Curiouser and curiouser: Could ecstasy actually heal brains as well as minds?

May 9, 2011

For 30 years we have had a systematic attack on the safety of ecstasy [MDMA]. This has been fueled by a desire by governments, lobbyists and some scientists to justify the illegal status of this drug which in the UK is at the very highest level – Class A. This puts it alongside drugs such as crack cocaine and heroin which by all scientific assessments are much more harmful [Nutt King and Phillips 2010].

Much of the so called scientific evidence that has been used to justify MDMA as being harmful is flawed, some just simply wrong as they used the wrong drug [Ricaurte et al 2002] and most findings are exaggerated. For example, a well reported recent study that claimed to provide proof that MDMA impaired memory in fact found a minimal effect in only one memory measure that was of no clinical significance. This was taken as proof that MDMA damaged the brain despite the fact that on some other measures of brain function, the MDMA-using group performed better than the controls [Schilt et al 2007].

It appears there is an assumption that MDMA will damage human brains because in studies in some animal species [rats and monkeys] it can lead to damage to the serotonin nerve cells. These effects are most pronounced at high doses and are not seen when human equivalent doses are used [Fantegrossi et al 2004]. But still the concern is there, at least in the mind of the Home Sec Jaqui Smith when she announced that MDMA would remain Class A against the recommendations of the ACMD. She said that as long as there were “public concerns” about the risks of ecstasy on the brain she would not be moved, even though these concerns were largely manufactured by the media and magnified by bad science on ecstasy [Forsyth 2001].

However you might feel that as all drugs may be harmful then ecstasy could surely only be harmful also?  Well maybe not. We should remember that MDMA was developed as a therapeutic tool for psychotherapy and its successful role here was severely curtailed when the drug was made illegal. Thirty years on, MDMA has only recently been reintroduced into clinical trials with great success in one study in resistant PTSD [Mithoefer et al 2010].

But what about the rats – does it still cause brain damage there? A new paper shows an intriguing effect and one, which many will find paradoxical: MDMA improved recovery from brain injury rather than worsening it [Edut et al 2011]. This paper has not apparently received any media attention so far which I why I felt compelled to do what I could to make it more widely known.

However the results are not so paradoxical if one remembers that the potential utility of such stimulant drugs to aid recovery from brain trauma was first reported over 30 years ago for amfetamine [see Gladstone and Black 2000]. I have made efforts to get stimulant drugs tested in clinical trials for the brain injured in the UK but always their controlled status makes using them difficult. Doctors are frightened, ethics committees worried, special licenses are required and are expensive and patients and relatives concerned (if it’s classified then it must be surely be dangerous?). For these reasons, we need to work to minimise the damage that legal controls on drugs have to impede research. The recent banning of mephedrone and naphyrone is likely to significantly limit new drug discovery in the area of antidepressants and anti-addiction agents [Nutt 2010, Nutt 2011].

Lets hope that this intriguing new finding of the potential therapeutic benefit of MDMA as a brain repair agent is taken up by the medical and scientific communities working in the fields of stroke and brain trauma. Some encouragement from the media could help this process.

Refs

Edut S, Rubovitch V, Schreiber S, Pick CG (2011) The intriguing effects of ecstasy (MDMA) on cognitive function in mice subjected to a minimal traumatic brain injury (mTBI)  Psychopharmacology 214, Number 4214, 877-889, DOI: 10.1007/s00213-010-2098-y

Fantegrossi WE, Woolverton WL, Kilbourn M et al. (2004) Behavioral and neurochemical consequences of long-term intravenous self-administration of MDMA and its enantiomers by rhesus monkeys. Neuropsychopharmacology 29(7): 1270–81.

Forsyth A Distorted? a quantitative exploration of drug fatality reports in the popular press International Journal of Drug Policy 12 (2001) 435–453

Gladstone DJ, Black SE. Enhancing recovery after stroke with noradrenergic pharmacotherapy: a new frontier? Can J Neurol Sci. 2000 May;27(2):97-105

Mithoefer et al (2010) The safety and efficacy of _3,4-methylenedioxymethamphetamineassisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study. Journal of Psychopharmacology. July 2010.

