Category: Ecstasy

— People who take the recreational drug ecstasy risk impairing their memory, according to an international study which surveyed users in places including the USA, UK, other European countries and Australia.

The study, which also surveyed non-drug users, found that those who regularly took ecstasy suffered from mainly long-term memory difficulties, and that they were 23 per cent more likely to report problems with remembering things than non-users.

The British research team, led by the University of Newcastle upon Tyne, also questioned volunteers about their use of other recreational drugs. It found those who regularly used cannabis reported up to 20 per cent more memory problems than non-users. Their short-term memory was mainly affected.

Because evidence has shown ecstasy users are likely to use other drugs, including cannabis, the researchers say they are vulnerable to a myriad of memory afflictions which may represent a 'time bomb' of cognitive problems for later life.

Results of the study are published in the current edition of the Journal of Psychopharmacology.

Use of ecstasy, otherwise known as 3,4-methylenedioxymethamphetamine, or MDMA, is on the increase, with up to two million tablets being consumed every weekend in the UK.

Until now, little has been known about the impact of ecstasy and other drug use on everyday and long-term memory.

Researchers from the Universities of Newcastle upon Tyne, Northumbria, Westminster, Teesside and East London surveyed drug users via a web-based questionnaire.

Volunteers were posed questions about their everyday and long-term memory and asked to rank the probability of scenarios such as finding a television story difficult to follow and forgetting to pass a message onto somebody.

The research team based their findings on responses from 763 participants but they also looked closely at a sub-group of 81 'typical' ecstasy users who had taken the drug at least ten times.

As well as analysing volunteers' responses to the memory tests, the team recorded the number of mistakes made when filling in the questionnaire.

They found the group of 'typical users' reported their long-term memory to be 14 per cent worse than the 480 people who had never taken ecstasy and 23 per cent worse than the 242 non-drug users.

In addition, this group made 21 per cent more errors on the questionnaire form than non-ecstasy users and 29 per cent more mistakes than people who did not take drugs at all.

Lead researcher Dr. Jacqui Rodgers, of Newcastle University, said: "We all know of cases where people have suffered acutely from the use of ecstasy, such as the teenager Leah Betts, but relatively little is known about the more subtle effects on the increasing number of regular users worldwide.

"Users may think that ecstasy is fun and that it feels fairly harmless at the time. However, our results show slight but measurable impairments to memory as a result of use, which is worrying.

"It's equally concerning that we don't really know what the long-term effects of ecstasy use will be, as it is still a poorly understood drug. The results indicate that users are potentially creating a time bomb of potential cognitive difficulties in later life.

"The findings also suggest that ecstasy users who take cannabis are suffering from a 'double whammy' where both their long-term and short-term memory is being impaired."

Dr. Rodgers, of the School of Neurology, Neurobiology & Psychiatry, added that the results could inform drug therapy techniques: "The findings may help drug services in the UK and elsewhere to explain the potential consequences of use so that people can make an informed decision as to whether to take ecstasy or not."

The study also found no significant differences between results from male and female participants.

The illegal drug MDMA (Methylene 3, 4 dioxy-methamphetamine) more commonly known as "Ecstasy" or "XTC," can trigger heart attacks, according to a case report in the December issue of Annals of Emergency Medicine. The case report describes a 27-year-old male who sought treatment at an emergency department after experiencing symptoms of chest tightness and discomfort for three hours.

The man reported that prior to experiencing these symptoms he drank a bottle of whisky and taken half of a pill of MDMA. He was diagnosed and treated in the emergency department for acute myocardial infarction as a result of MDMA use. This is only the second case reported showing evidence that MDMA can cause heart attacks similar to those caused by amphetamines, according to the report's authors. (Methylene 3, 4 Dioxy-Methamphetamine-Induced Acute Myocardial Infarction, p. 759)

The role of MDMA on coronary vessels is not well documented. However, the case report's authors from the National Taiwan University Hospital in Taipei, Taiwan, speculate that MDMA-related heart attacks may be similar to those caused by cocaine or amphetamine use. Other studies have found cocaine and amphetamines promote coagulation of blood that can lead to blood clots in the arteries, which can cause heart attacks.

Physicians in the emergency department should become familiar with this drug because of its emerging trend toward its use, advise the case report's authors. Although it was once thought that the drug does not cause dependency and adverse side effects, this belief has been overturned by many reports of side effects in recent literature, the report further explains.

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Annals of Emergency Medicine is the peer-reviewed journal of the American College of Emergency Physicians, a national medical specialty organization with nearly 23,000 members.

Women who take the drug Ecstasy in their first trimester of pregnancy may be putting their unborn child at risk for brain damage, according to a study published in the September issue of the journal Neurotoxicity and Teratology.

Jack W. Lipton, PhD, a neuroscientist at Rush-Presbyterian-St. Luke's Medical Center in Chicago, demonstrated that fetal exposure in rats to the drug Ecstasy during a period analogous to the first trimester in humans causes changes in the young rat's brain chemistry and behavior. The study was funded in part by the National Institute on Drug Abuse (NIDA). Ecstasy also is known as MDMA or 3,4-methylenedioxymethamphetamine.

