Ecstasy's effects on the brain

Some research suggests that regular use of Ecstasy (MDMA) may result in long-term memory problems, particularly in the area of prospective memory (remembering things you plan to do). It also appears that even a single dose can affect verbal memory.

Ecstasy damages mechanisms associated with serotonin, which is why long-term or heavy use can cause depression, anxiety, confusion, and difficulty sleeping.

There is also some evidence that long-term use may reduce the number of brain cells, especially in the hippocampus. Use of Ecstasy during pregnancy may damage the developing fetus, but only if taken during a particular critical period of pregnancy.

Having said that, a recent study designed to overcome the potential confounding factors in previous studies found little evidence of decreased cognitive performance in ecstasy users, with the exception of poorer strategic self-regulation (which may be a precursor rather than a consequence).

The first study to look at the effects of the drug ecstasy on infant development has shown that infants exposed to ecstasy before they were born tend to be behind, especially in motor and coordination skills, at four months.

The study involved 96 women who were questioned about their substance use prior to and during pregnancy. Most of the women surveyed had taken a variety of illegal drugs. 28 women had taken MDMA (ecstasy) during pregnancy. The infants of these women had poorer motor development and lower milestone attainment at 4 months, with a dose–response relationship to the amount of MDMA exposure.

The study is continuing, to see whether these children experience long-term problems.

Participants were primarily middle class with some university education and in stable partner relationships.

For more about the effects of ecstasy on cognition

Imaging the brains of 10 young men who were long term users of ecstasy and seven of their healthy peers with no history of ecstasy use has revealed a significantly smaller hippocampus in those who used ecstasy. The overall proportion of gray matter was also lower, suggesting the effects of ecstasy may not be restricted to the hippocampus.

Both groups had used similar amounts of recreational drugs other than ecstasy, and drank alcohol regularly. The ecstasy group had not taken ecstasy for more than two months before the start of the study on average.

[2218] den Hollander, B., Schouw M., Groot P., Huisman H., Caan M., Barkhof F., et al.
(2011).  Preliminary evidence of hippocampal damage in chronic users of ecstasy.
Journal of Neurology, Neurosurgery & Psychiatry.

In a study designed to minimize flaws found in many earlier studies, a comparison of 52 illicit ecstasy users and 59 matched non-users, aged 18–45 years, revealed little evidence of decreased cognitive performance in ecstasy users, with the exception of poorer strategic self-regulation, possibly reflecting increased impulsivity. This may reflect a pre-existing state, rather than being a consequence of the drug.

To overcome the potential confounding factors in previous studies, potential participants were ruthlessly winnowed. Only those who did not have significant life-time exposure to other illicit drugs or alcohol and did not test positive for drug use at the time of testing were included (a process that terminated in only 52 ecstasy users out of an original 1500). All participants also had to be members of the ‘rave’ subculture.

The researcher points out that regardless of the effects of ecstasy itself, it is dangerous because of the contaminants often found in the pills.

A study involving 42 students who were ecstasy/polydrug users has found that ecstasy, or the regular use of several drugs, affects users' prospective memory (remembering things you plan to do), even when tests are controlled for cannabis, tobacco or alcohol use. Cocaine use in particular was prominently associated with prospective memory impairment. Deficits were evident in both lab-based and self-reported measurements.

[164] Hadjiefthyvoulou, F., Fisk J. E., Montgomery C., & Bridges N. J.
(2010).  Everyday and prospective memory deficits in ecstasy/polydrug users.
J Psychopharmacol. 0269881109359101 - 0269881109359101.

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Older news items (pre-2010) brought over from the old website

Ecstasy can harm the brains of first-time users

Ecstasy targets neurons in the brain that use serotonin to communicate. Previous studies have found that long-term or heavy ecstasy use can damage these neurons and cause depression, anxiety, confusion, difficulty sleeping and decrease in memory. Now research into the effects of low doses on first-time users has revealed a decrease in blood circulation in some areas of the brain, along with a relative decrease in verbal memory performance in ecstasy users compared to non-users.

