Ecstasy, the Brain, and Serotonin (MIA)

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Biology 202
2002 First Paper
On Serendip

Ecstasy, the Brain, and Serotonin (MIA)

Amy O'Connor

3,4-methylenedioxymethamphetamine (MDMA), or ecstasy, is a synthetic, psychoactive drug with stimulant and hallucinogenic properties. Ecstasy is an often talked about drug due to its recent popularity and rapid spread amongst teenagers especially. Many newspapers and magazines have featured articles in the past 5 years highlighting the danger of this easily made drug, and its rampant use in the club/rave scene of almost all Western countries. The complete effects of ecstasy are still unknown, although much research has been produced that shows the deleterious effects of the drug on the brain. Ecstasy is also controversial because the content of pills varies widely; buyers and sometimes sellers don't really know what each pill consists of (1). The results of a survey published in 2002 set out with the purpose of examining the prevalence and patterns of ecstasy use among college students, and to determine characteristics, associated behaviors, and interests of ecstasy users. These results showed that from 1997-1999, ecstasy use increased significantly in every college subgroup except for noncompetitive schools. The variable most strongly associated with ecstasy use was found to be marijuana. In terms of social context, MDMA users were more likely to spend large amounts of time socializing, attend residential colleges, and belong to a fraternity or sorority.

The first study that provided direct evidence that chronic use of ecstasy causes brain damage was published in 1999. The study used advanced brain imaging techniques (PET scan) to show that MDMA harms neurons that release serotonin, a chemical that is thought to play an important role in memory, among other functions. The PET scans showed significant reductions in the number of serotonin transporters, the sites on neuron surfaces that reabsorb serotonin from the space between cells after it has completed its work. The lasting reduction of serotonin transporters occurred throughout the brain. This study and others suggest that brain damage and the amount of MDMA ingested are directly correlated (2). But what are the functional consequences?

The functional consequences of ecstasy use have just begun to be explored in the past few years. Another study, published in 2000, found that heavy ecstasy users (30-1000 occasions) as opposed to non-ecstasy users, reported significantly higher scores on tests for somatisation, obsessionality, anxiety, hostility, phobic-anxiety, paranoid ideation, psychoticism, poor appetite, an restless or disturbed sleep. Another interesting effect of MDMA found was a significantly higher degree of impulsivity. This particular characteristic of ecstasy users has been found in other studies as well (3). What is the connection between the neurobiology of MDMA use and the behavior of the user? How do reduced serotonin levels result in behavior changes such as impulsivity? Various animal studies have demonstrated that MDMA selectively affects serotonin and related chemicals in the brain. Brain concentrations of TPH, 5-HIAA and serotonin were decreased in rats treated with MDMA, while dopamine and similar chemicals weren't affected at all. In another study, rats treated with MDMA were found to have a dose-dependent decrease of serotonin in the hippocampus, hypothalamus, striatum and neocortex. Another study revealed a lasting loss of serotonergic axons in the forebrain after MDMA use. Even 52 weeks after the last MDMA treatment, serotonin concentrations were significantly reduced in the cortex and hippocampus; serotonin transporter binding was also reduced (6).

While there are numerous studies with results like the aforementioned, no convincing direct causal relations between neurochemical alterations and neuropsychological parameters have been thus far established (6). An equally important question is how can scientists present these relationships to the average ecstasy user in an understandable format? Sites such as dancesafe.org (4). and ecstasy.org aim to educate and provide users with literature and the most up-to-date research on ecstasy while not condemning using it (5). Approaches like this make imperative information much more accessible to users because it is both risk-free and personal.

The direct link between the neurotoxicity of MDMA and the psychosocial behavioral effects has not yet been figured out, but it is clear that a link does exist. Perhaps one day researchers will be able to find the missing link. Until then, ecstasy users can access web sites and science journals to attempt to use the drug in the safest possible way.

Works Cited

1)Drug Abuse Home Page, a government supported cite, strongly anti-drug, and useful reference

2)NIDA Home Page, a sub-group of the NIH

3) Parrot, A.C. et al. "Psychobiological Problems in Heavy 'Ecstasy' Users (MDMA) Polydrug Users. Drug and Alcohol Dependence. 60 (1999): 105-110.

4)dancesafe homepage, a great resource for youth especially, not anti-drug

5)ecstasy homepage, independent site for basic information on using ecstasy safely

6) McGuire, P. "Long Term Psychiatric and Cognitive Effects of MDMA Use." Toxicology Letters. 112-113 (2000): 153-156.

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