Amphetamines are a widespread drug in several countries, not always with the same methods of use. In some countries, amphetamines are a major drug of abuse intravenously or inhaled, while in others, use by mouth is reserved for party circles. MDMA or ecstasy is known as the protagonist of a “fashion” of the 90s, but it is not a new substance (it was synthesized in the early 1900s) nor is it new as a drug (it was already popular in the 70s), while new and the context.
The use substantially produces a state of increased energy, reduced need for rest and sleep, euphoria and a feeling of emotional closeness to others, bravado, impulsiveness.
Ecstasy is a substance with a neurotoxic power. In the oral formulation it does not tend to easily induce addiction, and is instead responsible for functional and structural damage to the nervous system. People who use it consider it a substance that can be managed without losing control, but they do not adequately consider the risk of harm from simple use, a risk that is greater when the use is repeated over short distances or in consecutive doses. The effect of repeated and cumulative doses may initially be reversible, however even if the symptoms of “down” disappear, the recurrence of consumption can gradually exhaust the ability of the brain to rebalance itself, or promote changes in brain function which are then maintained. even after months of discontinuing use.
The long-term effects, ie in people who are no longer using it, are depression, insomnia, depersonalization and flashbacks. Symptoms such as back pain, neck stiffness, joint stiffness with hindrance in movement, recurrent headaches, abdominal cramps are also reported among the frequent long-term effects.
The phenomenon of the flashback is an example of how the consequence of the use is not only a possible damage of opposite sign to the immediate effects of the substance (depression opposed to euphoria, anxiety opposed to disinhibition, depersonalization opposed to the feeling of great and easy involvement) . Some phenomena see the brain reproducing some effects as if it had “learned” an activity modeled on that of ecstasy.
Psychosis is rarer. However, there are reports of long-term psychosis in people without a family history of psychosis.
Compared to the classic model of psychosis, MDMA psychosis can have slightly different connotations, starting as disorders with somatic symptoms and a change in character towards a darker, listless mood, with a persistent feeling of being “changed”, not as before. , unrelated to their own life, their own interests, worried about not feeling well. To this can be added later in some of the people a real psychotic component, with delusions of reference (that others refer to us, generally in a negative sense), of persecution, of bodily change (having lost functions, feeling body parts that are rigid, swollen, immobile or displaced, crooked, etc.). Unlike classic psychoses, these delusions can develop without noticeable mood changes, or with minor changes,
Overall, we can distinguish phenomena corresponding to a sort of prolonged “down”, and symptoms corresponding instead to a prolonged intoxication (psychotic), perhaps united by a common mechanism.
The treatment of these pictures refers both to the type of symptoms presented and to the mechanism of action that mediates the toxicity of MDMA.
Creighton et al., 1991, Br J Psychiatry
Mc Guire et al., 1994- Br J Psychiatry
Cohen, 1995 – Prog Neuro-Psychopharmacol Biol Psychiatry
June 04, 2011
Dear Doctor Pacini I suffer from the very disorders it would cause prolonged exposure to ecstasy …
But when my ailments started I had never used ecstasy.
Indeed 2 years after the onset of the disorders trying an intake of ecstasy once in my life I had witnessed the total disappearance of my symptoms for a few hours …
Knowing that ecstasy is very bad I have not taken it anymore.
But it is curious that I have the same non-ecstasy symptoms that are identical to those caused by ecstasy and the remission of the same during an acute ecstasy administration.
So the circuits that ecstasy damages I must have malfunctioned myself.
So an adequate therapy in my case would be to reconstruct those circuits with some medicine by taking it for a long time.
June 04, 2011
Another thing if ecstasy in acute confers well-being empathy sociability swagger dishibition and in chronic the exact opposite.
It never occurred to me to synthesize a molecule that acts diametrically opposite to ecstasy.
In other words, that in acute cases it causes inhibition, malaise, anxiety, asociality, distrust.