"The limited data that exist suggest that women who use Ecstasy stop taking it when they learn they are pregnant," says Dr. Nora D. Volkow, director of the NIDA. "But many of the animal studies that linked this drug to neurological changes and learning impairments were conducted in situations analogous to the third trimester in humans. Thus, this study sought to investigate a more true-to-life situation by looking at neurobiological changes caused by Ecstasy early in pregnancy."

The researchers injected the drug twice daily from day 14 through day 20 of pregnancy. An equal number of pregnant rats were given sham injections of saline twice daily during the same period as a placebo. The most striking finding was that 21-day-old Ecstasy exposed rats had a 502% increase in the number of dopamine neuron fibers in the frontal cortex as compared to controls. The frontal cortex is important in planning, impulse control and attention.

Similar but smaller increases in dopaminergic fiber density were also evident in the striatum — an area involved in movement and reward and the nucleus accumbens — the primary site of action of rewarding stimuli. The investigators believe that this hyperinnervation is either due to MDMA-induced reductions in the normal cell loss that occurs during fetal development, or MDMA-induced increases in chemicals known as trophic factors which can mediate growth and survival of brain cells.

Lipton and his colleagues also found that behavioral changes were evident as well. When 21-day-old rats exposed to Ecstasy in the womb were placed in a new environment away from their littermates, they spent significantly more time exploring and did not habituate as easily to the new environment. Such findings suggest that the Ecstasy exposed rats may have learning or attention deficits or alterations in their anxiety levels. Another possibility is that they are simply hyperactive as a result of their in utero exposure.

"Our findings show that exposing rats to Ecstasy at a time of prenatal development that correlates with the first trimester in humans results in lasting changes in brain chemistry and behavior," notes Lipton. "This research warrants the continued monitoring of children exposed to this drug."

Rush-Presbyterian-St. Luke's Medical Center is an academic medical center that encompasses the 824-bed Presbyterian-St. Luke's Hospital (including Rush Children's Hospital), the 110-bed Johnston R. Bowman Health Center and Rush University. Rush University, with more than 1,270 students, is home to one of the first medical schools in the Midwest, one of the nation's top-ranked nursing colleges, as well as graduate programs in allied health and the basic sciences. Rush is noted for bringing together clinical care and research to address major health problems, including arthritis and orthopedic disorders, cancer, heart disease, mental illness neurological disorders and diseases associated with aging.

Researchers at Rush Presbyterian-St. Luke's Medical Center in Chicago have shown that 21-day-old rat pups exposed in the womb to the drug MDMA (3,4-methylenedioxymethamphetamine, often called Ecstasy) during a period corresponding to the first trimester in human pregnancy exhibit changes in brain chemistry and behavior.

"Existing data suggest that most women who use MDMA stop taking it when they learn they are pregnant," says NIDA Director Dr. Nora D. Volkow. "But the animal studies that linked this drug to neurobiological changes and learning impairments were conducted in situations analogous to the third trimester in humans. This study sought to investigate a more true-to-life situation by looking at the consequences of Ecstasy exposure early in pregnancy."

The study, funded in part by NIDA, was published August 29 on the journal of Neurotoxicology and Teratology Web site.

Dr. Jack W. Lipton, doctoral student James Koprich, and their colleagues injected 8 pregnant rats twice daily with MDMA from day 14 through day 20 of pregnancy, a period corresponding to the first 3 months of human fetal development. The scientists injected saline twice daily during the same period to another 8 pregnant rats. The researchers examined brain tissue of the rat pups when they were 21 days old. A 21-day-old rat pup is roughly equivalent to a 2- to 6-year-old child.

"Our most striking finding was that 21-day-old MDMA-exposed pups had a 502-percent increase in the number of dopamine neuron fibers in the frontal cortex compared with control animals," notes Dr. Lipton. Abnormal or overly numerous connections in the frontal cortex may result in aberrant signaling there, possibly resulting in abnormal behavior.

Dopamine is a brain chemical that carries or transmits messages between nerve cells. It is involved in a variety of motivated behaviors, such as eating, sex, and drug-taking. The frontal cortex is important in planning, impulse control, and attention.

The scientists also saw similar but smaller increases in dopamine fibers in the striatum (a brain area involved in locomotion and reward) and the nucleus accumbens (the primary site of action of rewarding stimuli).

MDMA-exposed pups also showed modest decreases in dopamine metabolism in brain structures that play key roles in reward, addiction, learning, and movement. There also was a reduction in serotonin metabolism. Serotonin also is a brain chemical that helps to regulate mood, sleep, and appetite. Interestingly, the reductions in dopamine and serotonin metabolism that were observed in the nucleus accumbens were evident in male, but not female, pups suggesting sex differences in vulnerability to some of MDMA's prenatal effects.

The rat pups also exhibited behavioral changes. When the Ecstasy-exposed pups were placed in a new environment away from their littermates, they spent significantly more time exploring, signifying they did not adjust as easily to the new environment as the control animals.

