MDMA and the Brain: A Short Review on the Role of Neurotransmitters in Neurotoxicity

A person experiences feelings of euphoria, increased energy, intimacy and emotional warmth, sensitivity to touch, and a distortion of time and of the senses. The development of MDMA dates back to 1912 when it played a role in suppressing a person’s appetite. The drug gained popularity in the 1980s with young adults at large music festivals and all-night dance parties or raves. NIDA research supports people affected by substance use and addiction throughout the lifespan and across communities. Information provided by NIDA is not a substitute for professional medical care.

MDMA-treated rats also displayed a deficit in recognition memory in the novel recognition test, which was believed to occur due to the damage to dopamine neurons (Cadoni et al., 2017). Hence, the effects of MDMA on memory are seen through the alterations in dopaminergic as well as the disruption of NMDA receptors. Thus, the main focus of the researchers for future studies should be on the treatment through these targeted areas. “The real question in all imaging studies is what these changes mean when it comes to functional consequences,” says NIDA’s Dr. Frascella. In this study, researchers administered several standardized memory tests to 24 MDMA users who had not used the drug for at least 2 weeks and 24 people who had never used the drug. In summary, people, especially young people, choose MDMA as their drug of choice due to its stimulating effects.

What is the percentage of people who have tried ecstasy at least once in their lives?

While there is some debate on ecstasy’s addictiveness, many users have experienced dependence on the drug’s pleasurable effects. With long-term abuse, ecstasy can cause damage to the serotonin center of the brain and the liver. Combined with how often street ecstasy is mixed with other drugs, ecstasy can be dangerous when abused.

• “The real question in all imaging studies is what these changes mean when it comes to functional consequences,” says NIDA’s Dr. Frascella.
• The National Institute on Drug Abuse (NIDA) is the largest supporter of the world’s research on substance use and addiction.
• Unfortunately, there is still an ongoing debate on whether the deficit of serotonin reflects damage to the neurons (Baumann, Wang & Rothman, 2007).
• Memory deficit was detected in young mice exposed to MDMA that was explained by the increased expression of early markers of plasticity, observed through the reduction in dopaminergic markers in the substantia nigra.
• In addition to managing a successful family medical practice, Dr. Hoffman is board certified in addiction medicine by the American Osteopathic Academy of Addiction Medicine (AOAAM).

Research by Substance

If a person has issues with MDMA, individuals can contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline. MDMA causes a surge of serotonin, after which the body will experience a depletion of this “feel-good” neurotransmitter. A person needs to seek immediate medical attention if they experience the above MDMA use. Ingesting other substances, such as cannabis or cocaine, along with MDMA greatly increases the danger of adverse reactions. The nickname “Molly” is short for “molecular.” It often refers to the drug’s powder form, which some people sell as capsules. what are the effects of mdma national institute on drug abuse nida Developing an FDA-approved e-cigarette for smoking cessation could improve public health.

• This causes the accumulation of the neurotransmitters between the synapses, which can result in excitotoxicity.
• Both studies suggest that the extent of damage is directly correlated with the amount of MDMA use.
• The National Survey on Drug Use and Health (2004) reported that more than 11 million people have tried MDMA at least once in their lives (NIDA, 2006).
• How long MDMA-induced brain damage persists and the long-term consequences of that damage are other questions researchers are trying to answer.

“Ecstasy” Damages the Brain and Impairs Memory in Humans

MDMA provides an immediate enjoyable feeling by stimulating the release of neurotransmitters, such as dopamine and serotonin in the brain. Unfortunately, abnormal regulation of the brain neurotransmitters, as well as the increased oxidative stress causes damage to the brain neurons after the MDMA exposure. Thus, the treatment of MDMA complications should be further explored mainly by targeting its mechanism of action in the neurotransmitter systems.

This category refers to a drug with high abuse potential and of no recognized medicinal use. MDMA (3,4-methylenedioxy-methamphetamine) is an artificial drug that people legally used in the 1970s for psychotherapy treatment despite a lack of data to support its effectiveness. MDMA first became popular in nightclubs, but people now take it in a wide range of settings.

