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`Ecstasy' can cause long-term brain damage

San Jose Mercury News - Thursday, October 29, 1998
UK Guardian - Friday, Oct 30, 1998

Positron emission tomographic evidence of toxic effect of MDMA ('Ecstasy') on brain serotonin neurons in human beings,
by U. D. McCann; Z Szabo; U Scheffel; R.F. Dannals; G. A. Ricaurte
The Lancet Vol 352, Oct 31, 1998, 1437

The "designer drug" Ecstasy, which has been associated with a number of deaths, causes long-term brain damage, researchers say.

A team from Johns Hopkins Medical Institutions in Baltimore and the National Institute of Mental Health took brain scans of 14 long-term users of 3,4-methylenedioxymethamphetamine, or MDMA, the chemical name for the drug that reportedly induces increased awareness of emotion.

They found the drug damaged the nerves in the brain which release serotonin, the naturally occurring chemical that plays a role in mood, memory, pain perception, sexual desire, sleep and appetite.

In a report published today in the Lancet, one of Britain's leading medical journals, the researcher said they tapped the drug users' spinal fluid and found low levels of a serotonin byproduct, evidence of damage.

Dr. George Ricaurte, head of the research team, which developed an examination technique over five years, said: "This is the first time we have been able to examine the serotonin-producing nerve cells directly in the brain.''

Ecstasy attaches itself to the molecules that transport and re-absorb serotonin into the nerve cells. The brain probes showed that Ecstasy users had far fewer serotonin transporters than people who did not take the drug. Those patients who had taken the drug most often had also lost the most transporters.

Some of the volunteers had not taken the drug for years -- but there was no evidence that abstaining improved matters.

"We have some indications that there may be changes in memory and cognition,'' said Ricaurte. "Our immediate concern is that people who use MDMA recreationally are unwittingly putting themselves at risk of developing brain injury.''

Dr. John Henry, a professor at St. Mary's Hospital in London, said that Ecstasy had been shown to damage nerve terminals in every animal tested. "We have had indirect evidence that it is harmful in man. Now we have direct evidence.''

Users of the drug would be likely to have a higher incidence of depression in later life, he added. "Serotonin is vital ... for maintenance of mood. As we get older, our serotonin turnover drops.''