Nutt 2010

Blogs
You say precaution, I say perversion: eight harms deriving from the precautionary principle

And

The ACMD and naphyrone – another example of evidence-free policy making?

Nutt 2011 Perverse effects of the precautionary principle: how banning mephedrone has unexpected implications for pharmaceutical discovery Therapeutic Advances in Psychopharmacology Editorial – in press

Nutt DJ  King LA Phillips LD (2010) Drug harms in the UK: a multicriteria decision analysis  Lancet 376: 155866

Ricaurte GA, Yuan J, Hatzidimitriou G et al. (2002) Severe dopaminergic neurotoxicity in primates after a common recreational dose regimen of MDMA (“ecstasy”). Science 297: 2260–3. Retraction printed in: Science (2003) 301: 1479.

Schilt T, Maartje ML de Win, Koeter M et al. (2007) Cognition in novice ecstasy users with minimal exposure to other drugs. Archives of General Psychiatry 64: 728–36.

17 Responses to “Curiouser and curiouser: Could ecstasy actually heal brains as well as minds?”

  1. Paul Driscoll Says:

    Pedantry: Edut et al. (2011) is about mice, not rats.

    Also I note that MDMA was administered _before_ trauma? Is that signficant? (Can’t get complete PDF, only the Abstract.)

  2. Matthew Roberts Says:

    Very interesting, but I find the message undermined once again by this statement: “This puts it alongside drugs such as crack cocaine and heroin which by all scientific assessments are much more harmful”. But surely, by all scientific assessments heroin is an incredibly benign drug. Isn’t it conclusively established that the harms that arise from heroin use are largely (and arguably exclusively) due to its illegality?

    I have no doubt that the comments here about ecstasy are accurate, but I fear that Professor Nutt seeks to add respectability to his comments by effectively saying “of course, I accept that heroin etc are bad drugs”. But I believe it is a dire mistake to try to destroy myths about one drug while reinforcing misconceptions about another.

    • Michael Wieland Says:

      Dear Matthew

      I guess he is talking about “street heroin” only, whose use is really very risky due to the results of its illegality (as you mentioned). But you’re absolutely right that pure human consumption grade diacetylmorphine does not damage your body. The swiss heroin programme shows that. The harms done to one’s body by repeated i.v. injections as a route of administration is another story though.

  3. TJC Says:

    was reading about mdma a few weeks ago, cant remember where I read it but until fairly recently it was available on prescription from the nhs under a branded name from some pharma company for use with social anxiety disorders, the site went into detail on the testing done on the chemical make-up of a number social anxiety treatments, and they found that the ones that relieved the symptoms best were those containing high amounts of mdma, with some being nothing more than mdma put into a capsule if I come across the site again then ill post a link, was actually a very interesting read

  4. David Says:

    MDMA has been tested for decades by millions of people without any discernable harm and is the illegal drug I feel most at ease in using in terms of my personal safety – this includes countless couples that use it for relationship counselling, people self medicating/counselling personality disorders, mentally revisiting traumatic times/events with a more positive perception to aid coping, acceptance and development, friends bonding and yes also more than a few people at parties/clubs. Its usage is similar but even more favourable when compared to alcohol as in people “grow out of it” and personal usage declines with age (without the addiction of the majority self treating anxiety or the very very small fraction of severely traumatised users seeking oblivion seen with alcohol).

    This is why I feel incredibly angry that as MDMA becomes harder to buy people unable to accept that something incredibly beneficial to their lives has been removed (despite their mature, free and responsible choice to use it) are being pushed into taking analogues of other substances to gain similar therepeutic effects. These drugs are substantially less tested, harder to identify for a user and sometimes offer a lesser experience. The restrictions on MDMA have led people away from a perfectly benign experience to, whilst probably not more dangerous substances, ones that certainly carry much more unknown. This does not seem responsible policy in terms of harm reduction to society or individual.

  5. Chris Bovey Says:

    I took my fair share of MDMA along with my friends back in the 90s, all I remember is having a bloody good time. We all knew that was rubbish about it being dangerous, we took enough of it to know that it was not. Statistically eating a peanut is more likely to cause death.

