Is MDMA neurotoxic? I’ve been lead to believe that chronic MDMA users experience neuronal degradation, especially serotononergic neurons. This leads to having “holes” in the brain. Let’s take a quick look.
Chronic users experience long term mood changes, anxiety and irritability, depression , that can last for years. This can exacerbate mental problems. Although this is not a sign of neuron destruction, it is a sign of compensation mechanisms due to the MDMA intake in the brain, compensating for the increased acute efflux of serotonin and dopamine.
Thomasius R, Petersen K, Buchert R, Andresen B, Zapletalova P, Wartberg L, Nebeling B, Schmoldt A “Mood, cognition and serotonin transporter availability in current and former ecstasy (MDMA) users.”Psychopharmacology 2003; 167: 85-96.
Scheffel U, Lever JR, Stathis M, Ricaurte GA “Repeated administration of MDMA causes transient down-regulation of serotonin 5-HT2 receptors” Neuropharmacology, 1992; 31(9):881-93.
The biggest problem with MDMA is that it causes a temperature increase in the body, leading to the person using the drug to overheat and this may cause detrimental effects, and death by dehydration or cardiac arrest.
Studies done in primates showing neuron loss:
Scheffel et al., “In Vivo Detection of Short- and Long-Term MDMA Neurotoxicity–A Positron Emission Tomography Study in the Living Baboon Brain”, Synapse 1998, Vol 29:183-192.
Research on methamphetamine-induced dopaminergic neurotoxicity has led some to conclude that long-term dopaminergic changes can occur without significant axonal loss - synaptic downregulation.
(Harvey, 2000; Wilson, 1996)
Synaptic downregulation can occur, due to a reflexive action of increased serotonin. This can downregulate serotonergic neurons and cause pruning of inactive neurons.
In this next study, monkeys were given Methamphetamine (someone suggested it wasn’t actually MDMA, but amphetamine that was given). MDMA is often cut with amphetamins in street excstasy. Amphetamine showed damage to the dopamine systems in monkeys at doses that humans use. This led to Parkinson’s disease and may constitute a loss of dopaminergic neurons:
Ricaurte GA, Yuan J, Hatzidimitriou G, Cord BJ, McCann UD “Severe Dopaminergic Neurotoxicity in Primates After a Common Recreational Dose Regimen of MDMA (“Ecstasy”)” Science, 2002; 297:2260-2263.
So the conclusion is that whether MDMA causes neurotoxicity, is debateable, but it is conclusive that it does cause long-term neuron changes in the brain. Studies also show that Sert protein levels decrease when using MDMA, and increase after not using MDMA after a period of time, this can be a sort of “recovery”:
Buchert et al., “Long-Term Effects of “Ecstasy” Use on Serotonin Transporters of the Brain Investigated by PET”, Journal of Nuclear Medicine 2003; 44:375-384.
IMO, MDMA is neurotoxic.
MDMA can be useful if used very sparingly ( once or twice per year in low doses) as a sort of “serotonin boost” that may kickstart your brain’s chemistry. Playing with the neurochemistry of the brain will always have some sort of reaction - “what goes up must come down” applies with any drugs that cause neurochemical changes. Read some literature and form your own conclusion.