"Our findings show that exposing rats to Ecstasy at a time of prenatal development that correlates with the first trimester in humans may result in lasting changes in brain chemistry and behavior," notes Dr. Lipton. "Our findings also suggest that MDMA exposure may result in hyperactivity or deficits in attention or learning. Further research is needed to learn more about the effects of prenatal exposure to this drug."

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The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports more than 85 percent of the world's research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to ensure the rapid dissemination of research information and its implementation in policy and practice. Fact sheets on the health effects of drugs of abuse and information on NIDA research and other activities can be found on the NIDA home page at http://www.drugabuse.gov

Disturbing evidence is emerging that the increasingly popular drug ecstasy can be linked to users suffering long-term brain damage.

University of Adelaide researchers have found that ecstasy taken on a few occasions could cause severe damage to brain cells, with the potential to cause future memory loss or psychological problems.

Dr Rod Irvine, an internationally regarded ecstasy expert from the University's Department of Clinical and Experimental Pharmacology, says with 7% of 17-year-olds reporting use of ecstasy, major health problems could be expected in the future.

"For many years it has been known from animal experiments that small doses of ecstasy-even if only taken on only a few occasions-can cause severe damage to certain brain cells," he says. "More recently, evidence has started to accumulate suggesting that this damage may also occur in humans. Brain scans and psychological assessment of ecstasy users has been used to obtain this information.

"If our suspicions are proved correct, it will mean many of our young people will have memory loss or psychological problems in the future."

Dr Irvine's research on brain damage caused by ecstasy shows that the drug seems to work mainly through its effects on one type of brain cell, and even through one molecule in those cells. It also seems likely that the way the body reacts chemically to ecstasy is important in producing adverse effects, as is the surrounding temperature, which can lead to users overheating.

Adelaide's reputation as having the highest per capita death rate from ecstasy in Australia-and perhaps even the world-forms another component of Dr Irvine's research.

Dr Irvine is looking at the shorter-term consequences of ecstasy "overdoses", and has established that the high rate of death is due to a different strain of ecstasy appearing on the Adelaide market in the mid1990s.

"Normal" ecstasy contains the pharmacological ingredient known as MDMA as its main ingredient, but the Adelaide strain often contained no MDMA but rather a more potent chemical known as PMA.

"PMA hasn't been around since the early 1970s when it was responsible for the deaths of several people in Ontario, Canada, and now it's reappeared here in Adelaide," Dr Irvine says. "We don't know where the PMA came from, but we do know that it has been prevalent in Adelaide since the mid 1990s."

Researchers in Spain have isolated for the first time a by-product of the illicit drug Ecstasy that is believed to cause some of the brain damage associated with the drug. They believe their finding will help them measure, with greater precision, the long-term neurotoxicity of Ecstasy in human users.

The report will be published in the September issue of Chemical Research in Toxicology, a peer-reviewed journal of the American Chemical Society, the world’s largest scientific society.

The findings may corroborate speculation that HHMA (3,4 dihydroxymethamphetamine), is at least partially responsible for Ecstasy’s harm to the human brain, according to lead researcher Rafael de la Torre, D.Pharm., of the Municipal Institute of Medical Research in Barcelona. Previous study had linked HHMA to many of Ecstasy’s known side effects, but until now researchers had not been able to accurately measure the amounts of HHMA in users.

HHMA is created when Ecstasy (known chemically as MDMA, or 3,4- methylenedioxymethamphetamine) is metabolized through the liver. Animal studies have shown Ecstasy to damage the brain’s thought and memory function, but research has indicated that such side effects don’t develop until the drug is metabolized. Accurately measuring the amount and concentration of HHMA in a person’s body can provide new insight into the drug’s effects, including how it is metabolized, and possibly determine its long-term effects, de la Torre said. HHMA does not occur naturally in the body and thus would not be found in a non-user of Ecstasy, he noted.

“This observation concerns not only Ecstasy’s acute effects, but more interestingly, its mid- and long-term neurotoxicity,” de la Torre said. “The detection of HHMA was hampered up to now by problems measuring it in humans, which we have solved.”

The research represents the first validated method for measuring HHMA in body fluids, according to de la Torre. It involved four men who each volunteered to take a 100-milligram dose of Ecstasy and submit blood and urine samples regularly for the following 24 hours. All were described as regular users of the drug. The researchers found nearly identical concentrations of HHMA and MDMA in the samples, establishing HHMA as a likely contributor to conditions associated with Ecstasy use, de la Torre said.

In widespread use since the 1980s, Ecstasy is a stimulant with effects similar to the short-term euphoria and increased alertness claimed by cocaine users, according to the National Institute on Drug Abuse. It is considered dangerous, however, since it has been shown to damage nerve cells in the brain critical for thought and memory, NIDA reports. Other experiments show that people who take MDMA score lower on memory tests and that animals have persistent effects from the drug six to seven years after exposure.

The research cited above was funded by the Spanish government and the Spanish National Plan on Drugs in Madrid.

Rafael de la Torre, D. Pharm., is a researcher in the pharmacology research unit at the Municipal Institute of Medical Research in Barcelona and a professor of toxicology and pharmacology at the Autonomous University in Barcelona.