New York Times
September 27 2002
By DONALD G. McNEIL Jr.
Study in Primates Shows
Brain Damage From Doses of Ecstasy
The amount of the drug Ecstasy that some recreational users take in a single night may cause permanent brain damage and lead to symptoms like those of Parkinson's disease, a study in primates has found.
But critics say that the monkeys and baboons in the study were given huge overdoses of the drug and that the kind of damage the researchers found has never been found in autopsies or brain scans of humans who took large amounts.
Dr. George A. Ricaurte of the Johns Hopkins University School of Medicine, who led the study, said its most disturbing finding was that just two or three Ecstasy tablets can damage the cells that produce dopamine, a brain chemical that helps control movement, emotions and the ability to feel pleasure.
To mimic the aging process, he gave some primates another drug that destroys dopamine production, and found that those that had taken both Ecstasy and the dopamine-killing drug moved less than those given only the dopamine reducer, suggesting that Ecstasy users could suffer the same consequences as they aged. The study appears today in the journal Science.
But a psychiatrist from Bellevue Hospital in New York and the leader of an organization that wants to test the psychiatric benefits of Ecstasy said Dr. Ricaurte's doses - delivered by injection, not tablet - were far greater than a human user could stand. Two of the 10 monkeys and baboons died of heatstroke, they noted, and 2 more were in such distress that they were not given a third shot.
Though heatstroke and dehydration are problems at dances where Ecstasy is used, human deaths from the drug are relatively rare. If 20 percent of all users died, these critics said, it would not be as popular as it is.
Three shots in six hours "was like 10 tablets in six hours, and the bulk of Ecstasy users at raves take 1.5 to 2.5 doses a night," said the Bellevue psychiatrist, Dr. Julie Holland, who is the editor of a book on Ecstasy. "Also, that's about $250 to $300 worth at street prices, and that's a lot of money.`
Dr. Una D. McCann, a psychiatrist and an author of the new study along with her husband, Dr. Ricaurte, said the doses were "actually slightly less" than a human might take. "I can't explain" why the two animals died, she said, "but if you're doing studies with only four or five animals, it's not appropriate to draw conclusions like `one out of five will die.' "
Ecstasy, also known as MDMA, is a methamphetamine whose users describe an overwhelming sense of peace and friendship for others, as well as the energy to dance for hours. Chronic users report never being able to repeat the pleasure of their first highs, and the drug apparently depletes the brain's reserves of dopamine and serotonin, which communicate pleasurable feelings.
Dr. Ricaurte has done research on the dangers of Ecstasy for years. In 1995 he found that it caused the brains of rats and squirrel monkeys to form abnormal connections in the serotonin-producing pathway. That, he theorized, could lead to problems like chronic depression.
Some of the same critics, including Rick Doblin of the Multidisciplinary Association for Psychedelic Studies, who has long sought government approval to test Ecstasy's usefulness for post-traumatic stress disorder, argued then that Dr. Ricaurte's test doses were 45 times what humans normally take.
In 1998, Dr. Ricaurte's review of brain scans of 14 humans who had taken Ecstasy up to 400 times found that they had fewer serotonin-absorbing brain cells than nonusers.
His new study "sends an important public health message - don't experiment with your own brain," said Alan I. Leshner, a former director of the National Institute on Drug Abuse and a supporter of Dr. Ricaurte's work. Dr. Leshner is now chief executive of the American Association for the Advancement of Science, which publishes Science magazine, but took pains to say he "had nothing to do with the decision to publish the study."
The study was important, he said, because it found similar results in two species and showed that Ecstasy could damage two different brain pathways.
Dr. Leshner was reluctant to endorse a warning that one-night Ecstasy users could suffer parkinsonism in later life. "I don't like hyperbole," he said, "whether it's in the direction that this drug is safe or that it's not."
Ecstasy, which was invented 80 years ago, was used as a stimulant and in some psychiatric research until 1985, when it was put in the same legal category as heroin and cocaine. A measure before Congress called the Anti-Rave Act seeks to penalize promoters of parties where "club drugs" are used, just as law enforcement officials sought to penalize landlords whose buildings were used as crack houses.
Critics said the study was timed to influence the Congressional debate, but Dr. McCann denied it. "We had no political intentions," she said.
Mr. Doblin, who has been seeking Food and Drug Administration permission since 1985 for legal psychiatric testing, said that similar drugs, like the amphetamines given to schoolchildren for attention deficit disorder, also affected dopamine levels but showed no evidence that they lead to the tremors or rigidity of Parkinson's disease.
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