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Current understanding of the MDMA mechanism of action arises from its effects on the psychological changes and dependence. Psychological changes are explained as the euphoria, sharpened sensory perception, an increase in social performance and empathy, and greater tolerance of the feelings (Kalant, 2001). However, MDMA dependence is still less understood, but it has been reported to be different from other drugs or alcohol (Degenhardt, Bruno, & Topp, 2010). The biological mechanisms involved in MDMA exposure are the changes in the serotonergic system, which affects serotonin (5-hydroxytryptamine (5HT)) and dopamine. Interestingly, a study by Popova et al. announced the observations contrary to this theory (Popova, Forsblad, Hashemian, & Jacobsson, 2016).

The toxicity effects induced by MDMA made the researchers motivated to explore its potential treatments. Several therapeutic methods have been suggested by the researchers for the treatment of MDMA abuse. For example, Garcia-Pardo et al. (2017) recently studied the role of NO pathway in MDMA rewards and they suggested a therapeutic option for MDMA abuse by manipulating this pathway. They also suggested that the NMDA receptor antagonism might be one of the therapeutic targets for MDMA-related problems (Garcia-Pardo et al., 2015). In addition, the potential treatments to protect toxicity caused by MDMA have also been studied. Dextromethorphan and its metabolite, dextrorphan, may have a protective effect against MDMA-induced serotonergic toxicity in the brain (Finnegan, Skratt, Irwin, & Langston, 1989; Ma et al., 2016).

Psychedelic and Dissociative Drugs

Another therapeutic option for MDMA abuse is rilmenidine, which is one of the antidepressants (Laurent & Safar, 1992). It was found recently to protect against MDMA-induced injury via full preservation of 5-HT arbours indicated by imaging (Mercer et al., 2017). Besides, co-administration of acute MDMA and mephedrone showed antidepressant-like activity and improved memory in mice (Budzynska & Michalak, 2017). Ginger was proven to reduce the activation of the caspase cascade responsible for cell death (Asl et al., 2013).

Ecstasy Statistics in the LGBTQ+ Community

While ecstasy use was once concerningly high among teens in the 2000s and early 2010s, those numbers have declined over the past 10 years. According to SAMHSA’s 2021 National Survey on Drug Use and Health, among people aged 12 or older, 0.8% (2.2 million people) reported using Ecstasy in the past 12 months. This refers to a sudden increase in body temperature, cardiovascular collapse, or significant dehydration.

“We don’t know just yet if we’re dealing with such a long-lasting effect in people.” The memory impairments found in MDMA users are among the first functional consequences of MDMA-induced damage of serotonin neurons to emerge. Recent studies conducted in the United Kingdom also have reported memory problems in MDMA users assessed within a few days of their last drug use. Memory deficit was detected in young mice exposed to MDMA that was explained by the increased expression of early markers of plasticity, observed through the reduction in dopaminergic markers in the substantia nigra. The NMDA receptor, a type of ionotropic glutamate receptors, was reported to be also involved in the rewarding effects of MDMA (Garcia-Pardo, Escobar-Valero, Rodriguez-Arias, Minarro, & Aguilar, 2015).

Both studies suggest that the extent of damage is directly correlated with the amount of MDMA use. Findings from another Johns Hopkins/NIMH study now suggest that MDMA use may lead to impairments in other cognitive functions besides memory, such as the ability to reason verbally or sustain attention. Researchers are continuing to examine the effects of chronic MDMA use on memory and other functions in which serotonin has been implicated, such as mood, impulse control, and sleep cycles. How long MDMA-induced brain damage persists and the long-term consequences of that damage are other questions researchers are trying to answer. Animal studies, which first documented the neurotoxic effects of the drug, suggest that the loss of serotonin neurons in humans may last for many years and possibly be permanent. “We now know that brain damage is still present in monkeys 7 years after discontinuing the drug,” Dr. Ricaurte says.