Ecstasy, literally the withdrawal of the soul from the body, mystical or prophetic rapture, bliss, is one of the fastest growing Schedule I drugs on the market (4). This designer drug known also on the street as the "hug drug", "love drug", XTC, or Adam, (1) has up until recently been shrugged off as an innocuous pastime. The usage of 3,4-methylenedioxymethamphetamine (MDMA), a drug invented by Parke-Davis in 1917 as an appetite suppressant (5), is increasing, and that has scientists and law enforcement alike finding reasons to curtail its consumption. These reasons are definitely justified.
Ecstasy, unlike the age population using it, is not kid stuff and the neurological implications of its effect on the brain, though somewhat unknown, range from damaging to very damaging. There are two biological aspects that are the most affected by Ecstasy consumption, and each was depicted in the above account of an Ecstasy trip: the millions of serotonin neurotransmitters in the brain, and the human consumers themselves. The most fascinating aspect of ecstasy use is taking a literal "trip" through the brain to see how it works and how that relates to what is projected in output.
The trip begins after the ecstasy has been ingested, usually in pill form (1), and makes its way through the blood stream to the brain. Just like the warm up of an engine it takes a little time, about an hour, for ecstasy to move into the parts of the brain where it is most active, the neurotransmitters. During this time the "trippers" feel hardly anything as they prepare themselves for the mindset of an all night ecstasy bash. Once ecstasy reaches its target neurotransmitters, it takes control of the chemicals that influence mood, appetite, sleep, and other important functions, as well the buzzword of the millennium, serotonin. Ecstasy then causes an explosion of serotonin molecules into the synapse space as the party begins (3). Wherever the ecstasy hits, it releases thousands of serotonin transmitters to interact with each other and the receptors of the corresponding dendrite. The receptors are now flooded with eager serotonin and cannot process the input fast enough. Each serotonin molecule becomes aware of all the others around it as it pushes for the receptor space. The rate of electrical firing of the receiving neurons increases exponentially, and this is primarily responsible for the similar behavior expressed by the individual (3). Just as the neurons are interacting at a fast pace the users themselves have entered into a crowded dance room and are thronging to the music feeling every last vibration of each beat or move. Jostling for position on the dance floor users have the ultimate awareness of what is going on around them and how they are reacting to that awareness. Just like the serotonin molecules, there is so much going on around an ecstasy user that there is pure excitement in taking it all in. The thronging of the serotonin molecules is mimicked in the flesh in the amount on sheer energy exhibited. "It puts you in another zone, it's trippy, you hear the music, it gives you energy, it does give you energy, you can go out and dance all night."(6) Back in the brain the ecstasy enhances more and more serotonin release and while some of it is being re-uptaken by the Serotonin Reuptake Transporters ecstasy fires the neurotransmitter faster than any other process (3). The user continues to feel the "high" of enhanced emotions for as long as the serotonin holds out, 4-6 hours. "It just makes you want to touch everybody and be touched by everybody. When you're in a club and they're playing good music, it becomes the best music you've heard in your life." (4)
On the micro-level there is so much is going on in the neural synapse that the serotonin transmitters do not notice that slowly but steadily serotonin is being cycled back into the axon by the transporters and then broken down by monoamine oxidase (3). Simultaneously the user is so involved in feeling and hyperconsciousness that body signals such as tiredness, dehydration, and high blood pressure go unnoticed until slowly one by one the users are "taken away" by collapse from exhaustion or sheer thirst (3). After approximately four hours enough of the serotonin has been removed from the synapse for the surge towards the receptors to slow down and the receptors become more selective, slowing the action potential firing (3). The monoamine oxidase continues to break down the returned serotonin leaving less and less for the receptors to use as current. As the level of serotonin drops well below the "normal" level found in each brain cell, the effect is literally a shut down in production and usage (3). The effect of this "come down" in the body is shown by the fatigue, depression and irritability of the user after loosing all the "firing" sensations of the previous few hours (6). The serotonin levels have been wiped out by over use; and depending on the dosage of MDMA taken, it can take the housing neurons days to recover and make a stock of new cells. This same "wiped out" feeling is a physical display of low moods, sleeping problems, and depression until the proper serotonin level is restored (6). In other words, both the serotonin levels and the user end up "down in the dumps" until the body's natural powers restore balance. Naturally, habitually depleting serotonin levels, as seen with regular ecstasy use, could lead to prolonged depression if the system is not properly replenished with the right tools for neural use.
