Relationship between MDMA and Depression - Research Paper Example

? Literature Review: Relationship between MDMA and Depression al affiliations Literature Review: Relationship between MDMA and Depression Concerns over the use of 3, 4-Methylenedioxymethamphetamine (MDMA), also referred to by its street name ecstasy and Molly, was first synthesized in 1910. Since this time, MDMA has attracted a great deal of research with respect to the longterm effects that use and overuse of this particular drug has upon the individual. A great majority of this research has been concentric upon the after-effects of use and overuse with regards to the side effect of depression that often ensues following heavy MDMA usage. Ultimately, MDMA is a recreational drug that affects the release of serotonin in the brain. Serotonin is a neurotransmitter that regulates an individual’s mood and cognition levels (Durdle, Lundahl, Johanson, & Tancer, 2008). By means of comparison, depression is a common mental disorder that is a recognized as a health issue globally. As such, the ultimate level of concern is that many individuals self-medicate using MDMA as a means of enhancing positive emotions and seeking to find happiness via this illicit substance. Yet, unlike other medicine that is available for depression, MDMA has a terrible long term side effect on not being able to provide the same level of happiness that they may have had when they used the drug the first time. However, MDMA use has turned out to be more harmful with regards to the regulation of depression. MDMA users that regularly integrate with the drug report a litany of major depressive disorders. Serotonin functionality has been under review by pharmacologists for decades; with the focus to determine neurological effects that result from the use of MDMA (Allott, Canny, Broadbear, Stepto, Murphy, & Redman, 2009). The literature review covered in this paper seeks to review different research conducted to determine the relationship between repeated MDMA use and depression. There is a hypothesis that the use of MDMA is closely related to the increased depressive disorders to MDMA users. The ten peer reviewed articles will focus on reviewing literature that supports this hypothesis. Durdle & Lundahl et al. (2008) conducted a research to determine the correlation of MDMA use to depression by examining depressive symptoms from MDMA users. The focus of the research was to determine the contradictory fact the MDMA has contributed to major depressive disorders in individuals that integrate with the drug habitually. Gender effects were also considered in the research. The researchers further utilized regression analysis to determine a relationship between MDMA use and key depressive symptoms. The research hypothesized that the relation between depression and the use of MDMA is complex and inconsistent. The sample involved 226 participants over a period of eight years and concluded that the relationship between depression caused by MDMA usage can only be exhibited in situations in which an individual overdoses repeatedly and depletes overall levels of serotonin in the brain; thereby creating a situation in which happiness and feelings of well-being cannot be experienced for several days or even weeks after the drug is taken. Montoya and Sorrentino et al. (2002) conducted research on the long-term consequences of MDMA use and found a close relationship between depressive disorders and MDMA usage. The research used typical profiles in the diagnosis of MDMA-related depressive symptoms to answer the dilemma of the effect of MDMA toxins with relation to depressive behaviors. MDMA is further attributed with reducing the enjoyment that an individual can experience with regards to sexual desire, food craving, and the sense of touch if any of these experiences are had while the individual is on the drug. Furthermore, the researchers note the psychological impacts that MDMA can have due to the fact that a person who uses the drug becomes psychologically dependent in the sense that they are of the opinion that they cannot be themselves or experience confidence and enjoyment to the same degree without the drug (Montoya & Sorrentino et al., 2002).The study based the relationship between MDMA and depression to animal experiments; conducted to determine MDMA effects to the central serotonergic systems. According to the lab reports, MDMA toxins affected the serotonergic system of animals in a negative manner; promoting depressive behavior and lethargy. This indicated that the toxins had a high probability to affect the human serotonergic systems in the same manner; inducing hyperactivity in the brain and correspondingly resulting in higher levels of depression (Montoya and Sorrentino et al., 2002). In a study to confirm the research findings by Durdle & Lundahl et al., 65% of the participants were male while only 35% were female. Individuals with no other medical conditions and who had targeted levels of prior MDMA usage were subjected to the research after a rigorous screening process. Participants were subject to a SCL-90 based on the drug usage questionnaire (DUQ). The results indicated that 11.5% of the subjects met the hypothesized outcome of having major depressive disorders as a direct result of the use of MDMA. Interestingly, females were found to have fewer indicators with regards to these results than their male counterparts. However, the main research drawback was that all of the participants were MDMA users; thereby