Wednesday, Jul 9, 2008
Worried that ecstasy may fry the serotonin cells in their brains, some ravers are taking Prozac.
Sep 1, 2000 | Chris is not about to let a good high ruin his brain. Or at least that's what he thinks. At a popular dance club in lower Manhattan, he plans to take one pill that will make him happy and another that will keep him sane. The first drug of the evening is ecstasy, which will pump Chris' head full of enough mood-altering chemicals to keep him dancing all night with strangers that he feels are his best friends.
The second drug, to be taken after the first burst of ecstasy tapers off, is the antidepressant Prozac. Thanks to scientific rumors that have made their way to the dance floor, Chris is taking the combo in the hope that the prescription mood enhancer will protect his brain from the illicit and more dangerous one.
"I want to keep partying for a long time," says Chris, smiling as if he has a doctor's note for the eternal bash.
Spend time with a group of young ecstasy users and you're not likely to hear much concern that the fun could end for good. It's the nature of the drug. Keep your head in the chemical clouds of methylenedioxymethamphetamine (MDMA), and you can't imagine that anything in the world could ever go wrong. Still, there are some ecstasy fans who seem worried about the long-term consequences of their habit. They have growing reason to. Experiments on rats and primates continue to demonstrate that MDMA destroys serotonin nerve endings, possibly beyond repair. A similar loss in human ecstasy users could mean a higher risk for depression, anxiety and memory problems.
The damage, according to one popular explanation, probably occurs when serotonin cells reabsorb the flash flood of chemicals unleashed by ecstasy. This is where Prozac comes in. By plugging serotonin receptors with a pharmaceutical cork, Prozac and other selective serotonin reuptake inhibitors (SSRIs) seem to keep the brain cells free of toxic trash.
"There is very good evidence that is in fact the case in animals," says Johns Hopkins' Dr. George Ricaurte, a leading authority on the dangers of ecstasy. "Whether this is also the case in humans, we don't know."
For now, such ecstasy defense plans are simply one of those esoteric ideas that get hammered out in research labs. But the strategy has proved quite successful in several different laboratory experiments with rodents. In a study done in Finland, researchers gave rats a bunch of MDMA and then divided them into groups that got Prozac at different intervals. Rats given Prozac for up to six hours after receiving the MDMA showed no signs of damage to serotonin nerve terminals, but the unfortunate rats given Prozac seven hours later or more did.
"In rodents you can essentially get complete protection," says Dr. David Nichols, a pharmacology expert at the University of Purdue. He stops to think of the implications: ravers popping Prozac and ecstasy with a scientific stamp of approval. Angry parents complaining that researchers said it was OK for their children to take drugs. You can almost hear his head shake back and forth over the phone.
"Kids should not take ecstasy," he says firmly.
Indeed, a few lucky lab rats are hardly a ringing endorsement for safer fun through chemistry. Ecstasy is illegal and risky no matter what you take with it. And adding Prozac to the neurological mix may turn out to be harmful as well. Results to be published soon suggest that combining an SSRI with MDMA damages other brain systems in the process of protecting one.
Nevertheless, the idea that certain antidepressants may defend against ecstasy's toxic effects is gaining some credibility with scientists and ravers alike. The theory goes something like this: Ecstasy launches serotonin from special storage cells known as axons. As a result, a tidal wave of chemicals washes over your brain. You feel very, very good. After a while, these feelings start to fade, which means that your axons have probably pumped out all the serotonin that they can.
"From a logical point of view, that would be the point when the toxic insult might occur," says Nichols. With all the serotonin dumped out, the axons are now vulnerable to trouble. Receptors on the cell try to vacuum up the happy-go-lucky chemicals, but in doing so, they may also suck in toxic substances -- either from the ecstasy itself or other brain chemicals like dopamine. The effort involved in pumping these toxins into the axon generates oxygen-free radicals that might damage the cells for good. Prozac, Zoloft or another SSRI can cover the receptor like a blanket, blocking these dangerous substances until they dissipate.
"Using an SSRI at this point is probably as good as using it at any other time," says Nichols.
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