Is MDMA Neurotoxicity Real?

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Concern over whether recreational use of the stimulant drug MDMA can cause neurotoxicity, or brain damage, has raised many questions, some answers, and unending debates.

It is known that MDMA, also known as ecstasy or Molly, comes with risks that can only be avoided by not using the drug at all. MDMA, the abbreviation for 3,4 methylenedioxymethamphetamine, is the active ingredient in ecstasy. According to the National Institute on Drug Abuse (NIDA), the drug’s intoxicating effects start within 45 minutes or so after one dose is taken. A normal dose of the drug can last four to six hours.

The effects of the drug include feelings of emotional warmth, enhanced sensory perception, a sense of well-being, and a detachment from self and surroundings, among other experiences. However, the life-threatening effects that can result from MDMA use include high blood pressure, faint, and panic attacks, among others. In severe cases, a person can lose consciousness or experiences seizures.

The effects of MDMA on the human brain have been under study, but there are different opinions on whether one can suffer from brain damage after using it regularly.

First, What Is Neurotoxicity? defines neurotoxicity as “the poisonous effects of harmful substances on nervous system function, and cause of brain damage.”

Common symptoms of neurotoxicity include:

  • Memory problems
  • Concentration difficulties
  • Learning difficulties
  • Mental processing speed
  • Sleep disturbances
  • Language problems
  • Emotional instability
  • Anxiety
  • Confusion
  • Depression
  • Fatigue
  • Numbness in hands, feet

How Ecstasy Affects the Brain

NIDA reports that MDMA increases three neurotransmitters in the brain: serotonin, dopamine, and norepinephrine. Serotonin plays a key role in mood regulation, pain, sleep, and appetite while norepinephrine affects emotions, sleeping, dreaming, attentiveness, and learning. According to NIDA, the drug releases these two neurotransmitters more than dopamine.

“Like other amphetamines, MDMA enhances release of these neurotransmitters and/or blocks their reuptake, resulting in increased neurotransmitter levels within the synaptic cleft (the space between the neurons at a synapse),” the federal agency writes.

It also notes that research in rodents and primates showed that moderate to high doses of MDMA, which were given twice a day during a four-day period, damaged nerve cells that contained serotonin.

NIDA also reported that one study showed “MDMA-exposed primates showed reduced numbers of serotonergic neurons seven years later, indicating that some of MDMA’s effect on the brain can be long-lasting.”

Still, it is not exactly clear if this research can support if long-term MDMA use causes neurotoxicity.

However, as of its last writing, which is September 2017, NIDA officials report that heavy MDMA use over a two-year span has been associated with decreased cognitive functioning.

Still, other factors can contribute to this decline in brain functioning, they say.

“Some of these disturbances may not be directly attributable to MDMA, but may be related to some of the other drugs often used in combination with MDMA, such as cocaine, alcohol, or marijuana, or to adulterants commonly found in MDMA tablets.”

More studies are needed to understand the specific effects that result from using MDMA regularly.

Is MDMA-Related Neurotoxicity Difficult to Define?

In the article, “Does MDMA Cause Brain Damage,” from the book Ecstasy, The Complete Guide, the authors Matthew Baggott, BA, and John Mendelson, MD, assert that the risks associated with possible long-term brain damage after using MDMA “are more difficult to assess.”

The comprehensive article raises several points, including that neurotoxicity is difficult to define.

“Though no universal definition exists, most definitions are broad enough to encompass both short-term alcohol-induced headaches and the permanent nerve cell loss caused by the drug MPTP. A more useful approach to the question of whether MDMA is neurotoxic is to describe the nature and mechanisms of the long-term changes it can cause.”

They mention that MDMA can produce long-lasting changes to the serotonergic system at some doses of it and that these changes are accompanied by structural changes to nerve cell axons.

“In this way, it is evident that some neurotoxic MDMA regimens produce both changes in the serotonergic system and acute damage to the brain by free radicals, and thereby cause a loss of nerve cell axons. This suggests that MDMA neurotoxicity is a type of drug-induced damage, even though the consequences of this damage are unknown.,” the authors write.

Another interesting point the article raises is whether the extent of MDMA neurotoxicity depends on the dose taken and if high-risk MDMA use, such as binging with multiple doses of it, comes with greater risks of brain damage.

Dosing in studies can be an issue in MDMA neurotoxicity research, write Baggott and Mendelson.

“Research on MDMA neurotoxicity has sometimes been criticized for the repeated high dose regimens that are commonly used. Some have questioned whether repeated injections of 20 mg/kg MDMA in rodents can provide useful information about the toxicity of single oral doses of 1.7 to 2.0 mg/kg MDMA in humans.”

MDMA Is Dangerous, But Maintain Perspective

While there doesn’t appear to be one firm answer to the question of whether ecstasy causes brain damage over time, there is the view that information about the drug and its use must be kept in perspective.

“Finding the truth about MDMA neurotoxicity amidst all these rumors can be difficult,” writes, a public health organization that promotes health and safety within the nightlife and electronic music community. It reports on its site that “frightening stories” have been printed in the media about the neurotoxicity of ecstasy and explains that it has tried to avoid extremes and present well-documented and factual information about the issue.

Paul A.T. Kelly, who wrote the article titled, “Does recreational ecstasy use cause long-term cognitive problems?” for the Western Journal of Medicine, also warns against overstating the case about the harm the drug can do.

“The young people most at risk are likely to reject out of hand any ‘scare stories,’ since they feel that there have been only a few well-publicized cases of harm from the drug. These numbers are small compared to the numbers of individuals who use MDMA regularly.”

Kelly is also clear about MDMA’s dangers, citing research and writing, “Nevertheless, health care professionals should be aware that cognitive disorders, mood disturbances, and increased risk of cerebrovascular accidents are among the possible long-term, negative consequences of MDMA exposure in humans.

“Although subtle at first, these effects may develop into major deficits over the lifetime of an otherwise healthy individual.”

Put MDMA Addiction Behind You

Pathway to Hope, a Delphi Behavioral Health Group facility, specializes in helping people who are battling an addiction to MDMA (Molly) or any substance, whether it’s legal or illegal. We focus on the roots of your addiction and mental health condition, help you or your loved one start healing from substance abuse, and give you the tools to leave it behind.

If you or someone you know is struggling with drug or alcohol dependence, call Pathway to Hope at (954) 866-4756 today or reach out to us online, so we can help you find the right treatment program. Don’t delay. If you need addiction treatment, now is the time to make that important step for your health and your life.



Elysia L. Richardson

Elysia L. Richardson is a content writer and editor who covers addiction and substance abuse issues for Delphi Behavioral Health Group. Previously a writer and editor for various digital and print publications, she enjoys researching news in the recovery field and finding engaging ways to share information that helps improve people’s lives.

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