making it difficult, if not impossible, to compare the results to non-users depression scores and deduce a firm conclusion. This results were similar to the results presented by Guillot (2007), which indicated that most of the MDMA users had significant high depression scores. Analysis of studies that have used the symptom checklist 90 (SCL-90) by Guillot (2007) indicated that the complexity of determining a relationship of MDMA use to high depression levels is raised from the fact that only two out of the five results are able to achieve results showing high depressive scores in MDMA users compared to non-users. In his study, Guillot (2007) determined, from the SCL-90 score, that the results were complex; making them difficult to relate the use of MDMA to the depression scores from the test subjects. The low outcomes from the two studies indicate that there was a need to come up with other measures to determine the relationship between MDMA use and depressive disorders. The Beck Depression Inventory (BDI-II) was the focus of two studies conducted by Falck, Wang, and Carlson (2008) and Titov, Dear, Mcmillan, Anderson, Zou and Sunderl (2011). The ultimate aim was to uncover the relation existing between the use of MDMA and major depressive levels after other studies have had substantial failures in proving their results in reference to their hypothesis. Research by Falck and Wang et al (2008) hypothesized that the use of MDMA can cause the depletion of serotonin and serotonergic neurodegradation; which results in depression. The research used the BDI-II to access the participants for depressive symptoms after a period of six months. A number of factors that included gender and age affected Symptomology scores (Falck & Wang et al., 2008). The study further hypothesized that the reported depression symptoms, both short and long term, are attributed to the use of MDMA. The total number of participants for this study was 402; with the recruitment demographic aged between 18-30 years. The participants were required to have not been any drug abuse program for at least 30 days prior to the study. The data was collected from the interview questions designed to fit BDIII score. Research measures were based on the BDI-II score that consisted of 21 items with each having a measure 0-3. This was used to analyze severity of depressive symptoms. The result of the study indicated that the use of MDMA in individuals caused high levels of depressive symptomatology. Furthermore, the BDI-II data indicated that people who used MDMA in more than 50 occasions portrayed higher levels of depressive symptoms than those who used the drug less often. The results confirmed the hypothesis in that MDMA users experienced higher levels of depression in the long term. This was in accordance to the results obtained by a research conducted by Woods and Barkus (2010). Woods and Barkus (2010) used a schizotypal personality questionnaire and applied BDI to measure the use of MDMA symptoms. The study examined the relationship between the MDMA use and self-report depression. It further focused the research to determine the relationship between MDMA usage, anxiety, and Schizotypy. The study involved 139 individuals with a mean age of 22.47 years. Moreover, the participants were separated into three groups; non-users, light users, and heavy MDMA users. The results of the study were similar to other research. However, the results were comparative in determining the relationship between MDMA use and depression because the study involved non-users light users and heavy MDMA users. The heavy user group indicated higher levels of depressive symptoms compared to the light user and no-users group. Similarly, light users group indicated higher depression compared to non-users. The results indicated a clear distinction of the effect of using MDMA on the depression level (Woods & Barkus, 2010). A psychopharmacological study approach to determine the relation of MDMA and depression by Carhart-Harris, Nutt, Munafo, and Wilson, (2009) sought to test the use of MDMA and abnormal sleep. The study hypothesized that the acute stimulants of MDMA cause sleeping hardships in users. The study used a sample of 1035 individuals; of which only 89 MDMA users were reported to have used small amount of the drug after an analysis of a questionnaire containing drug use and sleep. The 89 participants were further subdivided into two groups, one of 31 current users and 58 abstinent users. The results indicated that current-MDMA users had a worse sleep quality than the abstinent users (Carhart-Harris and Nutt et al., 2009). This confirmed the hypothesis of the study that MDMA users suffer persistent sleep abnormalities. The results were opposed by another psychopharmacological study by Allott and Canny et al. (2009). Allott and Canny et al. (2009) conducted a study that sampled nine male and eleven female users of MDMA. It hypothesized that despite proof of MDMA effect on serotonergic system on animal, it has no significant event on depression. The measures were taken on the neuroendocrine responses to pharmacological challenge with a selective serotonin inhibitor. The results were compared to nine male and eleven female under the influence of cannabis; as well as eleven male and eleven female non-users. The results indicated that there lacked a significant effect on mood and traits (depression triggering traits) from the use of MDMA. These results contradicted other research on the relation between MDMA