Ecstasy: Physiological effects

Last modified: Sunday, 31. May 2009 - 2:04 pm

Ecstasy affects a number of body systems. The effects of ecstasy on the brain system are what lead to both the desired and undesired Mental effects of the drug. Within the brain, there are different groups of chemical messengers called neurotransmitters that are responsible for the communication within the brain and between the brain and the body. Neurotransmitters flow from one neuron (nerve cell) to another, where they individually attach to sites called receptors, and trigger a signal or message from the sending neuron. Pumps, called transporters, then return neurotransmitters to the neuron that released them to be stored for future use.
Ecstasy is suspected to interfere with a number of different neurotransmitter systems, primarily serotonin and dopamine. Serotonin is involved in the regulation of mood, appetite, emotion, sleep, perception, anxiety, aggression, and memory; dopamine is involved in the regulation of movement, emotional response, and ability to feel pleasure and pain. Ecstasy stimulates an excess release of these neurotransmitters, while at the same time blocking the transporters that pump them back to the releasing neuron, which creates a high concentration of neurotransmitters in the space between the cells, called the synapse. This overabundance of serotonin and dopamine is what causes the feelings of elation, altered perception, and high energy.
During this time the neurons are unable to replace all the neurotransmitters that are being released and not returned, so in the days following ecstasy use fewer neurotransmitters are released, and the number of transporters is reduced. This diminished function, primarily serotonin function, explains the depressed mood and other disturbances previously described as occurring in the days following an episode of ecstasy use. Regular ecstasy use destroys a neuron’s ability to release serotonin, an effect that is long-lasting and may or may not be permanent.
Noradrenaline is another neurotransmitter similarly influenced by ecstasy use, and is involved in the regulation of blood pressure and heart rate. The effects produced by this system are undesirable and potentially harmful.
Other physical reactions that might be experienced during ecstasy use include muscle tension, jaw clenching, nausea and vomiting, excessive sweating, involuntary movements, chills, blurred vision, and feeling faint. Some of these reactions are associated with a sharp rise in body temperature induced by the drug itself and the increase in physical activity that often goes along with ecstasy use. Reactions such as jaw clenching and muscle tension and aches frequently continue after the period of drug use. Teenagers may use pacifiers to modify the jaw clenching associated with ecstasy use.
Overdose is usually characterized by an extremely elevated body temperature, heart rate, and blood pressure. Combining ecstasy with other drugs may or may not be intentional, since the true contents of an ecstasy tablet or capsule are rarely known to the user. For example, PMA, sold with or in place of MDMA as ecstasy, takes nearly four times longer than MDMA to take effect; therefore the user might take extra doses thinking the original was not adequate. Multiple doses, coupled with the toxic effects PMA has on the heart, can have tragic consequences.
Ecstasy is toxic to the body, and the extent to which a person is affected depends on many factors, including the body chemistry of the user, the dose consumed, additional drugs also consumed, and the chemical composition and quantity of the drug or drugs taken as ecstasy.
Harmful side effects
Ecstasy use is associated with physiological damage to a number of body systems. These include the heart, brain, liver, kidneys, and the body’s ability to regulate temperature. Ecstasy increases heart rate and blood pressure, which is especially dangerous for someone with a known or unknown heart condition, but can also cause an irregular heartbeat in an ordinarily healthy person. An irregular heartbeat means the heart pumps less effectively; therefore the blood flow to the brain and other organs is not adequate. This condition increases the risk for heart attack, stroke, and other types of heart failure.
The intense activity by ecstasy users at dance parties and raves contributes to the effect of the drug and results in profuse sweating and dehydration. A loss of bodily salt combined with rapidly drinking large quantities of water can result in a fluid imbalance that leads to epilepsy-like seizures or a compression of a part of the brain that regulates breathing or circulation. Salt and fluid depletion in combination with the intense activity and elevated body temperature often associated with ecstasy use can break down skeletal muscle cells, eventually leading to kidney damage and failure.
Elevated body temperature is one of the most toxic effects of ecstasy, and this risk is augmented by its use at dance parties and raves. The lack of air circulation in a crowded environment creates an elevated room temperature, which, together with increases in body temperature can cause brain toxicity similar to heat stroke. High body temperature can also lead to severe liver inflammation or damage, abnormal blood clotting, and death.
Long-term health effects
Animal studies on ecstasy have found that the effects of the drug on the brain appear to be associated with long-term impairments in memory, learning, impulse control, mood, and sleep. These studies have guided human research into the long-term effects of ecstasy to focus on the drug’s toxic effects on serotonin in the brain. As of 2001, clear evidence of long-term damage in humans is limited but suggests that excessive neurotransmitter activity induced by ecstasy use damages the neurons that release serotonin, which is thought to impair learning and memory. Researchers from Johns Hopkins University have demonstrated that this type of damage, in conjunction with verbal and visual memory impairment, persists for at least seven years in monkeys. Similar results were seen in humans who had not used ecstasy for at least two weeks, leading the investigators to declare that one instance of ecstasy use puts the user at risk for brain damage and long-term impairment in learning and memory. The period of no drug use prior to the learning and memory test suggests that the impairment cannot be attributed to any withdrawal effects.
Researchers at the National Institute on Drug Abuse, University College London, and University of Technology in Germany have found that ecstasy users and past-users perform worse than non-users on tasks associated with the serotonin system in the brain, such as learning, memory, and attention. This research also suggests that ecstasy use is associated with long-term depression and anxiety, even among people who had not used for more than six months.
Another study showed ecstasy users to have decreased blood flow to the brain (thought to be regulated by serotonin), and that the reduction in blood flow depended on dose, meaning there was a greater decrease among participants who had used ecstasy more often. Similarly, memory and learning impairment was more profound among people who had used ecstasy more often.
One difficulty with studying the long-term effects of ecstasy is that ecstasy users rarely use just one drug; therefore the deficits in learning, memory, and impulsivity cannot be linked exclusively to ecstasy. In addition, research in humans is too preliminary to be entirely sure that ecstasy use is causing these deficits. As of 2002, more studies are focusing on humans, and within the next couple of years research is expected to provide more definitive evidence of ecstasy’s long-term effects, the mechanisms of action, and whether the deficits presented in this section are irreversible.

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