from the Newsletter of the Multidisciplinary Association for Psychedelic
Studies
MAPS - Volume 4 Number 3 Winter 1993-94
MDMA Neurotoxicity Update
MDMA Neurotoxicity Update
New data from Drs. Ricaurte and McCann to consider
The results of Dr. Ricaurte and Dr.
McCann's multi-year study were first presented at a neurosciences conference
in mid-November,1993 and will be reported on in more detail in the next issue
of the MAPS newsletter. The study found that the MDMA-experienced group (of
which I was a member) had on average 30% lower levels of a serotonin
metabolite in their spinal fluid than did the control group. Interestingly
enough, the only functional and behavioral differences between the MDMA group
and the controls were that the MDMA users "reported less impulsive and
hostile personality traits, and greater constraint and control". As Drs.
Ricaurte and McCann point out, these differences are generally considered
positive. Furthermore, these findings are perplexing in that the generally
held view is that lower serotonin levels lead to more hostile and impulsive
behavior, not less. As with most MDMA neurotoxicity studies so far, this one
raises more questions than it resolves. More research is required to sort out
the findings.
One difficulty in interpreting the results of this study is
that comparing people to matched controls is as much art as science. People
are wonderfully unique, especially so when it comes to serotonin. Finding a
perfectly matched control is almost impossible since the normal level of brain
neurotransmitters varies enormously between individuals. Nevertheless,
comparing people who have used MDMA many times in the past to matched controls
who have not used MDMA does have some advantages over a controlled study
administering only a few doses of MDMA to its subjects. In a matched control
study, people who have used MDMA a substantial number of times can be
evaluated (Dr. Ricaurte's group averaged over 50), making any serotonin
changes caused by MDMA more likely to be noticed. Data from both sorts of
studies, with matched controls or subjects as their own control, will be
needed to assess more fully MDMA's complex and fascinating effects.
Neurotoxicity potential is optional
If someone were seriously concerned about
neutralizing the possibility of serotonin changes, (though I think the
evidence doesn't justify the effort), animal research has shown that combining
the prescription drug Prozac with MDMA prevents neurotoxicity, even when
Prozac is taken up to six hours after the MDMA. This works because Prozac
binds to the same serotonin re-uptake sites which can be damaged by MDMA
metabolites (though only when MDMA is administered at doses higher than the
standard therapeutic or non-medical amount). The presence of Prozac at the
re-uptake sites prevents the neurotoxic MDMA metabolites from binding,
eliminating its potential effect on the re-uptake sites. An interesting paper
by Dr. McCann and Dr. Ricaurte discusses the effects of the MDMA/Prozac
combination (Journal of Clinical Psychopharmacology, 13 (3): pp. 214-217,
1993.)
MAPS Inc.
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Rick Doblin, President
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