"Dr Mike Cooper is a fully qualified medical practitioner, specializing in psychiatry. He is also a professional DJ in Australia. Here, he attempts to give a non-biased perspective, using the very latest research and findings, to answer the question, does Ecstasy cause brain damage?

There has been a lot of talk lately that ecstacy may cause long term 'brain damage'. For more than 15 years it has been known that when MDMA is given to experimental animals, it damages nerve cells that releases a chemical called serotonin (the term 'neurotoxic' is used). It doesn't kill the whole nerve, but destroys the 'branches'. There has been a lot of publicity given to this in the media recently. There are claims and counter claims ... sense and sensationalism. Let's cut to the chase, what are some of the facts? The first point to make is that there are NO sure facts. To give you a feel for what's going on, there are hundreds of studies and reports by scientists, doctors, professors etc trying to find the answers. To a lot of the questions there is still doubt and debate amongst people in this field.

Firstly, is MDMA really neurotoxic to animals? Despite there being some unanswered questions there is a wealth of evidence suggesting that YES it is. The higher the dose the more damage. But aren't the doses they give to animals higher than those used by humans? 20-40mg of MDMA per kg of body weight (given once or twice) will destroy most of a rat's serotonin nerve fibres. The equivalent would be for an average size human to take 15-30 'good quality' pills! Unfortunately, because of differences in the way the human body 'handles' the drug, it takes proportionally less to cause damage in humans. Various researchers have estimated that it may take as little as 1.5mg per kg of body weight (1-2 pills) to cause SOME changes. Hopefully, this is being on the cautious side, and this is only an estimate using experiments on monkeys and special formulas to estmitate what the dose for humans would be. Other researchers believe that a single dose would not cause significant damage.

Is there any evidence that damage does occur in humans? To know for sure you would have take people, give them MDMA, chop off their heads and do tests on their brains ... obviously it might be tricky to find volunteers!!! So we only have indirect 'pointers'. Many studies compare long term users (but who have not taken ecstasy for a while) with 'control' groups from similar socioeconomic/educational backgrounds who have never taken ecstacy. They find that long term users have, amongst other things, different patterns on various brain scans; different brain electrical patterns; release different amounts of certain hormones. Does it make any noticable difference? Serotonin is important in mood, memory, sleep and other various brain functions. Recently, there have been several well publicized reports of studies showing that MDMA users have some degree of memory impairment. There have also been many other studies that show that MDMA may lead to problems with not only memory, but impulsivity, ability to plan etc etc. Most reputable scientific studies DO find a difference between regular users and non users! Sometimes the difference is small and would only be detected because of the thoroughness and scrutiny of the tests. Some studies suggest that, as a group, people who use MDMA don't, themselves, notice any more difficulties than would randomly be expected. On the other hand a lot of individuals do attribute memory problems etc to MDMA use. Several points here. As all researchers in this field concede, it is difficult to find broad groups of people matched in every way except for taking ecstacy or not, on which to conduct these studies. It's also likely there may be individual differences in how susceptible people are to MDMA's 'neurotoxicity'. There is also evidence that particular sorts of serotonin nerve fibres are resistant to damage.

Do the damaged branches grow back eventually? Some do. Others grow back, but into the wrong places, while there is evidence that some may be permently damaged. Now I don't want to be all gloomy here! There are some positive things emerging. There are various remedies that partly or completely PREVENT this damage to the nerves. These range from simple 'over-the-counter' remedies to several different prescription medicines. One of the prescription medicines is Prozac (and other 'SSRI' antidepressants). This has repeatedly be shown to prevent the nerve damage in animals. However, I can't recommend you take a Prozac next time you have a bender because there haven't been proper controlled studies done to make sure that it doesn't increase the risk of short term serious side effects (including death.... which is a pretty bad side effect , you'd agree). The other news is that there are some serotonin releasing agents that do NOT cause long term damage. These have been around for a while but have not found themselves in widespread use. Whether they don't give you as good a high? ... tradition? ... more difficult to manufacture? ... who knows?

To summarise, when ecstacy is given to experimental animals in high enough doses, it most probably DOES lead to loss of nerve cell branches (up to 90% loss!). In smaller doses it may lead to partial damage or no damage at all. The doses that humans use probaly DO overlap with the amount given to experimental animals to some extent. There is also evidence that there may be damage occuring in humans. Some people may be more susceptible than others. It's not a matter of telling anyone not to take drugs. There are good things and there are bad things about drug taking ... it's up to each individual to make the decision. It is however, important for more research to be done ... to further clarify what, if any, damage MDMA does do to humans and to see if there are any safe preventative measure.

Thanks to Dr Mike Cooper for the use of this report. If anyone would like further information or copies of reports with more detail, please email Mike on drmikecooper@hotmail.com"

from http://www.clubbed.com/
5th October 2001

Reproduced without permission