De Win, M. et al. 2006. Ecstasy: Is It Safe for the Brain? First Prospective Study on Effects of Low Doses of Ecstasy on the Brain in New Ecstasy Users, Using a Combination of Advanced MR Imaging Techniques and [123I]ß-CIT SPECT. Presented on November 27 at the annual meeting of the Radiological Society of North America (RSNA).

International survey finds Ecstasy use affects long-term memory

An international web-based survey of Ecstasy users and non-drug users found that those who regularly took ecstasy suffered from mainly long-term memory difficulties, and that they were 23% more likely to report problems with remembering things than non-users (14% more likely compared to those who had never taken Ecstasy, but had taken other drugs). Those who regularly used cannabis reported up to 20% more memory problems than non-users, and their memory problems mainly involved short-term memory. The Ecstasy users also made 21% more errors on the questionnaire form than non-ecstasy users and 29% more mistakes than people who did not take drugs at all. The study involved 763 people, from which 81 'typical' ecstasy users who had taken the drug at least ten times were selected for closer investigation. There were no significant differences between genders.

[367] Rodgers, J., Buchanan T., Scholey A. B., Heffernan T. M., Ling J., & Parrott A. C.
(2003).  Patterns of Drug Use and the Influence of Gender on Self-Reports of Memory Ability in Ecstasy Users: A Web-Based Study.
J Psychopharmacol. 17(4), 389 - 396.

Ecstasy may cause permanent memory damage

A comparison of memory performance in recent users of the drug Ecstasy, ex-users, and those who have never taken the drug, indicates Ecstasy may cause permanent damage to cognitive function. It appears that ecstasy damages mechanisms associated with serotonin, particularly in an area of the brain linked to memory.

[1022] Reneman, L., Lavalaye J., Schmand B., de Wolff F. A., van den Brink W., den Heeten G. J., et al.
(2001).  Cortical Serotonin Transporter Density and Verbal Memory in Individuals Who Stopped Using 3,4-Methylenedioxymethamphetamine (MDMA or "Ecstasy"): Preliminary Findings.
Arch Gen Psychiatry. 58(10), 901 - 906.

Researchers have isolated Ecstasy by-product believed to cause some of the brain damage associated with the drug

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.

[780] Segura, J., de La Torre R., Segura M., Ortuño J., Farré M., McLure J. A., et al.
(2001).  3,4-Dihydroxymethamphetamine (HHMA). A major in vivo 3,4-methylenedioxymethamphetamine (MDMA) metabolite in humans.
Chemical Research in Toxicology. 14(9), 1203 - 1208.

Use of ecstasy during pregnancy may produce learning and memory impairments in child

Researchers today reported the first evidence that a mother’s use of MDMA (ecstasy) during pregnancy may result in specific types of long-term learning and memory impairments in her offspring.
The research was conducted by scientists from Children’s Hospital Research Foundation and the University of Cincinnati College of Medicine, on rats. It appears the damage to offspring occurs only if the drug is taken during a particular critical period of pregnancy.

[1418] Broening, H. W., Morford LR. L., Inman-Wood S. L., Fukumura M., & Vorhees C. V.
(2001).  3,4-Methylenedioxymethamphetamine (Ecstasy)-Induced Learning and Memory Impairments Depend on the Age of Exposure during Early Development.
J. Neurosci.. 21(9), 3228 - 3235.

Long-term use of ecstasy may result in memory impairment in specific areas

A year-long study of 15 ecstasy users, ranging in age from 17 to 31, suggests that long-term use of ecstasy may result in memory impairment in specific areas, such as the ability to recall a short passage of prose being read out immediately and after a delay (this ability declined by approximately 50% between the first and second assessments).

[2386] Zakzanis, K. K., & Young D. A.
(2001).  Memory impairment in abstinent MDMA (“Ecstasy”) users: A longitudinal investigation.
Neurology. 56(7), 966 - 969.