From Prozac to Ecstasy: The Implication of New Evidence for Drug-Induced Brain Damage

Our society looks upon psychiatric drugs with such naive trust that it raises the moral, societal and "therapeutic" status of an illegal drug when it can be compared to a psychiatric drug. Thus Matthew Klam's personal account in the January 21, 2001 New York Times Magazine praised the amphetamine Ecstasy as a ''whooper of an antidepressant" that is better than Prozac®. Although illegal in the United States and elsewhere, Ecstasy or MDMA (methylenedioxymethamphetamme) has been used extensively since the 1980s as a "recreational" drug. It is known to cause degeneration of serotonin nerve cells and axons in rats (Ricuarte, Byran, Strauss, Seiden, & Schuster, 1985). In defense of MDMA, Klam criticized the U.S . government for funding and publicizing research that documents the brain-damaging effect of MDMA. He pointed out that "Prozac-style antidepressants produce some morphological [structural] abnormalities in the serotonin nerve network of rats that resemble changes seen with Ecstasy taken in high levels. Yet few people advocate the banning of Prozac." Klam is right that U.S. government health agencies are eager to show that illegal drugs cause brain damage but are reluctant to inform the public that selective serotonin reuptake inhibitor (SSRI) antidepressants have similar damaging effects. He is also right that the kind of research used to justif'y a ban on MDMA could also be used tojustif'y a ban on the SSRI antidepressants . In some research studies, the MDMA and SSRIs are shown to produce nearly identical morphological changes in the brain (see below). However, Klam arrives at the wrong conclusion. His observations should have raised his concern about both MDMA and the SSRIs. Instead, taking the lead from the cultural overvaluation of antidepressant drugs, he makes even more outlandish and dangerous claims for MDMA. Unfortunately, Klam's views are given credence by their publication in the New York Times. The appearance of this personal, undocumented story in a prestigious international newspaper indicates the extent of our cultural acceptance of illegal and legal drugs for mood alteration. The unbridled enthusiasm for a stimulant agent is darkly reminiscent of Freud's ecstatic enthusiasm for