MDMA (“Ecstasy”)

MDMA (3,4-methylenedioxy- How Does MDMA Affect the Brain? methamphetamine), popularly known as ecstasy, is a synthetic, psychoactive drug MDMA acts by increasing the activity of that has similarities to both the stimu- three neurotransmitters, serotonin, do- lant amphetamine and the hallucinogen pamine, and norepinephrine. The emo- mescaline. It produces feelings of in- tional and pro-social effects of MDMA creased energy, euphoria, emotional are likely caused directly or indirectly by warmth and empathy toward others, and the release of large amounts of seroto- distortions in sensory and time percep- nin, which influences mood (as well as tion. other functions such as appetite and sleep). Serotonin also triggers the re- MDMA was initially popular among lease of the hormones oxytocin and vas- White adolescents and young adults in opressin, which play important roles in the nightclub scene or at “raves” (long dance parties), but the drug now affects Is MDMA Addictive? a broader range of users and ethnicities. Research thus far on MDMA’s addic- tive properties has shown varying re- How Is MDMA Abused? sults, but we do know that some us- ers report symptoms of dependence, MDMA is taken orally, usually as a capsule including continued use despite or tablet. Its effects last approximately 3 to knowledge of physical or psychologi- 6 hours, although it is not uncommon for cal harm, tolerance (or diminished users to take a second dose of the drug as the effects of the first dose begin to fade. It response), and withdrawal effects. is commonly taken in combination with other drugs. For example some urban gay The neurotransmitter systems target- and bisexual men report using MDMA as ed by MDMA are the same as those part of a multiple-drug experience that in- targeted by other addictive drugs. Ex- cludes cocaine, GHB, methamphetamine, periments have shown that animals ketamine, and the erectile-dysfunction drug will self-administer MDMA—an im- sildenafil (Viagra). portant indicator of a drug’s abuse potential—although the degree of self-administration is less than some other drugs of abuse such as cocaine.

MDMA (“Ecstasy”) • December 2012 • Page 1 love, trust, sexual arousal, and other so- build up in the body if it is taken repeat- cial experiences. This may account for edly within short periods of time. the characteristic feelings of emotional closeness and empathy produced by the Compounding the risks of ecstasy use is drug; studies in both rats and humans the fact that other potentially harmful have shown that MDMA raises the levels drugs (including synthetic cathinones, of these hormones. the psychoactive ingredients in “bath salts”) are sometimes sold as ecstasy. The surge of serotonin caused by taking These drugs can be neurotoxic or pose MDMA depletes the brain of this im- other unpredictable health risks. And ec- portant chemical, however, causing neg- stasy tablets that do contain MDMA may ative aftereffects—including confusion, contain additional substances such as depression, sleep problems, drug crav- ephedrine (a stimulant), dextrome- ing, and anxiety—that may occur soon thorphan (a cough suppressant), keta- after taking the drug or during the days mine, caffeine, cocaine, or methamphet- or even weeks thereafter. amine. The combination of MDMA with one or more of these drugs may be haz- Some heavy MDMA users experience ardous. Users who intentionally or un- long-lasting confusion, depression, sleep knowingly combine such a mixture with abnormalities, and problems with atten- additional substances such as marijuana tion and memory, although it is possible and alcohol may be putting themselves that some of these effects may be due to at even higher risk for adverse health ef- the use of other drugs in combination fects. with MDMA (especially marijuana). Additionally, the closeness-promoting ef- What Are the Other Health Effects of fects of MDMA and its use in sexually MDMA? charged contexts (and especially in com-

MDMA can have many of the same phys- Does MDMA Have Therapeu- ical effects as other stimulants like co- tic Value? caine and amphetamines. These include MDMA was first used in the 1970s, increases in heart rate and blood pres- not as a recreational drug but as an sure, which are particularly risky for people with circulatory problems or aid in psychotherapy—although heart disease. MDMA users may experi- without the support of clinical trial ence other symptoms such as muscle research or FDA approval. In 1985, tension, involuntary teeth clenching, the Drug Enforcement Administra- nausea, blurred vision, faintness, and tion labeled MDMA a Schedule I chills or sweating. substance, or a drug with high abuse potential and no recognized In high doses, MDMA can interfere with medicinal use. Some researchers the body’s ability to regulate tempera- remain interested in its potential ture. On rare but unpredictable occa- therapeutic value when adminis- sions, this can lead to a sharp increase in tered under carefully monitored body temperature (hyperthermia), conditions. It is currently in clinical which can result in liver, kidney, or car- trials as a possible pharmacothera- diovascular system failure or even death. py aid to treat post-traumatic stress MDMA can interfere with its own me- disorder (PTSD) and anxiety in ter- tabolism (breakdown within the body), minal cancer patients. causing potentially harmful levels to

MDMA (“Ecstasy”) • December 2012 • Page 2 bination with sildenafil) may encourage Learn More unsafe sex, which is a risk factor for con- tracting or spreading HIV and hepatitis. For additional information on MDMA, please see http://www.drugabuse.gov/publication s/research-reports/mdma-ecstasy- abuse

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