As with any good "trip" there are unexpected variables along the way that those on the trip do not think could happen. In the neural synapse during ecstasy use there are a considerable number of dopamine transmitters released that bind with their respective receptors to produce part of the "happy" feeling as its output. These do not present a problem until they get trapped in the serotonin transporters and end up in a neuron where they do not belong (3). At the point where dopamine begins being transported wrongfully the transporters are not "thinking" about what they are doing and are just up-taking the nearest molecule that fits. Dopamine is extremely harmful to serotonin cells and causes the "neural toxicity" (4)(7) effect produced by ecstasy, essentially poisoning them (3). The dopamine, once in the serotonin cell, gets broken down by the monoamine oxidase into hydrogen peroxide which oxidizes a healthy cell into a deformed and no longer fully functioning one. This effect shuts down the cell temporarily and sometimes permanently depending on how habitual the poisoning is (8). (It is interesting to note many cites talked about the damage of ecstasy done to serotonin transmitters and the partial re-growth of some of them but only one pointed to an answer as to what chemically damaged the cell directly.) In the body of a user there are also unexpected aspects to each "trip" besides the immediate effects previously described. There are numerous reports of severe liver, heart and brain damage for long-term users (9) as well as potential memory problems associated with the damaged cells (8). Though there is controversy as to the connection, "Molliver et al. (1989) remarks on the similarity between serotonergic axons damaged by ecstasy and those seen in Alzheimer's disease" (10). Habitual users are also not "thinking" about the long-term effects of the drug, nor do they see where the "trip" is going to lead them in the end.
Another form of surprise found in both of this paper's functioning definitions of an ecstasy trip is the increasing occurrence of other drugs being mixed with pure MDMA. Hallucinations, violent mood swings, and hard crashes are all characteristics of other drugs such as LSD, cocaine, and heroin and have been showing up in documented cases of ecstasy use. These effects on the brain stem from the use of other drugs to "cut" the ecstasy and make it more powerful. The frequency of more harmful drugs in the mix with ecstasy is becoming alarming and producing too many variables in the definition of an "ecstasy trip" because it is no longer measurable as just ecstasy. This is one more reason why the use of ecstasy is being classified as increasingly dangerous. Dr. Alan Leshner says it best in summing up the harmful results, outlined in detail above, of the present ecstasy use: "There's no such thing as recreational ecstasy use; this is not like playing ping-pong or tennis" (4).
However, there are always the professional devil's advocates that tote the positive effects of the drug as it is now or potentially in the future. Many psychologists believe that controlled use of ecstasy can open doors for people at an emotional roadblock and help them get through a particularly difficult aspect of their lives (4)(1). Used in the right setting the drug could bring about positive change as the energy of the serotonin is channeled for good. Even under a controlled setting of a psychiatrist's chair the axon damage cannot be overlooked. However, the principle researchers and psychologists agree that a less harmful form of the drug or a different drug with the same benevolent effects would benefit many emotionally distraught humans (11).
Ecstasy use is a good example of the class material discussed, such as that of internal and external inputs producing outputs, as well as internal outputs wrapping around to become inputs. The serotonin transmitters and interface are affected by both the ingestion of ecstasy and the internal output of too much serotonin and dopamine. These, in turn, produce more harmful effects on the axons and the body itself. In this scenario, this cycle is best compared to the ecstasy scene itself where teens are drawn in and keep coming back using the weekdays as the middle part of a continuous circle of ecstasy use. Though the evidence of its addictive powers is still inconclusive, the habitual user keeps "inputting" the ecstasy if the output of a pleasant experience remains the same. The close connection of ecstasy's effects in the brain and on behavior form a strong example in support for the "brain-behavior" line of thought. Whereas many drugs produce some similar circular effects, the use of ecstasy, as outlined in this paper, proves a vital link between these two aspects of the mind. The words of Dr. Bill Wilson seem to sum up ecstasy quite effectively. "Ecstasy is a great drug," says Dr. Wilson. "It's just too bad it's so damn neurotoxic." (4).
2)NIDA Notes- "Like Methamphetamine "Ecstasy" May Cause Long-term Brain Damage.", Older studies about Ecstasy by the same researchers
3)This Is Your Brain on Ecstasy, This site was excellent. It gave detailed insight into the step by step workings of ecstasy in the brain as researchers understand it so far.
4)"The Big E.", Site promotes health issues and this article goes inside use of ecstasy.
5)"Ecstasy", Site gives a little of the history about ecstasy from the beginning.
6)"Use of Ecstasy explodes on-campus and in clubs", Site gives a little depiction of what your brain is like on ecstasy as well as good personal quotes of users.
7)"Ecstasy between Your Ears", Site is pro-ecstasy and totes the benefits of its use and downplays the negative. This site was good for a different opinion on the subject.
8)"NIDA Notes-"Ecstasy Damages the Brain and Impairs Memory in Humans", Site is about factual studies currently run on Ecstasy.
9)"Ecstasy turns to Tragedy for U.K. Teens", Site is about British findings on ecstasy.
10)"Adverse Psychological Effects of Ecstasy use and Their Treatment", Site is a thorough compilation of facts, stats, and interviews on the drug ecstasy.
11)"Drug 'Ecstasy' Linked to Brain Damage", Site is another view of Ricaurte's findings and the search for a new drug like ecstasy in benefits without the toxicity.