'Ecstasy: a Human Neurotoxin?' A Novartis Foundation Meeting. Press Coverage.
Warning: 'ecstasy users risk memory loss and depression'
A new warning over ecstasy was sounded today by scientists concerned that the drug can cause depression, eating disorders and memory and concentration problems.
This weekend, half a million ecstasy tablets will be taken by young people across the country. However, few of them are aware that repeatedly taking the pills may have devastating consequences in later life.
Today, scientists were meeting in London to evaluate the evidence that ecstasy, or MDMA, is neurotoxic, poisoning the brain's pathways by its effect on the chemical serotonin.
The initial feelings of euphoria and happiness associated with taking the drug are due to a boost in serotonin, but within hours the chemical is depleted, leading to feelings of lethargy and depression.
Professor Andy Parrott, head of psychology at the University of East London, said today: "The more we learn about this drug, the more problems we uncover. The strands of evidence we can pull together suggest that MDMA may indeed by neurotoxic for humans. What we don't know yet is how long-term those problems are".
Professor Parrott revealed that he had seen patients who were suffering severe depression and concentration problems at least one year after they had stopped taking the drug.
"There is concern that the reduction of the level of serotonin might be a permanent reduction", he added. "In some people the effect is mild but in others there are quite marked difficulties".
Animal studies, mostly in rats, have shown that MDMA can cause prolonged neural damage to the brain's pathways, and the question is now whether regular use of the drug has the same effect.
Since 1989, when ecstasy became popular on the club scene, more than 120 deaths have been attributed to the drug. Most of the people who died were in apparently good health.
Although ecstasy-related deaths are rare, some people are susceptible to the stimulant effects, which can lead to strokes and heart failure. A recent survey found that 13 per cent of university students had taken the drug.
Weekend drug abuse is a growing problem for hospital accident and emergency departments, where staff have coined the term Saturday Night Fever to describe the spate of casualties.
An increasing trend is for clubbers to mix ecstasy with other drugs such as cocaine, says Steve Barbour, a researcher with drugs charity Addaction.
"Many people are aware of the fact it might harm your health, but they also know that statistically there is a very slim chance of death compared with alcohol or even prescription drugs" he says.
"I think that the amount of people taking ecstasy by itself has levelled out, or even dropped, but the trend now is to mix it with other drugs, which is quite worrying. If you take it with alcohol, that can be pretty dangerous."
Scientists last night warned that the clubber's favourite drug, ecstasy, could trigger long-term damage to vital brain cells called serotonin neurons.
Serotonin is a brain chemical important in controlling mood. Although there is still no hard evidence, researchers believe this damage could lead to impaired memory, loss of self-control, increased levels of anxiety, sleeplessness, appetite problems and even long term psychiatric illness.
Ecstasy is the popular name for the 'recreational' drug methylenedioxymethamphetamine, or MDMA. It is taken, sometimes on a weekly basis, by hundreds of thousands of young people in Europe and the United States. There has been a small number of deaths linked with the drug but most users argue that it is safe.
But evidence from Britain, Italy and the US is beginning to tell a different story. Tests on animals - rats, guinea pigs, monkeys and baboons - have repeatedly shown damage to parts of the brain that work with serotonin.
Rat brain cells seem to recover. But Professor Una McCann of the US National Institute of Mental Health in Bethesda, Maryland, said that seven years after being treated to a four-day course of drugs, every monkey in a series of labs across the world had shown signs of irreversible damage.
Now, she and colleagues told a conference in London yesterday, tests and brain scans on human volunteers show similar damage.
George Ricaurte of the Johns Hopkins school of medicine in Baltimore, Maryland, said many neuroscientists were now concerned at the possible effect of this damage: users could be at greater risk of mood and sleep disturbance, aggressive tendencies and anxiety.
The catch is that scientists can only work with volunteers who have already become worried about the drug's effects.
The researchers are faced with other variables: they cannot be sure about the amount, the frequency or the quality of MDMA taken, or the role of other drugs that might have been used. They have no information about users who do not reveal their problems to doctors and they cannot ethically conduct the kind of 'double-blind' experiments which match large groups of patients with control - the technique used to answer questions about pharmaceutical drugs.
But they are in no doubt that ecstasy claims victims. Dr Fabricio Schifano, who heads an addiction treatment unit in Padua, said that at a conservative estimate 50,000 to 85,000 young Italians took ecstasy in clubs on Saturday nights. More than half of a group of 150 in Padua who had used the drug at least once suffered from depression, psychotic disorders, cognitive disturbances, bulimic episodes, impulse control disorders and social phobia.
"I know of no other recreational drugs", said Prof Ricaurte, "that prune serotonin nerve cells in the brain, and do so without producing any immediate and obvious change to the user to alert him or her that brain injury has occurred. That is the reading of the available clinical experience today.
"To me, the fact that we have a potent and selective neurotoxin in the brain cells, and that it can produce these changes without giving an immediate warning that something is amiss, to me that is one of the most insidious aspects of MDMA.
"It allows the user to continue using the drug for prolonged periods of time, potentially sustaining greater and greater serotonin nerve cell injury."
Andy Parrott, a psychologist at the University of East London, said that he had asked student users of ecstasy to rate their mood after taking the drug. "Ecstasy users were rating high elation and euphoria, as you'd expect", Prof Parrott said. "The thing was, the controls were almost as happy as the ecstasy users.
"In other words, they were having a good time on Saturday night. The actual benefit of the drug was very slight.
"Two days later the ecstasy users had significant levels of depression, sadness, bad temper, irritability: you name it, they were suffering from it.
"The controls were taking alcohol, or cannabis, a few were taking amphetamines: their mood changes that week were very slight. The ecstasy users' mood changes were really quite remarkable"