Two researchers are calling for rigorous scientific exploration of MDMA (ecstasy) to identify exactly how the drug promotes strong feelings of empathy, according to a Commentary in the journal Cell. Such research may help researchers develop new therapeutic compounds, particularly for autism and post-traumatic stress disorder (PTSD).
MDMA is described as an “empathogen,” a compound that promotes feelings of empathy and close positive social feelings in users. The drug is a strictly regulated Schedule I compound, a category reserved for substances with no accepted medical use and high abuse potential.
However, MDMA’s regulated status shouldn’t discourage researchers from studying its effects, argue Drs. Robert Malenka, a psychiatrist and neuroscientist at Stanford University, and Boris Heifets, also at Stanford.
“We’ve learned a lot about the nervous system from understanding how drugs work in the brain — both therapeutic and illicit drugs,” says Malenka.
“If we start understanding MDMA’s molecular targets better, and the biotech and pharmaceutical industries pay attention, it may lead to the development of drugs that maintain the potential therapeutic effects for disorders like autism or PTSD but have less abuse liability.”
Exactly how MDMA works in humans is still unknown. Researchers are unsure of which brain regions the drug targets or which molecular pathways it affects. While Malenka and Heifets don’t condone the recreational use of MDMA, they say that scientific study to uncover its mechanisms could help explain fundamental processes in the human nervous system, including how and why we experience empathy.
Early clinical cases and a small trial in 2013 also showed some use for MDMA as a treatment during therapy for patients with PTSD, potentially allowing patients to form a stronger bond with a therapist.
“Studying the response of the brain and nervous system to any drug is no different than running an animal through a maze and asking how learning and memory work, for example,” Malenka said.
“You’re trying to understand the different mechanisms of an experience. Drugs like MDMA should be the object of rigorous scientific study, and should not necessarily be demonized.”
In the last decade, technology has led to the development of new tools such as optogenetics, viral tracing methodologies, sophisticated molecular genetic techniques, and the ability to create knockout mice. These have contributed to the push for more research into MDMA.
“I started thinking five or six years ago that maybe we can actually attack how MDMA works in the brain in a more meaningful way, because now we have the tools to do it right,” Malenka said.
The researchers have already begun preliminary studies to test MDMA’s effects in mice, and they are writing a proposal to the National Institute on Drug Abuse for a larger project in collaboration with researchers who plan to tackle the human aspects of the study.
“There are going to be certain areas of the brain in which MDMA’s actions are critical for its behavioral effects,” said Malenka.
“You can give it to human beings under appropriately controlled, carefully monitored clinical conditions and do fMRI and functional connectivity studies, and you can begin to build up a knowledge base in an iterative fashion, combining the animal and human studies, where we start to gain more traction in understanding its neural mechanisms.”
Source: Cell Press