Editorial, 21 June 1997

DANGER! Hyping these findings can lead to intoxicating
headlines and unhelpful bouts of moral panic...
All scientific studies of the drug Ecstasy should carry such a warning.
And that includes the latest research indicating that Saturday night
doses of Ecstasy can lead to depression midweek and a blunting of
memory (see This Week, p 4).
Some moralistic fingerwagging seems inevitable, but the news is
unlikely to scare users of the drug. Many will know from experience
about the midweek low (taking Prozac to soften the landing has become
trendy), and many will already have heard claims that Ecstasy impairs
memory. The best informed will have swapped notes on the Net.
So we hope they will waste no time spreading the truth about the
latest studies. Anecdote and hearsay are all very well, but they are no
match for science when it comes to weighing up the risks and benefits
of taking drugs.
The danger is that the impact of the studies will be undermined by
hype and halfbaked extrapolations. Drug users everywhere will switch
off if they hear commentators playing fast and loose with the facts,
referring to mindfogged zombies or caricaturing the latest research as
"further evidence" that Ecstasy damages the brain. (There is no
evidence that Ecstasy damages human brain cells, only animal data
which is open to interpretation.)
In fact, some Ecstasy users may look at the latest studies and feel
somewhat reassured. This midweek "depression" is classified as no
more than "mild to moderate". And even heavy users of the drug
perform perfectly normally in tests of intelligence and reaction times.
Where mental sharpness is bluntedin tests of recallEcstasy users still
perform within the range of normal behaviour.
On the other hand, any cognitive deficit is bad news, and it is
important to start asking what will happen to today's Ecstasy users
when they grow old. The drug's effects on memory systems in youthful
brains may be subtle, but what happens when clubbers reach middle
age?
Another reason to be cautious about the latest findings is that the
researchers have no way of knowing precisely what their subjects have
taken. Dishonesty and forgetfulness are only part of the problem: drug
users often don't know what their pills contain.
This is no reason to dismiss the findings, but it is a strong argument
for confirming the studies on subjects who are also willing to give urine
samples. It is also an argument for granting psychologists permission to
give Ecstasy to human volunteers in a laboratory.
Because until such studies are completed there will remain only one
certainty about Ecstasyits remarkable ability to generate hysteria
among those who have never swallowed it.
~~~~~~~~~~~~~~
ARTICLE:
After the rave, the Ecstasy hangover
By David Concar a weekend dose of the drug Ecstasy can lead to
forgetfulness, poor concentration and midweek blues severe enough to
qualify the sufferer for clinical treatment, claim British researchers.
Valerie Curran of University College London, who has studied
depression, attention and memory in users of Ecstasy, formally known
as 3,4methylenedioxymethamphetamine or MDMA, says that the
drug's aftereffects are worse than those of drink. The depression
suffered by Ecstasy users is deeper, takes several days to surface and
lasts longer, she reports in a paper to appear next month in the journal
Addiction.
In another study, which has not been published, Andrew Parrott and
his colleagues at the University of East London and Keith Wesnes of
Cognitive Drug Research, a company in Reading that tests the effects of
drugs on memory and learning, have evidence of link between memory
impairment and Ecstasy.
And a third study, also unpublished, strengthens that link by
screening out the effects of other drugs such as LSD, amphetamines
and cannabis. Michael Morgan and his colleagues at the University of
Wales, Swansea, compared two groups of Welsh drug users with a
control group of people the same age. The two drug groups matched
each other for consumption of most drugs, but only one took Ecstasy.
In most tests, the three groups performed similarly, indicating that
Ecstasy users are no less intelligent than the norm. But the Ecstasy
group performed markedly worse in memory tests.
The psychological consequences of taking Ecstasy have been hotly
debated for years. In 1992, researchers in the US tested longtime
users and found some evidence of forgetfulness but none of depression.
However, that study involved no control subjects and looked only at
people who had not taken the drug for two months. It made no
attempt to monitor clubbers as they come down from a Saturday night
"high".
Curran addressed that issue by setting up makeshift psychology lab in
a London club, helped by research student and parttime DJ Ross
Travill. On successive Saturday nights, the researchers recruited a
dozen clubbers who claimed they had taken Ecstasy that evening and a
dozen who said they had only drunk alcohol. Volunteers completed a
round of mood and memory tests in the lab at the club, and were
tested again at their homes the next day and the following Wednesday.
One test involved counting backwards in sevens from a threefigure
number, a standard way of probing "working memory" and ability to
concentrate. In the club and the following day, Ecstasy users did almost
twice as badly as the alcohol group. By Wednesday, the scores were
closer but the alcohol group still did better.
But the biggest differences emerged with the mood tests. The day
after clubbing, those who had stuck to alcohol were just as irritable,
depressed and anxious as those who had swallowed Ecstasy. But by
Wednesday, the drinkers had snapped out of it while Ecstasy users had
slid deeper into depression. On average, their midweek scores for
irritability and restlessness were 50 per cent higher and their anxiety
ratings double those of the alcohol group.
"There was enormous variation," says Curran, "but some of these
people would have qualified for antidepressants." In a subsequent study
not included in the Addiction paper, Curran has evidence that the
depression lifts when clubbers skip their usual Saturday dose of Ecstasy.
In the study led by Parrott, Ecstasy users proved especially bad at
remembering words. In one test, 15 words appeared in middle of a
computer screen, one after the other. Afterwards, subjects were told to
write down as many as they could remember. Several days after a night
out clubbing, regular Ecstasy users typically recalled about 30 per cent
fewer words than those who said they had never taken the drug. Parrott
says that this is "obviously worrying given the widespread use of
MDMA among the young".
Some other researchers argue that the new data are inconclusive.
One major flaw is that none of the three teams could be absolutely
certain what drugs their subjects had taken, as they did not perform
urine tests. Nicholas Saunders, an independent researcher based in
London who has written a book about Ecstasy, argues that many of the
observed memory problems could be due to cannabis use.
The psychologists themselves caution against alarmist interpretations.
"The effects we're seeing are mild but could cause problems for
students taking exams," says Curran.
Why Ecstasy should cause midweek depression or impair memory is
far from clear. Animal studies indicate that Ecstasy can reduce levels of
serotonin, a brain chemical which helps control moods, impulses and a
range of other behaviours. But George Ricaurte of Johns Hopkins
University in Baltimore doubts this holds the key to the mood swings.
"The serotonin depletion persists, whereas the mood problem
improves," he says.

From New Scientist, 21 June 1997