E is for Ecstasy by Nicholas Saunders

Appendix 1: Reference Section

143 Letter from George Ricaurte of Johns Hopkins University, 23/11/93

"As to your question of whether lower levels of serotonin in and of themselves can be considered "damage", I would say that in addition to low levels of serotonin, MDMA produces loss of several other markers for serotonin neurons. In particular, MDMA induces a loss of serotonin uptake sites, the serotonin metabolite (5-HIA), and tryptophan hydroxylase (the rate limiting enzyme in the synthesis of serotonin). This constellation of neurochemical deficits, in conjunction with morphological evidence of serotonin neuronal damage, strongly suggests that MDMA and related drugs are indeed neurotoxic."