Response to Studies of MDMA (‘ecstasy’) neurotoxicity in animals: Implications for humans by George Ricaurte
Department of Liaison Psychiatry, South London & Maudsley NHS Trust, St. Thomas’ Hospital, Lambeth Palace Road, London, UK. E-mail:
The human brain goes through many changes in the course of our lives. When a baby is born, it has billions and billions of excess brain cells which proceed to die out over the next six months. If they do not die out then he or she will end up severely retarded. We need to remember that in the 1950s, it was considered beneficial for the mental health of many people to remove their entire frontal lobes. In the United Kingdom, we still carry out about 40 operations a year on brains for psychiatric purposes where we cut certain tracts, often using radiation to treat severe depression, obsessive compulsive disorder and so on. The implications of this are that we need to be very careful with the word ‘toxicity’ because a physical change in the structure of the brain is not necessarily a toxic effect. Toxicity implies that something bad has happened; as the brain changes, the results may be undesirable or they may not. When we become elderly our short-term memory is not very good, yet there is often the acquiring of wisdom. You may be much wiser than you were before and you maybe more tolerant. Once people are over forty, personality disorders tend to fade very considerably. The chances that they will kill themselves or somebody else goes down dramatically after the age of thirty-five. The brain is changing over this period of time, brain cells are being lost at a considerable rate especially after the age of 25, and there are changes in plasticity, in nerve terminals and in responsiveness. To say, ‘Well it has changed so it must be bad’ is quite a big step which needs looking at. Long-term ecstasy users should be asked how they feel. Many people, such as Alexander Shulgin who have taken ecstasy since the 1970s, do not feel bad.
Working in clinical psychiatry and liaison psychiatry involves drug problems and a lot of hospital psychiatry. We walk around the wards in St Thomas' Hospital (a very large hospital in London) and basically see everything that the doctors on those wards want us to see. There are not very many people referred to me as a result of having taken a lot of ecstasy and there are no psychiatric beds full of people who have taken a lot of ecstasy.
When is the supposed neurological time bomb going to go off? World famous multi-millionaire superstar DJs such as Paul Oakenfold have been taking large amounts of ecstasy, thousands of doses, since 1985. They are in their forties and a lot of them seem to be quite happy and not suffering from a lot more depression than exists in the general population. They are rich and are getting married. Nicholas Saunders was not depressed a few weeks before he died. He was just turning sixty so presumably he would have a lot less reserves than most people. Alexander Shulgin is a very productive, elderly gentleman and is much happier than a lot of people his age who have never taken any sort of drugs at all. This is really where we should look - at people and how they feel, rather than at nerve terminals.
I completely accept the findings of animal research, being replicated in many different laboratories, in many different countries for a very long time. This research began in the mid-1980s and while it is well replicated and valid, I do not agree with the word ‘toxicity’. Whether persistent changes in the serotonin system are bad or not is an entirely different issue. The point is that this is largely about policy, not neuroscience, because the United States is waging an extremely vigorous war. The "war on drugs" is a war on people.