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Ecstasy, not ECT

Use X as a pharmacologic substitute for electroconvulsive therapy.
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Depression is a big problem. There are effective medicines to treat depression, called selective serotonin reuptake inhibitors (SSRI); prozac and paxil are examples of this drug class. They work by increasing the amount of serotonin available to serotonergic axons in the brain. For reasons which are unclear to me, the SSRI drugs do not immediately alleviate depression - often they take 4-6 weeks to work - and if they aren't going to work for a certain individual, he or she must endure 4-6 weeks of depression before this fact is clear. A person who takes a tablet of prozac in fact usually feels nothing - there are almost no acute effects.

For depressed people who are at suicide risk or who are too depressed to take their medicines, the only fast acting treatment is electroconvulsive therapy (ECT). Although ECT works, and is "safe", it is distasteful to most and clearly another comparably active method would be welcome.

Ecstasy (MDMA) is an abused and maligned drug which also works by augmenting serotonergic release in the brain. Unlike the serotonergic drugs mentioned above, ecstasy does cause acute and usually pleasant effects.

Ecstasy is, pharmacologically, essentially fast acting prozac. I propose a study of severely depressed individuals who are candidates for ECT in which these individuals are instead treated with one or several doses of ecstasy in a controlled hospital environment. If it does not help, they could then go on to receive ECT anyway. If some do benefit, the next step would be a larger randomized trial comparing ECT to X.

bungston, Jan 05 2003

Electroconvulsive therapy http://www.psycom.n...on.central.ect.html
[bungston, Oct 04 2004, last modified Oct 06 2004]

Prozac http://www.prozac.c...Help/HowItWorks.jsp
Nifty animations! [bungston, Oct 04 2004, last modified Oct 06 2004]

Paxil http://www.paxil.com/about/nw_bet.html
More nifty animations! [bungston, Oct 04 2004, last modified Oct 06 2004]

Ecstasy http://www.drugtext...hive/19/default.htm
A thorough and balanced review of MDMA. Pharmacology is at the end. [bungston, Oct 04 2004, last modified Oct 06 2004]

Ecastsy therapy http://www.alternet....html?StoryID=12186
from the article: "Before Ecstasy became illegal in 1985 and illicit recreational use bloomed, MDMA was mainly a couch tool for a handful of therapists." [snarfyguy]

more... http://www.wired.co...,1286,48547,00.html [snarfyguy, Oct 04 2004, last modified Oct 06 2004]

more... http://www.wired.co...,1286,48547,00.html
[snarfyguy, Oct 04 2004, last modified Oct 05 2004]

Serotonin neuron damage and ecstasy http://mdma.net/tox...y/brain-damage.html
[Monkfish, Oct 04 2004, last modified Oct 06 2004]

Gurning http://en.wikipedia.org/wiki/Gurning
and ecstasy? [bungston, Aug 28 2006]

[link]






       Haven't psychiatrists been working with ecstasy treatments / therapy for some time now? Thought I saw an article about it a few years back. Will check...
snarfyguy, Jan 05 2003
  

       See links added.
snarfyguy, Jan 05 2003
  

       Tranquilizers are sometimes prescribed over the short-term (until the 'main' anti-depressant kicks in). I think there are also fast-acting uppers that get used occasionally.   

       Ecstasy is notorious for causing a nasty bout of rebound depression a day or two after taking it. People who are already depressed often avoid it for that reason. It's also pretty impairing, interferes with sleep and eating (the MA part of MDMA), might just cause brain damage, and so on; you probably shouldn't try to keep people on it for six weeks.
Monkfish, Jan 05 2003
  

       Actually, since you're planning to give out ecstasy and SSRIs at the same time, you're also risking serotonin syndrome and things like that. At the very least, it seems likely (?) that the two won't get along in various ways.
Monkfish, Jan 05 2003
  

       sp: E.   

       What about the damaging side effects?
- desire to dance like a monkey.
- sudden interest in naff gimmickry such as glow sticks.
- erosion of interest in melodic music in favour of relentless pummeling hard house, replete with "hoover noises"
- realisation that the gurning lackwit leering at you - a man you'd ordinarily cross the street to avoid - is, in fact, a truly lovely person you'd like to talk to for hours.
my face your, Jan 05 2003
  

       Hee! All good points, [m.f.y.].
snarfyguy, Jan 05 2003
  

       [my_face_your] - "Normal" music can certainly be enjoyed under the influence of this lovely drug too. Guitar & vocal stuff sounds great (so I'm told).
sild, Jan 06 2003
  

       I wish I could give a croissant for the term "Gurning lackwit". So quit your gurning, Gurny. Thats right, _Gurny_.
bungston, Jan 06 2003
  

       I think the testing of pure MDMA in controlled doses to alleviate the symptoms of depression would be an interesting study to conduct. Considering MDMA is supposedly the main constituent of "ecstacy", it may dispell myths about its potentially lethal and detrimental effects.   

       However, I don't think conducting a study using street-grade MDMA, or ecstacy would yeild any positive results as far as the treatment of depression is concerned. The "high" achieved from ecstacy is great for treating depression for about 1 hour, maybe 2 but then the effects wear off and keeping them sustained is pretty much impossible.   

       Users turn into pale faced, paranoid gibbering wrecks after 8 hours on the drug and take days, if not weeks to fully recover.   

       The use of street drugs to treat mental disorders, whose roots may lie far deeper than anticipated, is ridiculous.   

       Apart from anything else, where would the drugs be sourced? Would the pills be scientifically analysed to determine the exact ingredients? How would the effects of the other drugs present in the pill be eliminated/isolated from the experiment?   

       However, since I studied psychology @ A-Level, the thought of ECT makes me shudder. It seems such a crude and intrusive/physical "treatment" only conucted on people who have no say in the matter, i.e. those who are incapable of making a decision or appreciating the procedures involved. To apply electric shocks directly to the side of the head in the hope it may trigger a physical change of the brain seems complete madness to me. The brain is regulated by chemicals, so chemicals it must be to alter it - for the good or worse. I would rather be pilled up 24/7 than be the victim of ECT. It's just one stop short of removing the "offending" parts of the brain (see One flew over the cuckoos nest).
fairly, Sep 22 2005
  

       Did you then edit the wikipedia article, [UB]? I see that at the tailend of the article on gurning there is a reference to the facial expressions of persons on ecstasy.
bungston, Aug 28 2006
  
      
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