The strange case of the man who took 40,000 ecstasy pills in nine years

The strange case of the man who took 40,000 ecstasy pills in nine years

Doctors from London University have revealed details of what they believe is the largest amount of ecstasy ever consumed by a single person. Consultants from the addiction centre at St George's Medical School, London, have published a case report of a British man estimated to have taken around 40,000 pills of MDMA, the active ingredient in ecstasy, over nine years. The heaviest previous lifetime intake on record is 2,000 pills.
Though the man, who is now 37, stopped taking the drug seven years ago, he still suffers from severe physical and mental health side-effects, including extreme memory problems, paranoia, hallucinations and depression. He also suffers from painful muscle rigidity around his neck and jaw which often prevents him from opening his mouth. The doctors believe many of these symptoms may be permanent.

The man, known as Mr A in the report in the scientific journal Psychosomatics, started using ecstasy at 21. For the first two years his use was an average of five pills per weekend. Gradually this escalated until he was taking around three and a half pills a day. At the peak, the man was taking an estimated 25 pills every day for four years. After several severe collapses at parties, Mr A decided to stop taking ecstasy. For several months, he still felt he was under the influence of the drug, despite being bedridden.

Hallucinations
His condition deteriorated and he began to experience recurrent tunnel vision and other problems including hallucinations, paranoia and muscle rigidity. "He came to us after deciding that he couldn't go on any more," said Dr Christos Kouimtsidis, the consultant psychiatrist at St George's Medical School in Tooting who treated him for five months. "He was having trouble functioning in everyday life."

The doctors discovered that the man was suffering from severe short-term memory problems of a type usually only seen in lifetime alcoholics. But evaluating the full extent of his condition was difficult as his concentration and attention was so impaired he was unable to follow the simple tasks involved in the test.

"This was an exceptional case. His long- term memory was fine but he could not remember day to day things - the time, the day, what was in his supermarket trolley," said Dr Kouimtsidis. "More worryingly, he did not seem aware himself that he had these memory problems."

With no mental illness in his family and no prior psychiatric history, the doctors concluded that his unique condition was direct result of his intense ecstasy use.

"This is obviously an extreme case so we should not blow any observations out of proportion," says Dr Kouimtsidis. "But if this is what is happening to very heavy users, it might be an indication that daily use of ecstasy over a long period of time can lead to irreversible memory problems and other cognitive deficits."

For 10 years, MDMA has been suspected of causing these kinds of effects in heavy users. It is thought to be due to its disruption of the regulation of serotonin, a brain chemical believed to play a role in mood and memory. It remains unclear whether these effects are the result of permanent neurotoxic damage or just temporary reversible alterations in the brain.

A study today in a special MDMA issue of the British Journal of Psychopharmacology, suggests long-term side-effects may be temporary. The researchers from the University Of Louisiana could find no significant relationship between depression and recreational ecstasy use.

In the case of Mr A, a structural MRI brain scan failed to show any obvious damage or atrophy in his brain. However, these results, says Dr Kouimtsidis, are difficult to interpret. "A scan of this type is not sensitive enough," he said.

Such limitations in brain scanning technology, along with ethical and legal barriers to giving MDMA to human test subjects, have limited direct observation of the drug's effects in humans.

Instead, scientists have had to use recreational drug users as subjects in their studies. Conclusions from this are often flawed because few, if any, drugs users use ecstasy in isolation.

Cannabis user
Mr A was also a heavy cannabis user, and when he was encouraged to decrease his use, his paranoia and hallucinations disappeared and his anxiety abated. But his memory and concentration problems remained, leading the doctors to suspect that these may be permanent disabilities.

When he was admitted to a specialist brain injury unit and put on anti-psychotic medication, he did start to show some improvement. "Unfortunately, he discharged himself before we were able to complete the assessment," says Dr Kouimtsidis. "We continued to support him. But he started to use cannabis again and he dropped out. We tried to re-engage him but we lost him about a year ago."

The Guardian made several attempts to find the man without success.

