Doctor E Valuable Therapy with MDMA by Jesse Karlsberg Methylenedioxy-n-methylamphetamine, abbreviated MDMA (also known as ecstasy, E, X, and XTC) is on the U.S. Schedule I of controlled substances, and is illegal to manufacture, possess, or sell in the United States. Several studies have indicated that MDMA use correlates with decreased seratonin levels in the brain, which in turn is linked with clinical depression. However, a class of professional psychologists and psychotherapists believe the drug should be made available for medical use. Ecstasy, they say, is one of the most effective therapeutic tools in existence, when used in a medical setting by either the patient or the doctor. Ever since the discovery of MDMA, it has been used by people for purposes other than recreation. Low doses of MDMA (40-60 mg) have been used extensively by monks to assist in meditation. The increased ability to concentrate ascribed to MDMA also led to its use as a studying aid in small doses. Therapists over the past 40 years have also taken the drug, citing an increased ability to connect with patients. In the 1970s, before it was illegalized, MDMA was gaining a reputation in the psychiatric community as a valuable therapeutic tool. One class of therapists took the drug themselves. In this case, the drug allegedly increases the ability of therapists to empathize with patients, thus increasing the efficiency and usefulness of sessions. (Empathy is a known effect of ecstasy use) The perceived benefits of MDMA in this context have led some therapists to continue to use ecstasy despite its status as an illegal substance. An even greater group of therapists and psychologists in the 1970s encouraged their clients to take a single dose or occasional doses of MDMA. Patients invariably reacted positively to the use. One patient remarked that he "saw some of my problems that I didn't even know I had! All of a sudden, it seemed like the source, nature and sometimes even the solution of all my personal difficulties were completely obvious." Studies published by this school of psychotherapists display the ability of ecstasy to help patients deal with emotional and personal issues and even uncover repressed memories. Additionally, studies of ecstasy users indicate that a common side effect of the drug is an "increased positive outlook on life," with duration listed as "indefinite"! In the words of one patient, "one hit of X [MDMA] is worth 3 months of conventional psychotherapy". The ability of the drug to introduce users to fresh points of view is widely regarded as one of its greatest benefits. The substantial counter-argument to MDMA legalization for medical use is based on recent studies indicating its neurotoxicity. The nature of the neurotoxicity is linked to lower seratonin levels in the brain, a neurotransmitter the loss of which is linked to depression. One study (Peroutka) found no evidence of decreased seratonin levels, but a decrease was observed in at least two studies (Ricuarte). In the more recent study, a decrease of 30% was found when comparing non-ecstasy users with people who had used the drug 75 times on average (although many members of the latter group used other drugs as well). There is a considerable amount of evidence that MDMA use in animals corresponds to decreased seratonin levels, as much as 90% in rats. However, some species recover completely, others partially, and some not at all. Furthermore, it is important to note that no behavioral differences have been noted in any of the experiments on animals. Needless to say, given the inconsistency of results, it is also unclear how these findings translate to the human population. Surveys have shown that although some ecstasy users experience depression (and occasionally severe depression) after using MDMA, the vast majority reports the opposite: positive feelings, and a general sense of well being for the days after the use of the drug. There is also research on ways to combat the seratonin loss linked to MDMA. Experiments and studies indicate that taking antioxidants or a combination of vitamins may help. Additionally, Prozac, Zoloft, and Paxil radically, and in some cases wholly eliminate the seratonin loss if taken 0-6 hours after taking ecstasy. While minor relative to those of other drugs, ecstasy does have side effects other than the debated neurotoxicity. The most serious side effect is the occasional occurrence of nausea and vomiting. Other side effects include changing body temperature regulation, which, while unusual, is not dangerous, jaw clenching and teeth grinding, muscle tension, and mild dehydration which can be relieved by drinking water periodically while on the drug. Although some evidence suggests that MDMA use is dangerous and can cause depression, the perceived lack of depression among MDMA users should allow us nonetheless to consider the benefits of the drug to the medical community. In light of the recent discovery that marijuana is more carcinogenic than cigarettes and the willingness of government authorities to consider its legalization for medical use, it seems reasonable to consider MDMA in the same light. It has been shown that a single dose of MDMA can affect a miraculous, life-changing, positive, and psychologically quantifiable experience, an unparalleled benefit that clearly merits consideration. For a study detailing the effects of ecstasy use on the practices of 20 current psychologists, see "Phenomenology and Sequelae of 3,4 Methylenedioxy-methamphetamine Use" (Liester, Grob, Bravo, and Walsh) in J. Nervous and Mental Disease, Vol. 180, No. 6, June 1992, Serial No. 1315. See "Phenethylamines, Free Radicals, and Antioxidants" (MAPS Newsletter, Volume IV Number 1) for more information of combating seratonin loss through the use of vitamins and antioxidants. For information on the effects of antidepressants on seratonin loss resulting from ecstasy use, see McCann and Ricuarte in J. Clinical Psychopharmacology, 13 (3): pp. 214-217, 1993. Information on special cases in which MDMA use may endanger the user can be found at http://www.erowid.org/chemicals/mdma/mdma_health.shtml. Erowid.com was consulted for information on the chemistry and effects of MDMA as well as for general information on the drug. It is also a good place to look if you want to know more.