  6. Tony Ward Says:

    It’s really time we got some honest and open debate, The drugs industry is huge because there’s millions of satisfied customers, are our elected representatives the only people in Britain that don’t recreational drugs? non of them smoked a cheeky spliff at a festival, popped a couple of e’s out at a club or snorted a line at a party, of course they have, they need to stop being such hypocrites, the problem is the law not the drugs.
    The link below demonstrates how our governments current policy is the danger to society.

    http://www.thisisnottingham.co.uk/news/Dirty-heroin-Notts-cause-deaths/article-3534351-detail/article.html

    • Jake Says:

      Tony, have you ever seen this http://www.release.org.uk/nicepeopletakedrugs/deck-of-cards/ (click for close ups) – just look at how many elected officials have not only used recreational drugs that are currently ‘controlled’, but also admitted to it. Remember its fine for the rich and powerful to take drugs as its a ‘youthful transgression’, but if you’re poor or of a different ethnicity to the ruling class, drug taking is a savage crime on society that must be stopped at any cost in which death, addiction and more poverty are ‘deserved’… the hypocrisy is actually criminal in my eyes…

  7. Laurie King Says:

    In June of 2010 my boyfriend Chris sustained a brain injury due to oxygen deprivation after a motorcycle accident injured his lungs and filled his airway with blood. He subsequently had to relearn to use his arms and hands. Both his gross and fine motor skills were affected. Physically he recovered very quickly but he made almost no progress emotionally. My step father has Asperger’s and over many months my mom and I realized that the symptoms, ideas, thought patterns and behaviors of both men were uncannily similar. Apparently Chris had sustained damage to the portion of his brain that is affected by Asperger’s. Over several months I poured over articles, searched the internet, support groups and blogs. I read all about MDMA and how it may be helpful in treating these particular symtoms. I decided to get some and give it a shot. Chris took one pill then a few hours later he took another. He opened up and we had a great time. Within the next few days we both realized that ALL of his symtoms were gone. For the first time since the accident he felt at ease and his social anxiety was gone. Previously, he had not trusted anyone and had obsessive thought patterns thinking everyone was out to get him. He no longer experiences any of these. He says it was like he was just faking all of his friendships but now he feels the emotional bond that he was unable to before. He is able to articulate very well his thinking before, during and after his injury and recovery. Researchers could learn so much from us! I am sharing his story on the internet on blogs and sending it in to everyone hoping this information will help others. For us, MDMA is truly a miracle pill.


  8. I have sold prodigious amount of MDMA to people and am now facing federal time for it. Not one person complained or had a bad experience. Some responsible drug users are being treated differently than others who use the government approved, yet much more dangerous drugs Alcohol and Tobacco. This is oppression plain and simple. God save Casey William Hardison!

  9. Anna Says:

    “MDMA is penicillin for the soul, and you don’t give up penicillin, once you’ve seen what it can do”

    • Klaus Kaczor Says:

      Thankfully the Judge realized my criminal acts were a unique form of sincere community activism. I am currently serving a conditional sentence in the community (from my place of confinement– a lovely four bedroom home I share with artists and intelligent people and the internet and my ability to communicate intact). There was some question as to my unique mental make up influencing my behavior. The results for being self represented with the help of Darryl Bickler were very acceptable to me, I had nearly 1 pound of E and much else. I went as far as I could and an understanding judge took mercy on me. Through my actions before and during court, I was able to convince him that I was a sincere activist with community safety as my goal.

  10. Christine Says:

    Prof Nutt. I read in a Melbourne newspaper about your proposed study of ecstacy. I had a lifelong fear of flying. I had been subscribed valium but it really made no difference my anxiety was so bad that 20mg did nothing. Under normal circumstances that would render me unconcious. I had ecstacy once before getting on a plane. It was remarkable. Not
    only did it make that flight anxiety free it completely cured my fear forever. After 15 years of flying phobia it went and never returned.


