MAPS Forum Participants:
Here are some comments by Ilsa Jerome about the paper by Reneman just published in Lancet on Ecstasy and Women, and reported on by the AP in papers all over. She has not yet worked with Matt Baggott to develop final text but I thought I'd send you this now. MAPS is developing a rapid response
capability to comment on media reports about significant MDMA-related research.
This Lancer paper was reported in the Boston paper today, with the headline, "Party drug could harm women more than men, study says." The research data tells a different story, in that men are not actually harmed less than women, they are not harmed at all even from heavy use, average 530 tablets! In this context, harm is defined only in terms of SERT reductions, in the absence of any demonstrated negative functional consequences in this population of subjects.
To the extent the findings in this paper apply to MDMA taken in clinical settings, they support the case for clinical research. Men who have used MDMA in hot recreational settings show no reductions in SERT binding, even in a group of uses with an average consumption of 530 tablets. Women show no reductions from up to 50 tablets. Women who take above that amount show some reductions but they are reversed within a year or so of abstinence.
Therapeutic use in men or women is with much fewer than 50 tablets taken while resting in cooler environments with adequate fluid replacement. No reductions or any negative functional consequences, which is what really matters, are to be expected in either male or female patients enrolled in clinical trials.
ILSA: Specifically, moderate ecstasy users (those using no more than 50 tablets over a lifetime) showed no changes in SERT binding, and (if I am reading the paper correctly) the differences seen in heavy female users also vanish or are greatly reduced after a year of abstinence from ecstasy.
RICK: This point should be sent to the Forum. Can you double-check this. Also, are there any functional studies in this paper or is it just about SERT?
ILSA: Yes, it is definitely so: "Overall, B-CIT binding ratios were significantly higher in female ex-MDMA users than female MDMA+ [heavy ecstasy users] users, but were not higher than those of controls." (p.1867). Even more surprising, at no time does ecstasy use affect SERT binding in men! Not for any of the groups, including the heavy users, who on average took 530 tablets.
The paper does not report on any neurofunctional studies. If the sample is partially related to the sample used in a recent 2001 neurofunctional study (and it looks as if it might be, at least for controls, heavy users and ex-users), there were no gender-specific reports on neurofunctional differences. In fact, no study that I can think of ever has found a
gender-based difference in verbal memory or any other area, except perhaps Bolla, which found women doing better than men.
But comparing this paper with others leaves a number of puzzles, especially when noting the lack of gender differences in neurofunctional effects, either when present or when absent.
Ilsa
Ilsa Jerome
Research Associate
Multidisciplinary Association for Psychedelic Studies
[email protected]
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