Does Ecstasy (MDMA) really cause brain damage? There is a whirlwind of controversy surrounding Ecstasy and trying to determine whether it causes brain damage. Some people claim that the drug can cause significant damage to neurons, axons, and the entire serotonin system within the brain. Others claim that there is no solid scientific evidence to support the claims that Ecstasy causes brain damage. There are respected researchers on both sides of the spectrum – some believe that the drug isn’t dangerous while others think its use can have significant long term consequences.

Does Ecstasy cause brain damage? Controversial evidence.

If you do a search on Google, it seems as though there is a lot of conflicting evidence as to whether Ecstasy causes brain damage. One article will say that it is far more damaging to the brain than we originally thought, yet another says that there is no long-term damage as a result of taking Ecstasy. So what’s the truth? Does it damage the brain or doesn’t it? This is a topic certainly up for debate as much research surrounding the usage of MDMA has been falsely skewed as government propaganda.

Yes: Ecstasy causes brain damage.

Ronald L. Cowan (MD, PhD) states that MDMA is likely to produce several changes in the brain including “death” of various nerve cells. He went on to state that it could actually destroy some of the serotonin axons. He says he isn’t aware of any evidence supporting claims that serotonin receptors can regrow and reach their original potential once they are lost.

Other evidence claims that if MDMA is used in a controlled setting – e.g. under supervision of a professional, that adverse effects are less likely. In studies conducted with animals, there were a couple factors that controlled neurotoxicity including: body temperature and blood levels. High blood levels of Ecstasy accompanied by high body temperatures while on the drug are typically accompanied by brain damage.

Many people have heard reports that this drug is used in therapeutic settings for things like PTSD. This is true, but the amount ingested is lower and the body temperature of the person using it is often significantly lower than someone on a dance floor at a rave.

More evidence to support the claim that it causes brain damage comes from a study done with new ecstasy users. A study conducted in the journal “Addiction” demonstrated that individuals who took 10+ ecstasy pills over their first year had decreases in short-term memory function – in comparison to their initial pre-ecstasy performance. It is hypothesized that damage is done to the hippocampus – the area of the brain that is responsible for memory function.

Lead author Dr. Daniel Wagner says: “This study was designed to minimize the methodological limitations of earlier research, in which it was not possible to say whether cognitive impairments seen among ecstasy users were in place before drug use began. By measuring the cognitive function of people with no history of ecstasy use and, one year later, identifying those who had used ecstasy at least ten times and remeasuring their performance, we have been able to start isolating the precise cognitive effects of this drug.”

How Ecstasy is thought to damage the brain

  • Axon loss: Axons may get damaged or experience “death” as a result of ecstasy usage.
  • Memory function: Individuals may notice problems with memory functioning.
  • Short memory problems: Short term memory loss has been found to be an effect of recreational ecstasy use.
  • Nerve cells: Some researchers suggest that MDMA may actually cause permanent irreversible damage to important nerve cells.
  • Serotonin syndrome: Ecstasy has been hypothesized to lead to problems within the serotonergic system. This could result in depletion of serotonin receptors in the brain.

Source: http://archpsyc.jamanetwork.com/article.aspx?articleid=1151061
Source: http://www.ncbi.nlm.nih.gov/pubmed/22831704
Source: http://www.ncbi.nlm.nih.gov/pubmed/11888574

No: Ecstasy doesn’t cause brain damage.

Some evidence says that using ecstasy is unlikely to cause any sort of brain damage. One study compared illicit ecstasy users and non-users – and excluded individuals with lifetime exposure to illicit drugs and alcohol. This was done with 52 illicit ecstasy users and 59 non-users among ages 18 to 45.

The study findings by Halpern et al. (2011) found very little evidence of decreased cognitive performance in ecstasy users. These researchers suggest that there may not be as much evidence of neurotoxicity as previously thought. With that said, they did state that further research needs to be conducted.

Source: http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2010.03252.x/abstract

Is Ecstasy neurotoxic?

Much of the research suggests that Ecstasy is neurotoxic, but the neurotoxic effects may be prevented if it is used therapeutically, in a controlled setting, at a low dose. However, we do not know with 100% certainty that these effects can be prevented. All active doses of the drug are likely going to lead to oxidative stress within the brain. The pharmacokinetics of MDMA imply that even small increases in a dose could lead to large changes in plasma MDMA levels – which could have a neurotoxic effect.

Various types of pharmacological agents such as: antioxidants, SSRIs, and 5-HTP (hydroxytryptophan) injections have been shown to have a slight neuroprotective effect in rodent MDMA studies. With that said, the rodents that experienced neuroprotection typically receive injections of high doses of these protective agents – this may produce a more potent protective effect in rodents than humans.

Research conducted by Liechti in 2000 showed that pretreatment with 40 mg of an SSRI can decrease MDMA effects by 1.5 mg/kg. In 1999, Aguirre found that 2x daily administration of high dose alpha-lipoic acid completely blocked the neurotoxicity of Ecstasy in rats. Some even hypothesize that antioxidants even help enhance recovery from low doses of MDMA.

Does ecstasy cause permanent brain damage? Can it be reversed?

Even if you do sustain some sort of brain damage as a result of using Ecstasy (MDMA), the human brain is pretty resilient. There have been many cases of long term drug users recovering from what appeared to be “brain damage.” People that sustain brain damage are sometimes able to recover. With a drug like ecstasy, I would guess that if a person engaged in healthy activities, took the right supplements and antioxidants, they should be able to reverse the damage over the course of time.

Most things that kill brain cells are not going to have a long term effect – there is evidence that we can grow new neurons. We do not know if the axons and serotonergic system fully recovers after ecstasy usage, but it is logical to think that it would. A neurosurgeon that I spoke with hypothesized that people can sustain some damage in the brain and it typically won’t have a long term effect. With that said, most evidence does suggest that recreational ecstasy (MDMA) use will result in (at least) temporary problems and possible damage.