Effect of Ecstacy on Sexual Function and Obsessive-Compulsive Disorder

With me it improved sexual function since I had a problem with premature
ejaculation. 5 Minutes and I was ready to go. E delays orgasm thereby
improving sexual function for some. I heard that SSRI's are now prescribed
for this as well. I haven't done E in 7 years, since I don't know how to get
it anymore, but the positive effects are everlasting.

I think there are some long term negative effects resulting from the
chemical however. I have borderline obsessive-compulsive (OCD) symptoms. OCD
people get locked on intrusive thoughts and try to cancel them out with some
compulsive action; hand washing is common. Some people try to cancel a bad
thought with a good one. They do this over and over until the intrusive
thought goes away. Everyone has a fleeting thought from time to time that is
considered intrusive and not acceptable, but OCD people get locked on them
when they occur.

I admit that it's possible the condition was underlying and the use of "E"
brought it out. But, OCD is linked to serotonin depletion and so is E.
Conversely, E is linked to helping people with OCD, so I'm really not sure
what's going on. The symptoms are mild and I've learned to control them
through self study and therapy, so I live a perfectly normal life. One thing
is for sure, under the influence of E, I shed some self-confidence problems,
met my wife of 10 years, and the positive effects led to a successful career;
I'm now Director of Sales/Marketing for a multi-million dollar firm. What I
can't put my finger on is, did I always have this condition or did E cause
it? I've heard a lot of stories of anxiety disorders linked to the use of E,
and OCD is considered an anxiety disorder. Any comments would be
appreciated.

American man aged 33 working as a senior sales executive

Comments from a psychiatrist:

A wide variety of drugs are useful in premature ejaculation for
physiological reasons. If the effects were still evident 7 years later
however, then clearly the cause of the problem was emotional and this
neurosis was resolved during a psychotherapeutic experience aided by MDMA.
The set and setting of use would then be vital to achieving this particular
outcome. It would thus be erroneous to describe MDMA as a cure for prmature
ejculation. It was the emotional experience which provided the cure. Were
this not so, then the effect would only be evident while he was affected by
MDMA.

As you may recall from one of Dr Charles Grob's published works, MDMA has also
been used to treat OCD. There is no easy answer to this question. Certainly
drugs which enhance the action of serotonin such as Prozac are used to
treat OCD, but they are not very successful. Psychological methods are
rather more effective in general, suggesting that MDMA could alleviate the
condition in a certain set and setting of use, and exacerbate it in other
conditions of use. The use of Prozac and related drugs to alleviate OCD
does tend to suggest that long-term, high dose use of MDMA, which might
result in prolonged serotonin depletion, would be more likely than not to
exacrbate the condition.

On the balance of the evidence, I believe that persons with OCD should
avoid all psychostimulants, including MDMA and especially amphetamine and
cocaine. The latter are clearly linked with repetitive thoughts and
behaviours.

Dr. Karl Jansen
The Maudsley Hospital
63 Denmark Hill
London SE5 8AZ