Maybe in chronic a substance like this would have the acute effect of ecstasy.
That is when the effect passes you feel like lions.Technically a substance that hardens the character … Logically it would make sense …
No, frankly I don’t see the point. There are substances as you say, they are not drugs but medicines obviously used for other purposes, and those are side effects if ever.
The circuits on which drugs act exist in the brain, otherwise drugs would not enter them. Some therapies are designed to “rebuild” the functioning of these circuits, or replace it, regardless of the cause that has produced the malfunction.
June 04, 2011
I like the word rebuild more because it gives the idea of toning up reinvigorating repairing reinforcing those weakened circuits therefore going to cure the cause.
I like substituting less because I know so much how you can only work with the drug until this too does not lose its effectiveness …
What twisted thoughts …
It is obvious that everyone likes the first one more. But this has no weight. You care the way you can, not the way you want to.
June 16, 2014
Hi doctor, but problems like these can be seen through a brain magenetic resonance
June 16, 2014
Hello doctor, but problems like these can be seen through a brain magenetic resonance
Yes, but for now this does not add anything to the picture that one does with a visit, quite the contrary. The images confirm that there are anomalies, but they are tests done for research rather than to fine-tune the treatments. One day perhaps it will be possible to calibrate the treatments through neuroimaging studies.
June 19, 2014
So if I think I have these problems if I do a brain resonance and it turns out negative I can rest assured
No, we didn’t understand each other. I was afraid he would do this reasoning. First of all, these are other neuroimaging exams. Then from the way he speaks it seems that his thought is to exclude brain damage, then we did not understand each other. He hadn’t asked me this but if the symptoms described above also had corresponding “images” and if it did any good to do such tests to see them. The answer was, yes, they can be seen, and no, they are of no use to anything in particular.
August 06, 2014
Doctor Pacini I am always the guy of the last two questions. I wanted to ask if it was possible to exchange a couple of questions in private by e-mail or telephone perhaps. Thanks in advance, I await an answer from you as soon as possible, have a nice day!
January 16, 2016
Good morning Doctor, I wanted to ask you this question: even if you use this substance only once, the side effects you mentioned are produced,
if so, to what extent
and after when the brain resumes its normal functions
Once is unlikely, in the sense that in this case it is a trigger. It can happen but in this case the importance of amphetamine is relative or nil, it is a disorder that comes out with amphetamine as well as it could come out with other factors or on its own.
January 16, 2016
Thank you. Now I’d like to talk about myself … I’ve been using MDMA for about 5 years, it didn’t always happen once a month, sometimes 2, sometimes for 2-3 months I didn’t do anything. but I also used other drugs such as LSD and cocaine, even those occasionally like extasy. I sometimes even mixed them. I did not use large doses, never exaggerated.
then in 2014 I started using only MDMA and I reached their peak, the consumption was regular, 1-2 times a month with a dose of about 0.5-0.6 at a time. and I started to suffer from panic attacks and all the side effects you mentioned, on a physical level back pain, stiffness and so on, and sometimes I also felt precisely that I had lost functions, I felt swollen body parts or crooked or displaced … etc … But the worst were panic attacks and even more: depersonalization.
now and since January of last year that I no longer use anything.
and I must say that I no longer have anything, all the negative effects have disappeared, the only ones left are a bit of stiffness in my back and joints (which I am treating with stretching and exercise), but above all, which worries me, I still suffer of depersonalization and flashbacks. and here comes my question: how long these side effects can take, considering my past and that I have been doing nothing for a year now,
I feel that every day they vanish more and more. but every now and then I have just this feeling of not belonging to the world that everything is fake, I feel strange, I ask myself questions about life and death … and I worry. it does not always happen, indeed I must say that before it happened often, now yes and no once a month. but I would like to know if this thing will disappear altogether.
Thank you in advance.
