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Drugs of abuse that cause mind-altering experiences, whether a “high” or change in mood or perception of reality, upset the brain’s normal neurochemical balance. The synthetic drug Ecstasy (also known as MDMA) is no exception. Users typically experience an extreme elevation in mood, thanks to the drug’s stimulant and hallucinogenic properties.
Ecstasy/MDMA and Serotonin
Meanwhile, the brain under duress is undergoing its own transformation. Ecstasy acts on all of the major neurotransmitters. Each of these chemical messengers that sends signals between nerve cells fulfills a vital role in maintaining mental and emotional wellbeing. Ecstasy triggers the release of these neurotransmitters at much higher levels while, simultaneously, inhibiting their reuptake.
Consequently, over the long run, the brain readjusts to the presence of MDMA by scaling back its own natural production of neurotransmitters like serotonin. That begs the question, “Why is that a problem?” and “Are there ways to replenish serotonin once it is depleted?”
With these questions and others, we invited the help of two FHE Health experts: Chief Medical Officer Dr. Murtaza Ali, MD, and clinical psychologist Dr. Rachael Bishop, Psy.D., who specializes in neuropsychology and neurorehabilitation.
How Serotonin Works
What many people may not know is that serotonin occurs throughout the body and plays multiple roles. “Serotonin is produced in the brain stem” Dr. Bishop said. “It is involved in the regulation of pain, mood, appetite, sex drive, and falling asleep.” She added that “low serotonin is thought to be involved in depression, obsessive-compulsive disorder (OCD), and aggression.”
Strikingly, the gut produces an estimated 90 percent of the body’s serotonin, researchers have said. This is significant in light of recent science that has revealed a strong link between the gut and mental health.
Serotonin even occurs in platelets and facilitates healthy blood clotting, according to Dr. Ali. He said serotonin is also active in both the central and peripheral nervous systems and went on to explain how:
- In the central nervous system (CNS), which consists of the spinal cord and the brain, serotonin helps to govern attention and behavior and regulate body temperature.
- In the peripheral nervous system (PNS), namely the nerves and ganglia outside the CNS, serotonin is involved with functions ranging from digestion to the constriction of bronchial and uterine muscles and blood vessels.
What Causes Serotonin Depletion and What MDMA Serotonin Depletion Is
MDMA is like other drugs of abuse that, as Dr. Bishop put it, “may cause inflammation, toxicity, and/or can cause neurons to die, become dormant, or start firing irregularly.” With respect to serotonin, in particular, a study by the National Institute on Drug Abuse (NIDA) found that when taken twice daily for only four days, a moderate dose of MDMA damaged the nerve cells that produce serotonin. The resulting depletion in serotonin lasted long after use of MDMA (at least seven years).
How Serotonin Depletion Can Be a Serious Health and Quality-of-Life Concern
The problem with low serotonin levels is that it is “thought to be involved in depression, OCD and aggression,” Dr. Bishop said. In addition to these potentially serious impairments in quality of life, there can be other mental health issues associated with serotonin depletion. The same NIDA report cited above went on to list poor memory, confusion, anxiety, paranoia, and trouble with attention as symptoms of a serotonin deficiency.
Can My Brain’s Serotonin Levels Ever Return to Normal After MDMA?
Like many former drug users, those who once used MDMA often worry whether their serotonin levels can ever return to a normal level, given the depression and other negative symptoms they may be experiencing. Dr. Bishop was able to offer some hope in response to this concern:
The brain has an amazing ability to heal and change itself. This is known as neuroplasticity. It can create new neural pathways to adapt to its needs. It can rely on other parts of the brain to maintain adequate functioning.
How to Replenish Serotonin After Ecstasy
In other words, there are things one can do to replenish serotonin after Ecstasy use, and certain lifestyle choices can help to encourage this healing process. Dr. Bishop described some of these interventions:
Maintained abstinence is the key to allowing the brain the time and opportunity to begin the healing process. Exercise, adequate nutrition, cognitive-behavioral therapy, and mindfulness/meditation are very useful tools in helping the brain to “get back to normal” following addiction.
How Neurorehabilitation May Help
Dr. Bishop was also able to offer some promising insights from the field of neurostimulation and neurotherapy into how these groundbreaking interventions may be able to reverse serotonin depletion.
Neurostimulation Can Speed the Brain’s Overall Healing Process
“Neurostimulation is also very successful in assisting the brain to regulate itself,” Dr. Bishop said. “It is a process by which the brain learns how to self-regulate. The process induces a state of neuroplasticity—or a state in which the brain is primed for changing and healing. Participation in neurotherapy can assist the brain in ‘getting back to normal’ faster.
Neurostimulation May Restore Serotonin
Dr. Bishop also pointed to several scientific studies that suggest neurostimulation may “enhance serotonin production in the areas of the brain involved in reward (the frontal lobes, for example).” She added that “many forms of neurostimulation modulate neuronal excitability, which likely affects neurotransmitter concentration … that is to say, it is believed that we can alter neurochemicals by neurostimulation,” and, “in particular, neurostimulation may enhance serotonin production.”
When to Consult a Medical Professional
In some cases, serotonin deprivation can cause clinical depression, in which case a doctor or psychiatrist may recommend an antidepressant, like an SSRI. With medications like these, as well as 5-HTP and other supplements, Dr. Ali emphasized the importance of seeking trusted medical advice and receiving ongoing medication maintenance:
- First, too much serotonin in the brain and body can be very harmful. As an illustration, Dr. Ali mentioned his own experience of treating a patient with “serotonin syndrome.” Their serotonin levels were so high that they began to experience life-threatening symptoms. (In the worst cases, serotonin syndrome can lead to coma and death.)
- Second, SSRI medications can interact with other drugs and in turn trigger serotonin toxicity. For example, Dr. Ali noted that an SSRI medication like Zoloft, when combined with the muscle relaxer cyclobenzaprene, might send someone to the hospital with a case of serotonin syndrome.
In short, “we have to be careful in increasing our serotonin supply because some medications can prompt it,” Dr. Ali said.
The Importance of Individualized Care
“Every body (as opposed to “everybody”) is different,” said Dr. Ali. “There’s a reason there are so many SSRI’s—it’s because everyone will react differently, and every brain will react differently. That’s why it’s important to involve a healthcare provider before you switch to a new regimen. At FHE Health, we’re going to always have a psychiatrist on call overseeing patients’ health and safety. We also offer medical, psychological, and psychiatric help and can look at all these facets.”
Are you wondering if neurotherapy can help you feel better in the aftermath of drugs? One of our knowledgeable counselors may be able to help. Contact us today for more information.