  11. [...] var _wdfb_ajaxurl="http://www.mentalhealthnewstoday.com/wp-admin/admin-ajax.php";var _wdfb_root_url="http://www.mentalhealthnewstoday.com/wp-content/plugins/WPFacePages/facebook"; FB.Event.subscribe('edge.create', function(href){ var data = { post: '269', action: 'fbjax' }; jQuery.post('http://www.mentalhealthnewstoday.com/wp-admin/admin-ajax.php', data, function(response) { location.reload(); }); }); #split {}#single {}#splitalign {margin-left: auto; margin-right: auto;}#singlealign {margin-left: auto; margin-right: auto;}#splittitlebox {text-align: center;}#singletitlebox {text-align: center;}.linkboxtext {line-height: 1.4em;}.linkboxcontainer {padding: 7px 7px 7px 7px;background-color:#eeeeee;border-color:#000000;border-width:0px; border-style:solid;}.linkboxdisplay {padding: 7px 7px 7px 7px;}.linkboxdisplay td {text-align: center;}.linkboxdisplay a:link {text-decoration: none;}.linkboxdisplay a:hover {text-decoration: underline;} function opensplitdropdown() { document.getElementById('splittablelinks').style.display = ''; document.getElementById('splitmouse').style.display = 'none'; var titleincell = document.getElementById('titleincell').value; if (titleincell == 'yes') {document.getElementById('splittitletext').style.display = 'none';} } function closesplitdropdown() { document.getElementById('splittablelinks').style.display = 'none'; document.getElementById('splitmouse').style.display = ''; var titleincell = document.getElementById('titleincell').value; if (titleincell == 'yes') {document.getElementById('splittitletext').style.display = '';} } Ecstasy trial planned to test benefits for trauma victimsCuriouser and curiouser: Could ecstasy actually heal brains as well as minds? [...]

  12. Simon Says:

    Whilst I agree that MDMA, LSD, etc could potentially have useful medical applications, I, and many others, are living proof that these types of drugs CAN do harm, even with little use.

    These types of drugs can cause a visual perception disorder that is distinct from flashbacks due to their chronic nature, and also distinct due to the fact that they appear to be an inability of the brain to correctly process visual information, rather than true hallucinations. I say this because of the nature of the visual disturbances, and also because these symptoms can also appear in people who have never taken any drugs. However, by far the biggest triggers appear to be LSD, MDMA and the like.

    Visual symptoms can include visual snow, floaters, halos, starburts, afterimages, trails. ghosting, etc. Non visual symptoms can include headaches and tinnitus, amongst others. Depersonalisation and derealisation can be present as well.

    This group of symptoms has come to be known on self-help forums and the FEW in the medical community who are aware of it as Hallucinogen Persisting Perception Disorder (HPPD), which is recognised in the States. HPPD is a DSM-IV diagnosis with diagnostic code 292.89. The technical DSM-IV diagnostic criteria is a little different from what HPPD is thought as within the medical community, and so you may note differences in the DSM-IV criteria, and what I have outline above.

    HPPD is for when the visual disturbances have been caused by the use of drugs. There is no recognised term for the when the disturbances have not been caused by drugs, although this could soon change. See this recent study to be presented at the Annual Meeting of the American Academy of Neurology on April 21st by Dr. Goadsby (top UK neurologist who you may well have heard of), and others (http://www.abstracts2view.com/aan/view.php?nu=AAN12L_S36_006&terms=) – note that this is not a study into substance abuse, yet 40% of patients experiencing these symptoms have taken illicit drugs in the past.

    Patients with these symptoms often leave medical professionals stumped, due to lack of research and understanding. Many professionals will have never come across this disorder before, often mistaking their symptoms as something else entirely, setting treatment on the wrong path. Sometimes professionals will even see these symptoms as trivial, based on anxiety, and simply in the patient’s head, which they are most certainly not. Anxiety can be present, but this is because of the symptoms, not the other way round.

    There appears to be a LITTLE awareness with regard to these symptoms as a result of drug use in the States, but this disorder is virtually unheard of within the UK. Indeed I am only aware of it through my own research – I have found all of this out on my own – no medical professional I have spoken to thus far in the UK has been able to give me any answers, although I have had a consultation with a doctor located in the States who recognises that my symptoms are as a result of drug use, and will be getting in contact with my doctors over here.