Effects of ecstasy
MDMA is one the most intensely studied recreational drugs in history. But despite thousands of research papers and studies, scientific evidence on the side-effects remains inconclusive.

Death by overdose
Undoubtedly, large amounts of ecstasy can lead to over-heating which in turn, in rare cases, can trigger fatal heat stroke. Many factors contribute: number and strength of pills taken, environment, alcohol-consumption, body weight - but women seem more at risk. The bulk of ecstasy-related deaths around the world have been young women.

Water-poisoning
Panicking users, fearing they are overdosing, drink too much water and provoke hyponaetraemia (water-poisoning). Leah Betts died after drinking 14 pints in just 90 minutes. The recommended amount of water to drink per hour is one pint.

Toxic reactions
Much of the reports of toxic reactions are muddled with overdose or water-poisoning deaths. There is no clear evidence that some people suffer allergic reactions to ecstasy. However, around 10% of Western users do lack a key liver enzyme CYP2D6 needed to break down MDMA. This may make them more sensitive to the effects and more prone to accidental overdose.

Depression
Many weekend users report a mid-week mood dip. This is suspected to be related MDMA's effect on serotonin, but hard evidence is lacking. In heavy users, dips can turn to crashes and depression. However studies suggest this effect reverses after a 2-3 month abstinence.

Positive effects
Users still claim "long lasting improvements in self-awareness, self-esteem, openness and insight into personal problems", reports the study from the University Of Louisiana. In the US, research continues into the use of MDMA-assisted psychotherapy to treat Post Traumatic Stress Disorder.
Bron

[coopergirl]

Indrukwekkend... Dat is wel heel intensief gebruik...

[Paars_Draakje]

Inderdaad, 4 jaar lang 25 pillen per dag. Dat hij het overleeft heeft. Zou ook wel niet goed koop zijn...

[pete da pornkid]

damn, hoe kom je erop om dit 'experiment' uit te voeren?

misschien was ie stoned

[MTpower]

Hoe heeft die gozer dat kunnen betalen

Relatief gezien zullen de kosten wel meevallen. Hij kocht natuurlijk in dikke hoeveelheden waardoor de prijs per pil erg goedkoop wordt.
Roken is ook duur

Niet vreemd, bij zo intensief gebruik.

[Zyh]

das een dikke trip van 9 jaar....and counting

pillen

[zeehond23]

mwah, pillen zijn best ok af en toe, maar je kan alles te veel doen, en dit is duidelijk niet af en toe

[Mephisto]

Ben er wel grotendeels op uitgekeken, maar het is inderdaad behoorlijk extreem en waar hij de centen vandaan heeft gehaald vraag ik me ook af.

[coopergirl]

Mephisto schreef op 05-04-2006 @ 14:30 :
Ben er wel grotendeels op uitgekeken, maar het is inderdaad behoorlijk extreem en waar hij de centen vandaan heeft gehaald vraag ik me ook af.

Gesubsidieerd onderzoek

Neurological and Psychopathological Sequelae Associated With a Lifetime Intake of 40,000 Ecstasy Tablets

TO THE EDITOR: The medical and psychopathological consequences of both acute and chronic “ecstasy” (MDMA, MDA, and derivatives) consumption have been extensively described, but little is known with respect to the relationship between both severity and persistence of these disturbances and lifetime number of ecstasy tablets ingested. At-risk MDMA intake seems to be related to long-term functional dysregulation in 5-HT2 pathways, resulting in altered regulation of mood, impulse control, and memory.1,2 Ecstasy consumption has spread since the late ‘80s, and the reduction in price observed over the last few years has possibly increased access to the drug. Clinicians are now meeting with a generation of patients who have been exposed to the drug for more than a decade. In this report, we describe both the transient and persisting sequelae associated with an unusual amount of ecstasy consumption.