and depression. A different approach by Leung, Abdallah, Copeland, and Cottler, (2009) aimed at determining the relationship of recent depression of individuals to the past usage of MDMA. The research aimed to determine the whether modifiable risk factors such as risk perception, recent depression, perceived behavioral control, and current MDMA dependency. The study was conducted on 601 MDMA users; who were interviewed twice a week. Multivariate logistic regression technique was applied to determine the relation of the fur modifiable risk factors in relation to, MDMMA use. Results for the study indicated that recent poly-drug use was statistically associated with the use of MDMA; moreover, the dependency of MDMA was closely related to the use of the drug. The results were similar to a qualitative exploration by Kuwabara, Van Voorhees, Gollan, Alex, and (2007) that was focused to correlate depression to the age of individuals. The study focused on emerging adults aged 18-25 years with the highest prevalence of depressive symptoms. High depression levels in adults are closely associated with marital problems, parenting problems, substance abuse (MDMA). Further, lower educational levels of achievement and sexual dysfunction can have lasting affects (Kuwabara & Van Voorhees et al., 2007). The study hypothesized that emerging adults that have high levels of depression are likely to face social morbidity. An interview was designed for the study based on questions focused on personal life dimensions. The participants were recruited from the Midwestern United States through an advertisement. Participants that qualified for the study were selected based on prior depression diagnosis and depression episodes. Selected participants were 10 women and 5 men aged 18 to 25 years who reflected a range of high depressive symptoms. Depressive symptoms were determined by the use of center for epidemiological studies-depression scale (CES-D). The results confirmed the hypothesis as two participants on MDMA were reported to have consistent suicidal thoughts. Consequently, the use of MDMA to control depression only increased depressive disorders. This indicates that there is a close relationship of MDMA and depression. Summing up the results from the various studies, there is a positive correlation between the use of MDMA and major depressive orders ( Carhart-Harris & Nutt et al., 2009; Durdle & Lundahl et al., 2008; Guillot, 2007; Kuwabara & Van Voorhees et al., 2007; Montoya & Sorrentino et al., 2002; Leung and Abdallah et al., 2009; Titov and Dear et al., 2011; Woods &Barkus, 2010). Increased use of MDMA worsens the deterioration of the serotonergic system that regulates moods and cognitive behaviors. However, one of the studies deviates from the results indicating that there is no relationship between MDMA use and high levels of depression (Allott and Canny et al., 2009). More controlled research and longitudinal analysis should be done in future research. It is important for researchers to understand depression caused by other socio-demographic factors other than the use of MDDMA to be able to come up with a reliable relation between MDMA and depression. This would facilitate a better approach to the assessment of the MDMA effect to serotonin, a neurotransmitter that control human moods. References Allott, K., Canny, B., Broadbear, J., Stepto, N., Murphy, B. and Redman, J. (2009). Neuroendocrine and subjective responses to pharmacological challenge with citalopram: a controlled study in male and female ecstasy/MDMA users. Journal of Psychopharmacology, 23 (7), pp. 759--774. doi:10.1177/0269881108092336. Carhart-Harris, R., Nutt, D., Munafo, M. and Wilson, S. (2009). Current and former ecstasy users report different sleep to matched controls: a web-based questionnaire study. Journal of psychopharmacology, 23 (3), pp. 249--257. doi:10.1177/0269881108089599. Durdle, H., Lundahl, L., Johanson, C. and Tancer, M. (2008). Major depression: the relative contribution of gender, MDMA, and cannabis use. Depression and anxiety, 25 (3), pp. 241--247. Falck, R., Wang, J. and Carlson, R. (2008). Depressive symptomatology in young adults with a history of MDMA use: a longitudinal analysis. Journal of Psychopharmacology, 22 (1), pp. 47--54. doi:10.1177/0269881107078293. Guillot, C. (2007). Is recreational ecstasy (MDMA) use associated with higher levels of depressive symptoms?. Journal of psychoactive drugs, 39 (1), pp. 31--39. Kuwabara, S., Van Voorhees, B., Gollan, J., Alex and Er, G. (2007). A qualitative exploration of depression in emerging adulthood: disorder, development, and social context. General hospital psychiatry, 29 (4), pp. 317--324. Leung, K., Abdallah, A., Copeland, J. and Cottler, L. (2009). Modi!able risk factors of ecstasy use: Risk perception, current dependence, perceived control, and depression. Addictive behaviours, 35 pp. 201-208. Montoya, A., Sorrentino, R., Lukas, S. and Price, B. (2002). Long-term neuropsychiatric consequences of" ecstasy"(MDMA): a review. Harvard Review of Psychiatry, 10 (4), pp. 212--220. Titov, N., Dear, B., Mcmillan, D., Anderson, T., Zou, J. and Sunderl (2011). Psychometric comparison of the PHQ-9 and BDI-II for measuring response during treatment of depression. Cognitive Behaviour Therapy, 40 (2), pp. 126--136. Woods, L. and Barkus, E. (2010). Ecstasy (MDMA) and its relationship with self-report depression, anxiety and schizotypy. Health NHS Foundation Trust, 21 (2), pp. 151-157. doi:10.5093/cl2010v21n2a4. Read More