    For those who are dealing with these symptoms, something has clearly gone wrong in the brain. It appears some people may be genetically susceptible to these disturbances, and drugs can often act as the trigger. I believe there is some research currently taking place in the States in this respect, but has not yet been approved for publication due to lack of funding. Of course, if more research were to take place, and this were proved, those wishing to take these types of substances for medical reasons could be screened beforehand.

    There are lots of things which have not been picked up by the media – good and bad. You have mentioned some of the good things, now I have mentioned some of the bad. It would be interesting to hear your views on the matter, whether you are aware of the condition or not. These post is just a very brief outline – I would be happy to discuss this with you further if you wish.

  13. hellyharrap Says:

    I find it hard to accept the use of illicit drugs to help heal minds. Ecstasy is similar to mdma a drug used along side LSD on the ’60’s to help mental health patient’s, When studying psychology a big part was the effects of drugs on the brain. So many times these drugs are claimed to open minds and help people reach self actualisation. In some cases David it does work but in many illicit drugs can cause more harm than good and lead to suicide.

    Further I used of magic mushrooms can have devastating effects on organs such as kidneys and how can it be excused to heal one illness another could be accumulated.

    Similarly with cannabis another healing drug can can physiological changes in lesions in the brain causing people to perceive things differently.

    For those these therapies have helped heal minds I feel nothing but say well done you but for many where illicit drugs have caused nothing but misery I cannot agree with this form of counselling.

    I have seen excellent results by involving people and allowing them progress by empowering them life choices and providing options and support.

    Maybe it is that I find illicit drugs difficult to accept yet the negatives out way the positives and a positive result is not always the outcome. Hence some ones culture and acceptance of these drugs first must established before a healing hand can be given?


    • From Admin not David;-
      Hi, thanks for taking the time to contribute your thoughts.
      You’re right that illicit drugs can be damaging, but this is true of virtually all medical treatments. For example, even the everyday drug paracetamol destroys the liver and kidneys if too much is taken. Medical science determines the correct way to use these potentially harmful substances to bring benefits rather than harms. Research has shown that controlled doses of all three of the drugs you mention, MDMA cannabis and magic mushrooms, can be given to healthy people with very little risk of harm. Cannabis is already licensed for medical use in some countries, (in the UK, the legal cannabis medication is called Sativex) and doctors should only ever prescribe this when they think that the benefits it can offer outweigh the small risks. Cannabis does not cause brain lesions, although it can certainly make people perceive things differently as you say, and if used long-term for medical reasons, the patient and doctors would be on the look-out for any side-effects (e.g. anxiety or dependence), as with any medication. Magic mushrooms (psilocybin-containing mushrooms) do not damage organs, they are very powerful but non-toxic. However, a very small number of people have indeed destroyed their livers and kidneys by taking poisonous mushrooms by mistake. If therapeutic properties of the mushrooms can be proven, perhaps patients will be able to be given a very pure, precise dose of the active chemical legally by a licensed psychiatrist or psychotherapist. Then they will not have to pick or buy the mushroom s themselves and will not risk poisoning. Finally, MDMA (which is ecstasy) is the most physically dangerous of the three drugs, as it is possible to take an overdose, as with paracetamol. However, as long as the dose is controlled and it is not used regularly, the risks will be similar to or lower than those of many common medical drugs, like opiate painkillers.
      You mention the risk of suicide, and this is a good example as to why the therapeutic use of currently illicit substances is so important. MDMA is being studied as a possible treatment for post-traumatic stress disorder, which is itself a major cause of suicide. If MDMA is proven to be as effective as the first experiment has shown, then it may be possible to prevent many suicides and much suffering by effectively treating PTSD. You will be pleased to hear that the research being undertaken now on magic mushrooms (psilocybin) and MDMA involve a great deal of support and empowerment. The drugs alone are not themselves the cure but they seem to allow the psychotherapy to be super-effective.
      Already there are drugs like diamorphine and benzodiazepines that can cause considerable suffering to people who are addicted, but which also are used safely and effectively by doctors to relieve suffering. Just because something can be misused outside of medical use does not mean that it is inappropriate for medical use.
      It is very important that the scientists and doctors who prescribe any drugs do so responsibly and with an awareness of the risks, and I’m confident that they will be able to use their expertise to correctly judge how to use these drugs to minimise human suffering rather than adding to it.


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