To get the latest information on the toxic effects of Ecstasy (MDMA or methylenedioxymethamphetamine) I did an Advanced Search in the National Library of Medicine's excellent PubMed database ( http://www.ncbi.nim.nih.GOV/PubMed ). My search for all journal articles concerning Ecstasy toxicity in humans (formulated as "MDMA AND toxicity AND human") came up with 52 relevant publications. Before I reproduce the abstracts of 3 of the most relevant ones, I'd like to stay that the hazards of Ecstasy include potentially fatal hyperthermia, hepatitis, bond marrow shutdown, and a variety of neuropsychiatric disturbances. What concerns me the most is the research in primates which indicates that MDMA actually kills neurons (brain cells) which produce the vital neurotransmitter known as serotonin. People who lack sufficient amounts of serotonin in the brain manifest a variety of behavioral and mood problems, including, but not limited to, depression, self-destructiveness, violence, and irritability. It strikes me as extremely risky for people to take a drug which might lead to a permanent deficiency of serotonin in the Central Nervous System. Now, here are the abstracts from 3 of the 52 articles which came up in my literature search:
Ann Emerg Med 1998 Sep;32(3 Pt 1):377-80
Death by "ecstasy": the serotonin syndrome?
Mueller PD, Korey WS
University of Florida, Gainesville, USA.
"Ecstasy" or 3,4-methylenedioxymethamphetamine (MDMA) is a popular
drug of abuse and is generally regarded as safe by
the lay public. There are an increasing number of reports of
MDMA-induced toxicity that exhibit features of the serotonin
syndrome. We report a case of severe hyperthermia, altered mental
status, and autonomic dysfunction after a single
recreational ingestion of MDMA.
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FASEB J 1997 Feb;11(2):141-6
The abused drug MDMA (Ecstasy) induces programmed death of human
Simantov R, Tauber M
Department of Molecular Genetics, Weizmann Institute of Science,
The widely abused amphetamine analog 3,4-methylenedioxymethamphetamine
(MDMA, also called "ecstasy") induces
hallucination and psychostimulation, as well as long-term
neuropsychiatric behaviors such as panic and psychosis. In rodents
and monkeys, MDMA is cytotoxic to serotonergic neurons, but this is
less clear with humans. Herein, MDMA was cytotoxic
to human serotonergic JAR cells; it altered the cell cycle, increased
G2/M phase arrest, and induced DNA fragmentation in a
cycloheximide-sensitive way. This apoptosis was not observed in
nonserotonergic human NMB cells. The stereospecific effect
of amphetamines in JAR cells, and the key role of NO and dopamine in
MDMA-induced apoptosis were determined. The
relevancy of MDMA-induced cell death to drug users is discussed.
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Addiction 1994 May;89(5):539-51
3,4-Methylenedioxymethamphetamine (MDMA, "Ecstasy"):
pharmacology and toxicology in animals and humans.
Steele TD, McCann UD, Ricaurte GA
Department of Neurology, Johns Hopkins University School of Medicine,
(+/-)3,4-Methylenedioxymethamphetamine (MDMA, "Ecstasy"), a
ring-substituted amphetamine derivative first synthesized in
1914, has emerged as a popular recreational drug of abuse over the
last decade. Pharmacological studies indicate that MDMA
produces a mixture of central stimulant and psychedelic effects, many
of which appear to be mediated by brain monoamines,
particularly serotonin and dopamine. In addition to its pharmacologic
actions, MDMA has been found to possess toxic activity
toward brain serotonin neurones. Serotonergic neurotoxicity after MDMA
has been demonstrated in a variety of experimental
animals (including non-human primates). In monkeys, the neurotoxic
dose of MDMA closely approaches that used by humans.
While the possibility that MDMA is also neurotoxic in humans is under
investigation, other adverse effects of MDMA in
humans have been documented, including various systemic complications
and a number of untoward neuropsychiatric sequelae.
Notably, many of the adverse neuropsychiatric consequences noted after
MDMA involve behavioral domains putatively
influenced by brain serotonin (e.g., mood, cognition and anxiety).
Given the restricted status of MDMA use, retrospective
clinical observations from suspecting clinicians will probably
continue to be a primary source of information regarding MDMA's
effects in humans. As such, this article is intended to familiarize
the reader with the behavioral pharmacology and toxicology of
MDMA, with the hope that improved recognition of MDMA-related
syndromes will provide insight into the function of
serotonin in the human brain, in health as well as disease.
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I hope that you find these references useful. Although the kind of long-term studies you were looking for are not yet published in the literature, I would be concerned by the various reports of significant toxicity which appear in the literature. If I were you, I'd stay away from Ecstasy. Better safe than sorry!
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
You can find more information about hallucinogen and stimulant abuse (Ecstasy has both of these properties) on my Ask DrSteve web site, which is conveniently hyperlinked below.
Steve Adelman, M.D. (a.k.a. DrSteve)
Keywords: MDMA, Ecstasy, drug toxicity
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