Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

8. Marijuana, Hallucinogens, and Club Drugs 163MDMAMDMA has many names, but is perhaps best known as Ecstasy. It is sometimesclassified as a stimulant and does have similar properties to the amphetamines,although it also has some unique effects that distinguish it (Hermle et al., 1993;Shulgin, 1986). MDMA was legal in this country until 1985, when it was madea Schedule I drug. Prior to that, its use was unregulated and therefore legal.The primary appeal of MDMA is its psychological effect, a dramatic andconsistent ability to induce a profound feeling of attachment and connection inthe user. The compound’s street name is perhaps a misnomer; the Los Angelesdrug dealer who coined the term “Ecstasy” originally wanted to call the drug“Empathy,” but asked, “Who would know what that means?” (Eisner, 1968).MDMA has long been known to damage brain serotonin (5-HT) neuronsin laboratory animals (McCann & Ricaurte, 1993; Montoya, Sorrentino, Lucas,& Price, 2002). Although a minority of researchers disagree with the conclusion,it has become increasingly apparent over the past decade that MDMA isneurotoxic to humans. Furthermore, the neurotoxicity has real and functionalimplications (McCann, Eligulashvili, & Ricaurte, 2000; Montoya et al., 2002;Morgan, 2000; Sprague, Everman, & Nichols, 1998). Ecstasy use is associatedwith sleep, mood, and anxiety disturbances, elevated impulsiveness, memorydeficits, and attention problems. Many of these disturbances appear to be permanentand seem likely to depend on the overall amount of MDMA consumedover time, but may be caused by as little as a single dose (Rodgers, 2000; Turner& Parrott, 2000).HistoryA synthetic process for the creation of MDMA was patented in 1914 by Merckin Darmstadt, Germany (Shulgin, 1990). MDMA was not, as is sometimesthought, intended as an appetite suppressant. It was most likely developed as anexperimental compound. Except for a minor chemical modification mentionedin a patent in 1919, there is no other known historical record of MDMA untilthe 1950s. At that time, the United States Army experimented with MDMA.The resulting information was declassified and became available to the generalpublic in the early 1970s. These findings consisted primarily of a number ofLD 50(median lethal dose) determinations for a variety of laboratory animals.Humans probably first used MDMA in the late 1960s. It was discovered asa recreational drug by free-thinking individualists (New Age seekers), peoplewho liked its properties of inducing feelings of well-being and connection(Watson & Beck, 1986). MDMA does induce feelings of warmth and connectedness,and using this rationale, its use was promulgated by therapists in the1970s (Shulgin, 1990). Before the compound became illegal in 1985, it wasused extensively for this purpose (Beck, 1990).