Clubbed by the drug
By RNW.nl – June 2001
Since Ecstasy emerged as the popular party drug of choice during the 1980s, it’s been swallowed by untold numbers of people. And it seems that there’s no sign of a decrease in the use of these illicit tablets. But what about the long-term effects? This is still a relatively small field of research, but the number of scientists getting involved has increased in recent years. Some of the most recent findings come from Amsterdam.
‘Nathalie’ (not her real name) was curious about the effects of all the Ecstasy she had taken over the years, so when she heard about research going on in Amsterdam, she jumped at the chance to take part. At the Department of Nuclear Medicine in the Academic Medical Centre, she and 68 other people underwent tests to assess their memories and certain kinds of cells in their brains.
Dr Liesbeth Reneman explains why she did the research: “We’re concerned about the effects of Ecstasy in people, because there have been a number of studies in animals which have shown that Ecstasy or ‘MDMA’ causes selective damage to serotonergic brain cells – cells that communicate through a neurotransmitter called serotonin. The doses used to induce these neurotoxic changes in animals approach those used by humans, so the data is very relevant.”
Dr. Reneman and her colleagues divided the test subjects into four groups – non-users, moderate-users with a lifetime exposure of less than 55 tablets, heavy-users, and ex-users who indicated using their last tablet more than a year earlier. They used a brain scanning technique called SPECT (single photon emission tomography) to measure the number of serotonergic brain cells present. And they assessed memory performance, for example by testing how many of fifteen spoken words the volunteers could remember.
The results were published recently in the Lancet and the Archives of General Psychiatry. The SPECT studies showed that female Ecstasy users are particularly vulnerable to damaging their serotonergic system, with heavy users showing the greatest loss of cells. However in people like ‘Nathalie’ who had stopped taking the drug at least a year before, the number of serotonergic cells appeared to have recovered in many areas of the brain.
The memory studies revealed less encouraging news. Unlike people who had never taken the drug, all Ecstasy users showed signs of memory loss – to an extent that Liesbeth Reneman says is clinically significant. Unlike the SPECT results, there was no difference found between men and women and there was no sign of any memory improvement in those people who had already given up. Dr. Reneman is worried that, while these subjects are not currently noticing these effects, the memory loss could become more apparent and more significant in the longer term, as the number of serotonergic cells decreases naturally as a result of ageing.
Certain aspects of Dr. Reneman’s research are controversial. Sixty-nine subjects is not a large number on which to base statistical evidence. Some of her techniques have also been criticised by other researchers in the field. However, her results fit well in the larger picture of what is known about Ecstasy – according to Dr. Alex Gamma of the Psychiatric Department at Zurich University Hospital in Switzerland.
But he, like a number of other scientists, is also concerned about the future of Ecstasy itself – or rather, it’s main ingredient ‘MDMA’. He thinks that while Ecstasy abuse may cause long-lasting damage, this should not obscure the fact that MDMA itself is a drug with considerable potential benefits.
Baby and Bathwater:
“What people may not realize is that before MDMA became a recreational drug it was used for many years in psychotherapy in the USA. The reputation it has gained as a recreational drug has certainly prevented efforts to use it in this way. There have been struggles going on to get official permission to use MDMA as a therapeutic agent, which have now proven successful. For example, in Spain a study is going on and in the USA the Federal Drug Administration has recently approved a similar study where the drug is to be used for the treatment of post traumatic stress disorder.”
With evidence on one side of the harm that Ecstasy seems to cause, Dr. Gamma is keen to point out that therapeutic MDMA would be given under very different circumstances. “It would be given only once or twice in a place where the well-being of the patient was being monitored all the time. We have conducted many studies in which MDMA was given in a single dose and we didn’t find any evidence for lasting psychological, psychiatric or cognitive consequences – nor that single doses cause any toxic changes in the brain.”