What extacy does to the brain

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Try out PMC Labs and tell us what you think. Learn More. The drug is an amphetamine derivative, with the pharmacologic name 3,4-methylenedioxymeth-amphetamine MDMA. Indeed, many users and social commentators believe that with better management, the negative consequences of MDMA use can be avoided. The latter risk, it is believed, would be eliminated by better quality control as a result of legalizing the drug.

A review of the scientific literature, however, paints a very different picture of this drug, which is far from benign. Numerous animal studies have yielded clear evidence of potent neurotoxic effects of MDMA that are specific to central serotonergic 5-HT systems. Although the applicability of these to the human condition has been vigorously contested, clinical observations are sufficient to raise legitimate concern over the negative consequences of exposure to MDMA in humans. The evidence that MDMA is toxic to central serotonergic nerve terminals wasderived from experiments in several different species, including rats 2 and a variety of subhuman primates.

Although initially it was thought that toxicity required multiple exposure to relatively high doses of MDMA, subsequent studies have shown that a single exposure to a high dose, or several exposures to lower doses, can induce the same profile of toxicity. Despite the loss of a high proportion of 5-hydroxytryptamine 5-HT terminals throughout the forebrain in animals, functional imaging reveals that the short- to medium-term effects of repeated MDMA treatment are largely limited to alterations in subfields of the hippocampalformation 8 where changes in glucocorticoid and 5-HT receptor expression are also evident.

Although initially it proved difficult to find any cognitive sequelae that correlated with these changes, 11 recent animal studies have shown subtle, but lasting, deficits in cognitive behaviorsthat do correlate with the levels of damage to 5-HT systems in What extacy does to the brain hippocampus. Evidence from human studies has What extacy does to the brain more slowly, but it is becoming apparent that the toxic effect of MDMA on central serotonergic systems found ly in animal studies has a clear parallel in human users of the drug.

There is now direct evidence of a lasting decrease in 5-HT uptake sites a marker for the integrity of 5-HT nerve terminals in human volunteers with a past history of MDMAabuse.

What extacy does to the brain

In addition to the hippocampal formation, both the amygdala andareas of neocortex may be affected byMDMA. The manifestations of this neurotoxicity, in terms of altered cerebral function and behavioral change, range from neuroendocrine impairments 16 to deficits in verbal memory and reasoning, 17 short-term memory and semantic recognition, 14 and visual memory.

The effects of MDMA on cognitive performance arising directly from drug—induced neurotoxicity may be compounded by indirect effects on the cerebral circulation. As well as providing extensive innervation of forebrainneuronal systems, there is What extacy does to the brain evidence that cerebral blood vessels are innervated by the same serotonergic neurons arising from themesencephalon. In rats, the acute effect of MDMA is to produce pronounced focal cerebrovascularhyperemia, 23 which, in anatomic distribution, is directly parallel to the occurrence ofMDMA-associated hemorrhagic stroke in humans.

If these vascular accidents are neurologically silent, however, they may only become apparent at a later date. This effect may parallel the type of cognitive decline seen in patients with multi-infarctdementia. Findings from animal studies suggest that long-term cognitive problems are associated with MDMA exposure, and clear parallels are now emerging from clinical experience.

What extacy does to the brain

It is important, however, not to overstate the case. These s are small compared to the s of individuals who use MDMA regularly.

What extacy does to the brain

Studies of the drug can be criticized on the basis that they depend heavily on the quality of self-reported data. The data analysis may also be confounded by failure to report multiple drug use or inaccuracies in the reported duration of drug abstinence immediately prior to the investigation. Nevertheless, health care professionals should be aware that cognitive disorders, mood disturbances, and increased risk of cerebrovascular accidents are among the possible long-term, negative consequences of MDMA exposure in humans.

In particular, minor short-term deficits may be exacerbated by interaction with normal aging processes in the brain, or as a result of subsequent exposure to physiologic or psychologic stress. Even if these long-term effects are confined to a subpopulation of particularly susceptible individuals, the very scale of current usage— 3.

Competing interests: None declared. National Center for Biotechnology InformationU. Journal List West J Med v. West J Med. Paul A T Kelly 1. Author information Copyright and information Disclaimer. Correspondence to: Dr Kelly, ku. This article has been cited What extacy does to the brain other articles in PMC. Radiologic and cognitive changes Despite the loss of a high proportion of 5-hydroxytryptamine 5-HT terminals throughout the forebrain in animals, functional imaging reveals that the short- to medium-term effects of repeated MDMA treatment are largely limited to alterations in subfields of the hippocampalformation 8 where changes in glucocorticoid and 5-HT receptor expression are also evident.

What extacy does to the brain

Cognitive changes in ecstasy users The manifestations of this neurotoxicity, in terms of altered cerebral function and behavioral change, range from neuroendocrine impairments 16 to deficits in verbal memory and reasoning, 17 short-term memory and semantic recognition, 14 and visual memory. What should we tell ecstasy users? Open in a separate window. Figure 1. Notes Competing interests: None declared.

What extacy does to the brain

References 1. Better than well [Editorial]. The Economist April 6,pp J PharmacolExp Ther ; Brain Res ; MDMA selectively damages central serotonergic neurons in the primate. JAMA ; Br J Pharmacol ; Relationship between the dose of MDMA and frequency of administration on the What extacy does to the brain neurodegeneration of rat brain 5-HT. Br J Pharmacol ; P. Ricaurte GA.

Studies of MDMA-induced neurotoxicity in non-human primates: a basis for evaluating long-term effects in humans. Psychopharmacology Berl ; Chronic3,4-methylenedioxymethamphetamine MDMA administration decreases glucocorticoid and mineralocorticoid receptor, but increases 5-HT1C receptor gene expression in the rat hippocampus. Neuroscience ; 61 Site-specific regulation of corticoid and serotonin receptor subtype gene expression in the rat hippocampus following 3,4-methylenedioxymethamphetamine: role of corticosterone and serotonin.

Neuroscience ; 78 JPharmacol Exp Ther ; Behavioural analysis of the acute and chronic effects of MDMA treatment in the rat. Psychopharmacology ; Toxicol Lett ; Ecstasy— long-term effects on the human central nervous system revealed by positron emissiontomography. Br J Psychiatry ; Altered neuroendocrine and behavioral responses to m-chlorophenylpiperazine in3,4-methylenedioxymethamphetamine MDMA users. Neurology ; 51 Impaired cognitive performance in drug free users of recreational ecstasy.

What extacy does to the brain

JNeurol Neurosurg Psychiatry ; 68 Blasted by ecstasy:psychopathological implications of the loss of serotonergic axon terminals caused by substituted amphetamines. Neurol Psychiatry BrainRes ; 5 Clinical and toxicologicalaspects of ecstasy XTC use. Ned Tijdschr Geneeskd ; Central serotonergicnerves project to the pial vessels of the brain.

What extacy does to the brain

Nature ; Experimental neocorticalhyperemia produced by acute exposure to methylenedioxymethamphetamine. Scott Med J ; 37 Enhanced cerebrovascular responsiveness to hypercapnia following depletion of central serotonergicterminals. J Cereb Blood Flow Metab ; 15 Cohen RS, Cocores J. Prog Neuropsychopharmacol Biol Psychiatry ; 21 Addiction ; 92 Davison D, Parrott AC.

Ecstasy MDMA in recreational users:self-reported psychological and physiological effects. HumPsychopharmacol ; 12 Support Center Support Center. External link. Please review our privacy policy.

What extacy does to the brain

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