Case Report
Mr. A, 37 years old, used ecstasy between the ages of 21 and 30. For the first 2 years, he took 5 tablets every weekend, escalating to an average daily use of 3.5 tablets for the next 3 years, and further escalation to an average of 25 tablets daily over the next 4 years. An estimate of lifetime consumption yielded a total intake of more than 40,000 tablets. At the time of his presentation, Mr. A reported current cannabis consumption, together with a previous history of polydrug misuse (i.e., solvents, benzodiazepines, amphetamines, LSD, cocaine, heroin). After three episodes of “collapsing” at parties, Mr. A finally stopped his ecstasy use. For a few months, he felt as if he was still under the influence of ecstasy and suffered several episodes of “tunnel vision.” He eventually developed severe panic attacks, recurrent anxiety, depression, muscle rigidity (particularly at the neck and jaw levels), functional hallucinations, and paranoid ideation. His family and before-drug-use psychiatric history were negative. The Mini-Mental State Exam revealed disorientation to time, poor concentration, and short-term memory difficulties. Decrease in level of cannabis intake led both to disappearance of his paranoid ideas and hallucinations and reduction of his panic attacks, but remaining symptomatology persisted. Administration of the Wechsler Memory Scale (3rd Edition)3 suggested the existence of global memory-function impairment, with no subtest score being above the 10th percentile. Assessment of daily functioning skills identified major behavioral consequences of his memory loss (i.e., repeating activities several times). Although Mr. A was able to fully understand the instructions given, his concentration and attention were so impaired that he was unable to follow the sequence of the tasks required. A structural MRI brain scan revealed no focal cerebral lesions; specifically, both temporal lobes showed normal symmetrical hippocampal areas. The structural areas of the “Dealy-Brion” system were normal. There was no evidence to suggest atrophy. Mr. A was then prescribed olanzapine 10 mg and admitted to a brain-injury unit, where there was some improvement of his memory skills as a result of the use of compensatory strategies.

Comment
To our knowledge, this is the largest amount of ecstasy lifetime consumption ever described, the heaviest lifetime intake previously reported being around 2,000 tablets.2 Although much information is self-reported and might have been affected by Mr. A’s memory impairment, the history given was confirmed by notes from another service he attended just after having stopped ecstasy use.

All ecstasy misusers would develop a (mild-degree, in most cases) serotonin syndrome after acute drug intake, which is characterized by enhanced physical activity, hyperthermia and sweating, increased muscle rigidity, rhabdomyolysis, hyperreflexia, trismus, jaw-clenching, myoclonus, tremor, and nystagmus.4 An additional, non-serotonergic mechanism of MDMA activity at the neuromuscular junction-level has recently been suggested.5 Although these observations relate to acute MDMA intoxication effects, they might partly explain the persistent muscle rigidity of which Mr. A was complaining. The “tunnel vision” effect observed by Mr. A in the first few months after withdrawing from MDMA had never been reported before in this context. The neurocognitive profile here described was very similar to that shown by current heavy ecstasy users; it has been suggested that the extent of memory decline positively correlates with intensity or frequency of ecstasy consumption.6 It is also confirmed here that selective impairments of neuropsychological performance associated with regular ecstasy use are not reversed by prolonged abstinence.

Contrary to results of other neuroimaging observations,7 Mr. A’s brain scan did not show any gross cerebral abnormalities, especially at the hippocampal level. We feel that this case report adds to the existing limited knowledge of persistent sequelae associated with heavy and regular ecstasy intake.

Mr. A gave consent to his history being reported to a medical journal.

Christos Kouimtsidis
Fabrizio Schifano,
University of London, UK
Tim Sharp, Watford, UK
Lisa Ford
Justin Robinson
Colm Magee, Slippers Hill, UK

Studie

[Moustache]

w00t dat zijn er wel veel!

[Droyd]

Volgens de hoeveelheid pillen dat hij naar binnen wist te werken vind ik dat hij er verassend "goed" vanaf komt. Een wonder eigenlijk dat hij nog rondloopt.

[All Out Of Love]

ik twijfel zwaar aan het waarheidsgehalte :/


25 pillen 4 jaar lang elke dag ?

donder toch op.