Scholars say they are closing in on how ecstasy, 3,4-methylenedioxy-methamphetamine (MDMA), produces feelings of euphoria in users and in a new paper say that it might be useful in the treatment of anxiety and post-traumatic stress disorder.  A small study using MDMA as an adjunct to psychotherapy reported positive preliminary results.

The limitation of the new paper; these were brain images and done for a television show a year and a half before it was in a journal.

Due to its nature as a stimulant that can produce hallucinations, Ecstasy has been a popular recreational drug since the 1980s, but little is known about which areas of the brain it affects. The new study says it is the first to use functional magnetic resonance imaging (fMRI) on resting subjects under its influence. Twenty-five volunteers underwent brain scans on two occasions, one after taking the drug and one after taking a placebo, without knowing which they had been given.

The images showed MDMA decreases activity in the limbic system – a set of structures involved in emotional responses. These effects were stronger in subjects who reported stronger subjective experiences, suggesting that they are related. Communication between the medial temporal lobe and medial prefrontal cortex, which is involved in emotional control, was reduced. This effect, and the drop in activity in the limbic system, are opposite to patterns seen in patients who suffer from anxiety.

MDMA also increased communication between the amygdala and the hippocampus. Studies on patients with post-traumatic stress disorder (PTSD) have found a reduction in communication between these areas.

Dr Robin Carhart-Harris from the Department of Medicine at  Imperial College London, who performed the research, said, “We found that MDMA caused reduced blood flow in regions of the brain linked to emotion and memory. These effects may be related to the feelings of euphoria that people experience on the drug.”

Project leader David Nutt, the Edmond J. Safra Professor of Neuropsychopharmacology at Imperial College London, added, “The findings suggest possible clinical uses of MDMA in treating anxiety and PTSD, but we need to be careful about drawing too many conclusions from a study in healthy volunteers. We would have to do studies in patients to see if we find the same effects.”

As part of the Imperial study, the volunteers were asked to recall their favorite and worst memories while inside the scanner. They rated their favorite memories as more vivid, emotionally intense and positive after MDMA than placebo, and they rated their worst memories less negatively. This was reflected in the way that parts of the brain were activated more or less strongly under MDMA. Those results were published in the International Journal of Neuropsychopharmacology.
Carhart-Harris said, “In healthy volunteers, MDMA seems to lessen the impact of painful memories. This fits with the idea that it could help patients with PTSD revisit their traumatic experiences in psychotherapy without being overwhelmed by negative emotions, but we need to do studies in PTSD patients to see if the drug affects them in the same way.”

Citation: R.L. Carhart-Harris et al., ‘The Effects of Acutely Administered 3,4-Methylenedioxymethamphetamine on Spontaneous Brain Function in Healthy Volunteers Measured with Arterial Spin Labelling and Blood Oxygen Level-Dependent Resting-State Functional Connectivity.’ Biological Psychiatry, 2014. DOI: 10.1016/j.biopsych.2013.12.015