Ecstasy & Memory
Information about Ecstasy (MDMA) is clouded by hearsay, panic, hysteria, and just sheer ignorance from both sides of the debate. Users cover up the side-effects. Unintelligible studies are done. Newspapers get hysterical.
Frankly, it's a mess.
We've gone through all the latest evidence about Ecstasy and its effect on the brain - scientific studies, news reports, and websites - and broken it down into easily digestible facts as truthful, impartial, and well-researched as possible.
The conclusions, unfortunately, are not good. According to the latest research:
FACT: Ecstasy use appears to impair memory
Specifically: immediate & delayed verbal memory (remembering what someone has just told you), delayed visual recall (the ability to remember images), and short term memory (also known as "working memory").
Overall, Ecstasy users find it more difficult to recall and memorize information than non-E users.
These effects have been detected days, weeks, and months afterwards in both light (20 pills in a lifetime), moderate (20-100 pills) and heavy (100+) users.
FACT: The degree of memory impairment is between 20-40% below average
This is still, technically, well within what is classed as "normal" memory performance. It does not seem to affect users' everyday lives.
SUSPECTED: The more Ecstasy you take, the worse the memory impairment.
The more E you take, the worse your memory performance may be - especially short term memory and immediate vocal recall (Gouzoulis-Mayfrank). This has been confirmed by another, less well designed study (Bolla).
However, nobody yet knows exactly what "more" means. It could be lifetime exposure, monthly dose, frequency or duration of use, or amount of E per single occasion.
UNKNOWN: If you stop taking Ecstasy, your memory will get better again
There is conflicting evidence. Some preliminary evidence from one study (Morgan) appears to imply that abstinence from E for six months may normalize memory performance. And another solid study (Semple) found that memory appeared to recover after abstinence from E.
But another study (Wareing) found that very heavy E users (1300 pills lifetime doses) still performed worse than control subjects even after a year of abstinence. Note: 1300 pills is very heavy use, the equivalent of 3-4 pills twice weekly for 4 years.
UNKNOWN: Ecstasy may affect other brain functions
For instance, moderate E users (93 pills in a lifetime) in one well-designed study (Gouzoulis-Mayfrank) showed worse performance in: problem solving, general knowledge, selective attention, and logical thinking. No other studies have tested these areas yet.
FACT: Smoking marijuana as well as taking E makes memory performance even worse
Marijuana use appears to increase the impairment of working memory or play its own role in memory impairment which may interact with MDMA's effects. (Gouzoulis-Mayfrank)
There have been over 100 scientific studies examining the effects and side-effects of Ecstasy. Fifteen in particular have studied the effects of MDMA on human memory performance.
However, not all studies are equally well-designed, especially when attempting to measure something as insubstantial and as fluctuating as memory performance. So many factors can influence the results - age, sex, education, intelligence, mood, lifestyle, fitness, sleeping pattern, diet, alcohol, drug use, even time of day.
The best studies attempt to filter out these factors by carefully matching the Ecstasy-users with their non-Ecstasy-using 'controls'. A majority of Ecstasy studies, for example, have failed to factor out cannabis use, which has a significant effect itself on memory performance. Others have used to few subjects, or have only studied heavy users.
Of the major studies carried out to date (April 2001) on the effects of Ecstasy on memory performance, only two - Gouzoulis-Mayfrank and Semple - are worth examining closely.
Ecstasy and Memory Study 01
"Impaired cognitive performance in drug free users of recreational ecstasy (MDMA)"
Gouzoulis-Mayfrank E, Daumann J, Tuchtenhagen F, Pelz S, Becker S, Kunert H-J, Fimm B, Sass H (2000) J Neurol Neurosurg psychiatry 68: 179-725
Read the entire study: pdf | html
Three groups. Matched for age, sex, and education.
1) 28 regular ecstasy users who had either been using the drug at least twice monthly for six months or longer in the last two years, or had used E more than 25 times in the last two years. Excluded were those who regularly used other drugs, or were heavy drinkers. Most smoked cannabis to various degrees. The average total lifetime dose was 93 pills (3.5 per month).
2) 28 people who had never taken ecstasy before, nor any other drugs, and no regular heavy alcohol use
3) 28 people who had never taken ecstasy but did use cannabis matched with the ecstasy group. Again, no drug or heavy alcohol use.
Various, evaluating simple & complex attention, memory and learning, reaction times, selective visual attention, divided attention, short term memory, word fluency, abstract logical thinking, and general knowledge.
While test results were within normal range, the ecstasy group performed worse than the control groups in more complex tests of attention, memory and learning (especially working short term memory and verbal memory), and in tasks reflecting general intelligence.
Decreasing immediate verbal recall and working memory performance correlated with increasing lifetime doses of Ecstasy.
The study says: "These results raise the concern that ecstasy use, even in typical moderate recreational doses and possibly in conjunction with cannabis use may lead to a subclinical cognitive decline in otherwise healthy young people"
read the entire study: pdf | html
Ecstasy and Memory Study 02
"Reduced in vivo binding to the serotonin transporter in the cerebral cortex of MDMA ("ecstasy") users."
Semple DM, Ebmeier KP, Glabus MF, O'Carroll RE, Johnstone EC (1999) Br J Psychiatry 175: 63-6
Read the entire study here
Ten male users between 18 - 35 with an average lifetime consumption of 672 Ecstasy pills and a minimum of 50, abstinent from E for an average of 18 days.
Matched to 10 control subjects, of the same age, sex, education, and drug use (tobacco, alcohol, cannabis and amphetamines) bar ecstasy.
Several standard memory tests but mainly - and importantly - brain imaging, to measure serotonin transporter binding, i.e. how effectively the serotonin system was working in their brains.
Increasing lifetime exposure to Ecstasy was clearly linked with decreasing memory performance. Serotonin transporter binding was significantly lower in Ecstasy users in several brain areas, meaning the serotonin system was impaired.
The time of abstinence from Ecstasy did appear to improve serotonin transporter levels, implying that neurotoxicity may be temporary and recover with time.
FACT: It is undeniable that if you take Ecstasy, you are risking memory impairment.
While the degree of memory impairment, so far measured, is still within limits considered "normal", there is a growing body of evidence to suggest that even moderate use messes with your head. Whether it does so temporarily or permanently is yet unknown.
There will be more, better-designed studies over the next few years that will help you understand the issues clearly. For now, refer to the original studies quoted if you can. Use reputable sources on the Internet to find out facts.
Ecstasy and Memory Sources
Semple DM, Ebmeier KP, Glabus MF, O'Carroll RE, Johnstone EC (1999) "Reduced in vivo binding to the serotonin transporter in the cerebral cortex of MDMA ("ecstasy") users."
Br J Psychiatry 175: 63-6 - online version
Gouzoulis-Mayfrank E, Daumann J, Tuchtenhagen F, Pelz S, Becker S, Kunert H-J, Fimm B, Sass H (2000) "Impaired cognitive performance in drug free users of recreational ecstasy (MDMA)"
J Neurol Neurosurg psychiatry 68: 179-725 - online version
Gamma, Alex Ph.D, "Does Ecstasy cause memory deficit? - A review of studies of memory function in Ecstasy users"
January 7, 2001 - online version