What is Ecstasy and what is its connection to depression?
Ecstasy is an illegal substance whose chemical name is MDMA (3,4-methylenedioxy N-methyl amphetamine), and whose other street names are X, Adam, Beans, and Molly. It belongs to the amphetamine-type family of stimulants. Ecstasy can both alleviate and cause depression. MDMA-assisted therapy has been shown to promote increased trust between therapist and client, which improves therapeutic outcomes. However, some studies show that the drug can have negative long-term impacts on mood and induce depressive episodes via its effects on serotonin and the sympathetic nervous system (The Recovery Village®, 2019).
MDMA was originally synthesized in 1914 by the pharmaceutical company Merck. During the 70s, Ecstasy was used in therapy settings. It helped people “open up” more easily in their therapy sessions. But, its use was soon discontinued after several animal studies showed that it produced brain lesions in mice. Recent studies, however, are once again showing that Ecstasy used under controlled conditions can indeed be beneficial. It comes in tablet form and has energizing effects that remove mental barriers and inhibitions.
Can depression be cured by using Ecstasy? (The Recovery Village®, 2019)
In addition to MDMA-assisted treatment for post-traumatic stress disorder (PTSD), MDMA for depression treatment has been the subject of promising new clinical trials. These studies show that clinical supervision in a safe environment can potentially counteract some of the negative effects of recreational MDMA use. By making sure people are supported with ongoing therapy, MDMA’s depressive aftereffects may be mitigated.
The Ecstasy used to treat depression in therapy sessions is clinically pure. It is administered prior to an 8-hour-long session of talk therapy three times a month. These sessions are supported with additional weekly counseling sessions without the aid of Ecstasy. The way Ecstasy helps in these sessions is by establishing a rapport with the therapist more quickly and by making people overcome the fears that hold them back from looking into troubling emotional issues. This can be very helpful in people with history of trauma and greater difficulty opening up to a professional.
Currently, clinical trials are underway on these aspects of Ecstasy use in therapy for depression. What needs to be established is whether the short-term therapeutic benefits of using Ecstasy in this way outweigh the long-term risks of depressive symptoms associated with its use.
Does Ecstasy cause depressive symptoms?
The acute medical risks of using Ecstasy are well documented. Among other effects, it acts as a stimulant and can induce rapid breathing and heart rate. Overdose can lead to death on account of brain swelling, seizures or kidney failure.
Other risks of Ecstasy use include acute anxiety and panic attacks, mainly on account of the release of epinephrine via stimulation of sympathetic nervous system. Also, it is not unusual for people to experience periods of depression when they use stimulant drugs on a regular basis. The brain chemicals responsible for the rush and elevated feelings Ecstasy induces are eventually depleted and a recovery period is needed for the brain to replenish them. During this period, people often feel depressed.
This has been borne out by research of various investigators, such as (a) Valerie Curran and Ross Travill, (b) Lynn Taurah at London Metropolitan University, in 2003, (c) Taurah and associates, in 2014, (d) Briere and associates at the University of Montreal, in 2012. These studies leave no doubt that it can. However, other research from the same period also shows that Ecstasy can actually help some people who have depressive disorders (The Recovery Village®, 2019).
Potential Side Effects of Ecstasy (Ghoshal, 2019) (Sadock, et al., 2017)
Some of the reported side effects of MDMA include:
- Jumbled thoughts
- Increased blood pressure
- Restless legs
- Loss of appetite
- Nausea, sweating, and chills
- Hot flashes
- Muscle stiffness
- Impaired depth and spatial awareness
- Depression, anxiety, irritability, and hostility
- Reversible or even permanent neural damage
- Delirium and fatalities
Current Situation with Regard to Ecstasy and Its Role in Depression (Mammoser, 2018)
Currently, the Drug Enforcement Administration (DEA) still classifies MDMA as a Schedule 1 Narcotic. What that translates to is that it has “no currently accepted medical use and a high potential for abuse.” But, as things stand, that designation may soon change.
A study published in The Lancet Psychiatry in May 2018 showed that psychotherapy conducted with Ecstasy was successful in treating PTSD in a majority of participants. Researchers recently moved into phase III trials for the drug to treat PTSD, and they say they expect approval from the Food and Drug Administration (FDA) for the drug by 2021.
Doblin and the MAPS organization have shown with phase II studies the effectiveness of Ecstasy therapy in the treatment of social anxiety. Ecstasy suppresses activity in the amygdala, a part of the brain responsible for fear and anxiety. The drug produces empathetic and prosocial feelings, which relieve the anxiety caused by interaction with other people.
Although the use of Ecstasy for depression hasn’t been as well-established as it has been for others, such as PTSD and anxiety, the potential use for Ecstasy to treat depression is “theoretically well-grounded”. Ecstasy is able to instill feelings of calmness and trust, and thus may be helpful in a therapy setting for individuals dealing with depression and other common comorbidities of PTSD.
Ghoshal, M., 2019. MDMA, Depression, and Anxiety: Does It Harm or Help?. [Online]
Available at: https://www.healthline.com/health/mental-health/mdma-depression
[Accessed 22 Oct 2019].
Mammoser, G., 2018. Here Are 4 Conditions That the Drug Ecstasy May Help Treat. [Online]
Available at: https://www.healthline.com/health-news/4-conditions-that-ecstasy-may-help-treat#1
[Accessed 22 Oct 2019].
Sadock, B. J., Sadock, V. A. & Ruiz, P., 2017. Kaplan and Sadock’s Comprehensive Textbook of Psychiatry. 10th ed. Philadelphia: Wolters Kluwer.
The Recovery Village®, 2019. MDMA and Depression. [Online]
Available at: https://www.therecoveryvillage.com/ecstasy-mdma-addiction/related-topics/mdma-and-depression/#gref
[Accessed 22 Oct 2019].