"Ecstasy's Dividend"
Has a Parkinson's disease sufferer, who can only find relief (albeit
temporarily) in an illegal drug, accidentally discovered a reliable treatment?
By Jonathan Margolis
New York Times
British film stuntman Tim Lawrence was only 34 when he was diagnosed with the
debilitating neurological condition Parkinson's disease six years ago. It
meant a swift end not just to his parts in movies like Braveheart, Splitting
Heirs and Frankenstein, but also to an active lifestyle that included
acrobatics, martial arts and skydiving. With his body alternating between
rigidity and uncontrollable spasms, almost the only physical recreation left
for Lawrence was going out with friends to London clubs. Under the strobe
lights his thrashing movements could be mistaken for enthusiastic dancing. So
clubs became the one place he didn't feel self-conscious.
It was at such a club three years ago that Lawrence took the illegal drug
ecstasy. What happened next is promising to turn established theories about
Parkinson's disease on their head. While experts still warn strongly against
Parkinson's sufferers taking ecstasy, Lawrence may have stumbled accidentally
on the nearest thing yet to a reliable treatment for the disease, which
afflicts an estimated 4 million people worldwide. Within half an hour of
taking ecstasy, Lawrence felt more than just the sense of elation users of
the drug experience. For the first time in years, he regained control of his
body, and he retained it until the next morning. "It was like a Road to
Damascus," he told Time. "I was suddenly looking down at my body aware that
the twitching had gone, and I had this incredible fluidity. I was completely
normal."
At first, Lawrence regarded the episode as a freak occurrence. The symptoms
of Parkinson's are notoriously unpredictable, and it seemed like just another
of the disease's erratic turns. But then he tried ecstasy again, and once
more he was able for hours at a time to regain something close to the
athletic grace he once possessed. Yet when he mentioned the experience to his
doctors, they dismissed it as a result of the street drug's known amphetamine
qualities. So Lawrence thought little more about it, other than to make the
most of ecstasy's unexpected side effect the couple of times a month he went
clubbing. He also kept quiet about his chance discovery, since, in Britain as
in many countries, taking the drug is a criminal offense as serious as using
heroin or crack cocaine.
Now, however, Lawrence's discovery is being hailed as the beginning of a
medical breakthrough. After seeing footage from a forthcoming BBC television
documentary, two leading Parkinson's researchers have begun full-time
investigation into why ecstasy has such a dramatic effect on his condition.
The documentary, to be aired this week, shows Lawrence in a gym doing forward
rolls, somersaults, backflips and swallow dives despite his debilitating
condition. The researchers, Professor Alan R. Crossman and Dr. Jonathan M.
Brotchie of the University of Manchester, are trying to find a component of
the banned substance that might be developed into a safe drug to mimic
ecstasy's good effects while suppressing the bad, which include memory loss,
brain cell death and depression. And they think such a safe drug could be
available for testing within a year.
Parkinson's is an incurable disorder of the central nervous system usually
associated with the elderly but now increasingly affecting younger people.
Sufferers include Muhammad Ali, Billy Graham, Janet Reno and, according to
some reports, the Pope. But research into Parkinson's remained underfunded
and under-publicized until actor Michael J. Fox announced he had the disease
in 1998, having developed it a decade ago at age 30.
Parkinson's is caused by a breakdown of the brain's production of the
neurotransmitter dopamine, which relays the electrical impulses involved in
muscular movement. The last great breakthrough in treatment was in the late
1960s, when the "miracle" drug levadopa, or L-dopa (the chemical precursor of
dopamine) was discovered to "unfreeze" patients who for decades had been
practically rigid, unable even to produce facial expressions. Though it
remains the standard treatment for Parkinson's, there is a serious downside
to L-dopa. After a couple of years, during which patients seem to be cured,
they start developing the jerky, uncontrolled twitching and tremors that most
people today associate with Parkinson's.
In a healthy person, natural dopamine is released in tune with the body's
needs, but using L-dopa is the equivalent of running a car's turbocharger in
traffic. The result for Parkinson's patients is that their condition
oscillates between hyperactivity while they are on L-dopa and immobility when
they are not. Pharmacologists have been searching for 30 years for a drug to
combine effectively with L-dopa and mute the turbocharger effect, but none
has emerged.
Ecstasy is an amphetamine-like drug that affects emotions by boosting levels
of another neurotransmitter, serotonin, which is normally connected with
feeling happy. Serotonin has rarely been associated with muscular movement.
Confusingly for the researchers, scans of Lawrence's brain show that ecstasy
has a beneficial effect on his Parkinson's even when he takes it on its own,
without L-dopa.
Researchers around the world, including Crossman and Brotchie, have suspected
that serotonin may have some connection with Parkinson's and have been
searching for a serotonin-stimulating drug to combine with L-dopa. They have
had little success, though, and the news that the missing link may be
ecstasy, or at least something in it, has cheered the Manchester duo. "The
reason we're excited by Tim's case is that we've spent between us the best
part of 50 years trying to understand movement disorders, and the effect we
see in him with MDMA [ecstasy's scientific name] is the biggest we've ever
seen," says Brotchie. "Ecstasy on its own isn't going to be a useful
treatment. But the potential may now be there to develop completely new drugs
for Parkinson's."
Brotchie's enthusiasm is shared by Dr. Thomas N. Chase, a neurologist who
heads the experimental therapeutics branch of the National Institutes of
Health in Bethesda, Maryland. "We don't work with street drugs, but we are
not averse to taking clues from all sources," Chase says. "Parkinson's is a
condition for which there is no adequate therapy, so if this observation with
ecstasy is reliable, it could lead to a line of research which could benefit
many, many people with this disease. And my guess is that this observation
will pay off."
It was by chance that Lawrence's case came to the notice of researchers at
all. Documentary director Jemima Harrison of Carlton Television, which
produced the bbc documentary, was making what looked like a routine report on
Parkinson's research. A friend of hers had recommended Lawrence as an
especially articulate sufferer. "We were talking about filming him trying a
new surgical technique in Spain," says Harrison. "Then one day I asked him
out of curiosity if cannabis helped him at all. He said no, and I nosily
asked if he'd tried any other drugs. He said, 'Well, I occasionally take
ecstasy, and it renders me completely normal for several hours.' So I started
looking up the science, and it seemed impossible for ecstasy to have that
effect. That's where it started getting interesting."
Lawrence is uneasy about his impending celebrity: the former British
soldier's views on drug use are far from libertarian. "Other people take
ecstasy because they want to be in an impassive state, have a different
perception listening to music and to dance all night. I do it to experience
normality. But I also feel the heightened sensory perception, and I wouldn't
want to be experiencing that on a daily basis because you wouldn't get
anything else done. So if there is an outcry over my using ecstasy, if I was
investigated and if people were really anti, I'd have to be a bit more
careful." Yet if the research Lawrence has inspired somehow does pay off,
nobody is likely to fault him simply for wanting to dance.