Ecstasy: The Clinical, Pharmacological and Neurotoxicological Effects of the Drug MDMAStephen J. Peroutka The variety of viewpoints expressed in this book illustrate the many contro versies surrounding MDMA [1]. On the one hand, the proponents ofMDMA use believe this agent offers a unique psychoactive effect that may have important clinical applications, especially in the field of psychotherapy. On the other hand, the scientific data concerning the neurotoxic effects of the drug are unequivocal. The most striking feature of the human information of MDMA is the paucity of data that has been generated on the drug since it was patented in 1914. As pointed out by Beck (Chapter 6) and others, a clear need exists for better epidemiological and clinical data on MDMA. In the absence of such data, arguments both for and against the cotinued use ofMDMA with humans will be difficult to support. Unfortunately, the currently available data must be used to develop rational policies for potential human users of MDMA. At the present time, there are no data indicating that recreational doses of MDMA permanently damage the human brain. Nonetheless, based on a review of the contents of this book as well as on informal discussions with approximately 200 recreational users of MDMA, the following personal observations suggest that MDMA is radically different from other recreational drugs. |
Contents
| 1 | |
2 THE THERAPEUTIC USE OF MDMA | 21 |
THE CASE OF PSYCHEDELIC DRUGS | 37 |
4 RECREATIONAL USE OF MDMA | 53 |
5 HUMAN DEATHS AND TOXIC REACTIONS ATTRIBUTED TO MDMA AND MDEA | 63 |
6 THE PUBLIC HEALTH IMPLICATIONS OF MDMA USE | 77 |
A NEW CLASS OF PSYCHOACTIVE AGENTS? | 105 |
8 NEUROCHEMICAL EFFECTS OF MDMA | 133 |
ACUTE VERSUS LONGTERM CHANGES | 151 |
PHARMACOLOGIC PROFILE AND EVIDENCE OF NEUROTOXICITY FROM NEUROCHEMICAL AND AUTORADIOGRAPHIC STUDIES | 171 |
11 A TISSUE CULTURE MODEL OF MDMA TOXICITY | 201 |
12 EFFECT OF MDMALIKE DRUGS ON CNS NEUROPEPTIDE SYSTEMS | 213 |
13 NEUROENDOCRINOLOGICAL EFFECTS OF MDMA IN THE RAT | 225 |
| 241 | |
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3,4-methylenedioxyamphetamine 5-HT and 5-HIAA 5-HT concentrations 5-HT uptake sites abuse potential acute administration of MDMA amphetamine analogues animals Battaglia behavioral Biochem brain regions cerebral cortex clinical cocaine compound control values Controlled Substances corticosterone decrease depletion dopamine dopaminergic dose of MDMA drug discrimination Drug Enforcement Administration Ecstasy effects of MDMA enantiomers entactogens experiments fenfluramine Figure fluoxetine Gibb Glennon Grinspoon hallucinogenic hippocampus inhibitor injection isomers ketanserin levels long-term MBDB MDEA MDMA and MDA MDMA or MDEA MDMA users MDMA-induced MDMA's metabolite methamphetamine methylenedioxymethamphetamine mg/kg mg/L neurons neurotensin neurotoxic effects neurotoxicity Nichols nigral observed patients percent of control Peroutka Pharmacol pharmacological placebo pretreatment psychedelic drug Psychoactive Drugs psychotherapy rat brain receptors recreational release reported response saline Schedule serotonergic serotonergic neurons session Shulgin significant similar stimulant striatal striatum studies substitution synaptosomes therapeutic therapists therapy tissue toxicity TPH activity treatment tryptophan hydroxylase umol/L