The Agony of Ecstasy: Memory Loss

From the WebMD Archives

April 9, 2001 -- It's not just loss of sleep from weekends spent at all-night rave parties: Long-term ecstasy users lose important parts of their memory.

As have previous studies, a report in the medical journal Neurology finds that people who use the drug known as ecstasy, X, or E have trouble remembering things. The new study, however, shows that people who take the drug only two or three times a month experience memory loss. And that loss continues to worsen over time.

"We certainly know that for those who are chronic users, their memories are indeed impaired over time," lead author Konstantine Zakzanis, PhD, tells WebMD. "The question that remains is, "Is this change permanent or reversible?"

Ecstasy is a MDMA, short for methlyenendioxymethamphetamine, a member of the amphetamine family of drugs known to damage important brain cells in animal studies. The drug has been around for a long time, but achieved popularity only in the 1980s with the advent of the all-night dance parties known as raves.

"It was originally used as a diet suppressant in the first world war," says Zakzanis, a psychology professor at the University of Toronto in Canada. "In the 1940s and 1950s, it was used in marital counseling to help couples deal with their emotions. In the mid-'80s, it found its way into the rave culture. Most people feel euphoric, happy -- a lot of people get energetic, too, but that may be because the ecstasy people buy on the street is often mixed in with other substances, such as caffeine or Tylenol or amphetamine."

Unlike previous studies that tested ecstasy users only one time, Zakzanis enrolled 15 users in a yearlong study. The participants, aged 17-31, used the drug an average of 2.4 times each month. All study subjects agreed to stop taking the drug for two weeks at the beginning and at the end of the year -- a drug vacation confirmed by blood tests -- so that measurements of mental function would not be confused by lack of sleep or a lingering "high."

Memory tests showed that the ecstasy users' memories declined over the course of the year. Certain types of memory were affected -- particularly the ability to recall the contents of a news story that was read to them. On this test, they did only half as well as they had done a year before.

The ecstasy users' vocabulary skills also declined, as did their abilities to remember people's names and to remember how to get from one place to another.

"The subjects were listening to a news story and they found it difficult to remember the story after a delay," Zakzanis says. "They reported driving and forgetting where they were going, but didn't forget how to drive a car. And they had difficulty remembering names when introduced to someone."

Zakzanis says heavy ecstasy users also lost the ability to remember to do something in the future. "The more chronic users were impaired more greatly than sporadic users -- so the more you use this drug, the more function you lose," he says.

Una D. McCann, MD, led several studies of ecstasy's effects while a section chief at the National Institute of Mental Health. Now an associate professor of psychiatry at Johns Hopkins University in Baltimore, she continues this research and is familiar with Zakzanis's work.

"We and actually a handful of other groups have found that [ecstasy] users don't perform as well on a variety of tests for [mental] functions -- but the one problem that comes up most is memory," McCann tells WebMD. "It seems that the more complicated a memory task is, the more of a deficit we see."

The Zakzanis study is the first to follow patients over time, McCann says. "It takes away a lot of the criticisms of other studies, because people say maybe the subjects had worse memory to begin with. But the finding that the users got worse over the course of a year counteracts that complaint -- that's the beauty of this study."

Zakzanis says that the ecstasy users in his study are still coming in for tests. Some of them have quit using the drug -- but only time will tell whether the damage to their brains can be undone.