a few knowledgable members here finding how the media has mis represented the research, or is this research adequate reason for concern?

    My immediate reaction is they did not seem to use people that were definately even using MDMA "Because the MDMA content of ecstasy pills was unknown, lifetime MDMA exposure was estimated as the amount of ecstasy consumed.". But other than that (from only a breif scan) I can't find many other factors wrong with their methodology.

    Maybe they fail to make the distinction between responsible use vs irresponsible abuse of MDMA, but that's quite expected. Anyone want to comment on this study further?
  9. voiceduck

    But the report is on the safety of MDMA... whether it can be used theuraputically... were would "street" ecstasy come into that if pure MDMA could be used legally?
  10. Priapism9
    Also keeping in mind that they are saying MDMA use causes neurotoxicity. There are ample methods for preloading and postloading to help prevent neurotoxicity.

    Anyone who does E without the proper pre and post protocols is abusing the drug in my opinion.
  11. Bajeda
    It is extremely irritating that some researchers continue to interpret findings of their research on "ecstasy" users within the framework of MDMA's long-term effects. Increased incidence of deleterious effects has been observed in polysubstance (ab)users relative to those who use single substances, and I believe there was even a study demonstrating that people who used "ecstasy" but did not consume alcohol or other drugs had better scores on tests of cognitive function. Given the disparity in measurable chronic effects noted by research on persons who only used MDMA vs. those who used street products containing the substance and/or who indulged in polysubstance use, I think it is misleading and conceptually ill-founded to present the study as investigating serotonin neurotoxicity in "recreational MDMA users." At least the researchers mentioned the fact that the study participants were polysubstance users, but it is maddening that they would explicitly relate the findings to research on therapeutic use of MDMA without noting the manifold substances commonly present in street ecstasy and the confounding effects such polysubstance abuse could have on attribution of any reported outcomes.

    Maybe I missed it, but I didn't see a single acknowledgment that MDMA might not be the sole/primary ingredient of ecstasy; the assumption is simply that ecstasy = MDMA. Considering that the researchers gave consideration to the impact of "use of birth control, estrogen level and age" on serotonin receptor density, it is difficult not to suspect that the omission of these well-documented confounding factors was deliberate. This isn't to say that the research is completely without merit, but I think the publication was either intentionally framed to better mesh with the general anti-drug rhetoric/narrative or the authors felt that they simply had a weaker paper if they couldn't attribute the effects to MDMA with certainty so they conveniently ignored evidence unhelpful to their findings.

    We have copies of multiple publications in the archive that examine the impact of polysubstance abuse and/or do a better job of attempting to ferret out the chronic effects of MDMA or other drug use while controlling for the numerous variables ignored by this study. Additionally, in response to this article MAPS referred to an article by Jonathan Halpern in Addiction from Feburary 2011 that addresses some of the methodological issues that arise when studying this topic, though it doesn't go into as much detail on the specifics as some of the other papers. Still, abstract and link is below for reference:

    Halpern JH, Sherwood AR, Hudson JI, Gruber S, Kozin D, Pope Jr HG. (2011), Residual neurocognitive features of long-term ecstasy users with minimal exposure to other drugs. Addiction, 106: 777–786

    Aims: In field studies assessing cognitive function in illicit ecstasy users, there are several frequent confounding factors that might plausibly bias the findings toward an overestimate of ecstasy-induced neurocognitive toxicity. We designed an investigation seeking to minimize these possible sources of bias.
    Design: We compared illicit ecstasy users and non-users while (1) excluding individuals with significant life-time exposure to other illicit drugs or alcohol; (2) requiring that all participants be members of the 'rave' subculture; and (3) testing all participants with breath, urine and hair samples at the time of evaluation to exclude possible surreptitious substance use. We compared groups with adjustment for age, gender, race/ethnicity, family-of-origin variables and childhood history of conduct disorder and attention deficit hyperactivity disorder. We provide significance levels without correction for multiple comparisons.
    Setting: Field study.
    Participants: Fifty-two illicit ecstasy users and 59 non-users, aged 18-45 years.
    Measurements: Battery of 15 neuropsychological tests tapping a range of cognitive functions.
    Findings: We found little evidence of decreased cognitive performance in ecstasy users, save for poorer strategic self-regulation, possibly reflecting increased impulsivity. However, this finding might have reflected a pre-morbid attribute of ecstasy users, rather than a residual neurotoxic effect of the drug.
    Conclusions: In a study designed to minimize limitations found in many prior investigations, we failed to demonstrate marked residual cognitive effects in ecstasy users. This finding contrasts with many previous findings-including our own-and emphasizes the need for continued caution in interpreting field studies of cognitive function in illicit ecstasy users.

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