I can last a long time, and drug therapies that improve the metabolism of those MDMA-damaged neurons probably have a favorable effect on recovery. While it must be said that the more the symptoms are expressed, the more there is the possibility that the disorder will consolidate and remain stable.
July 27, 2016
You dear Dr. Pacini can also come here and suck my balls well with your fucking article.
When I read it I totally learned since the symptoms described here matched mine after overdosing on MDMA a year ago and never since that time, but it doesn’t take into account the fact that they can also be caused by anxiety, too. problem that in fact I have and no persistent psychosis. So you carefully moderate the terms before making people paranoid about having sporadic MDMA use, and portraying us all as irrecoverable lunatics, because once you happen to use a little more of it; instead let’s see how the symptoms can be adequately verified and what can be other possible causes other than the use of amphetamines
Dear (indeed rude) user,
If you learn by yourself without having understood anything, it doesn’t concern me, just as your rudeness doesn’t concern me.
The article says exactly what you are saying, the problem and that you did not understand anything about the article. Nobody said you should have anything, they asked about it. The article says “psychosis is rare”.
But instead of rereading it and taking it out on himself, he prefers to waste time introducing a series of offenses.
You moderate the terms, if you are unable to understand the articles because you are reading them in an alarmed state, do not read them.
Her offensive style, associated with not having understood one iota of the article, covers it up for ridicule. In any case, I report this to the staff to see if it is appropriate to prevent her from intervening again here and elsewhere.
July 27, 2016
Don’t worry I will refrain from writing alone again, that was just what I was interested in saying
Great, congratulations. In a few lines it was rude, took it for things that the article does NOT say and did not express any idea. It seems to me that
# 20 is enough
The user – rude – has been permanently deleted from this platform.
Such foul language is not allowed on medicitalia.it.
I also remember that the online offense (on blogs, forums or social networks) is defamation in the press and is considered, now more than before, due to its persistence and latency, a much more serious crime than other means of communication such as radio, TV, newspapers or even on the street.
I would add that education is a must for those who make themselves available to others in a disinterested way, as in this case dr. Pacini and how the more than 8 thousand professionals registered on this medical-scientific portal do.
You can disagree, without necessarily offending.
03 June 2020
I’ve read all of his articles and just wanted to ask you one question.
I have used mdma a few times. I have used it sporadically, 3 or 4 times a year for 3 years. Since the last time I have had problems with panic attacks and depression. It has been a year since I last used it. In this year I have had periods of total well-being and negative periods.
Lately I have constant anxiety all day, light very light but constant.
He thinks it is due to previous use of MDMA and that they may be irreversible symptoms
A syndromic diagnosis must first be made, then categorical (such as panic, or dag, or other), and on the basis of this then any treatment is carried out. Since these are common syndromes, if we are talking about anxious, or even humoral, syndromes, it is not worth thinking about the role of sporadic use of substances, it is simply one of the possible triggering factors, which means that it tends to affect those who are predisposed. .
June 04, 2020
Yes I have been to a psychiatrist.
For him mine was an anxious and obsessive type problem. I was constantly wondering if I had done irreversible damage to myself. No psychosis or other more serious things.
This anxious state then led me to get depressed and leave my hobbies and my life.
Then I recovered and had some very good weeks.
My psychiatrist told me that if I did irreversible damage, I would not have any improvements and therefore neither would I have those positive weeks.
She would confirm it
. Now I’m better, only the thought has remained a little.
When I feel anxious or a little sad, I think back to that episode and I wonder if MDMA could be responsible, but I certainly feel much better than before.
The thought has remained from time to time but now I lead a normal life and I am more peaceful.
Thank you so much for her time.
Thought has remained for a while, and it must not go away for reassurance, because in this way it feeds itself. If one is better, or perhaps well, and that problem arises, the answer is not for someone to tell her if irreversible damage has occurred, in this way she loses the ability to judge things directly and in a practical and summary way, and remains prisoner of paradoxical doubts about nothing.
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