Tittilating revision dodging trivia...

[The chap]

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

· Usage increased to 25 tablets a day at peak
· Memory problems and paranoia may be lasting

David McCandless
Tuesday April 4, 2006
The Guardian


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 special two-part MDMA study in recent issues of the Journal of Psychopharmacology (available online at sagepub), 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 of 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.

[nighteyes]

now that is scary!

[hr]

i didnt say i was consistant, just right!

[Lyeta]

Not that it is anything to do with the actual content of your post...but just wondering what you are revising for? Or what you expect everyone else to be revising for? Please don't tell me people are studying for exams already...it's not even Easter.

[nighteyes]

im studying for my psych exam cause im shitting myself - ive been studying since i came home. im glanceing over medievel history sources and writting gobbets. they only subject im not paying any attention to is the physical universe.
i like being prepared, its never too early to start studying.

[hr]

i didnt say i was consistant, just right!

[munchingfoo]

Well, if the letter everyone is going to receive next week is anything to go by we might not have some exams at all.

[hr]

Tired Freudian references aside - your mother played my mighty skin flute like a surf crowned sea nymph trying to rouse Poseidon from his watery slumber!

[nighteyes]

letter? what letter?

Quoting munchingfoo from 18:23, 6th Apr 2006
Well, if the letter everyone is going to receive next week is anything to go by we might not have some exams at all.

[hr]

Tired Freudian references aside - your mother played my mighty skin flute like a surf crowned sea nymph trying to rouse Poseidon from his watery slumber!

[hr]

i didnt say i was consistant, just right!

[Raindance]

Quoting munchingfoo from 18:23, 6th Apr 2006
Well, if the letter everyone is going to receive next week is anything to go by we might not have some exams at all.

You what now? It's bird flu isn't it?

[hr]

Maybe all I'll see is sunshine

[papercutheart]

Or...lecturers strike maybe?

[hr]

[munchingfoo]

Na, its from Roger Smith explaining what will happen if the strikes go on through to exams. He basically is suggesting that we might have to check our e-mails everyday then just get told that we have an exam the next day at short notice. (aye that'll be fucking right)

[hr]

Tired Freudian references aside - your mother played my mighty skin flute like a surf crowned sea nymph trying to rouse Poseidon from his watery slumber!

[Midget]

Surprise exams! Yay! Would make it more difficult to police celebrations, every cloud has a egg and flour covered lining.

[hr]

IMAGE:img9.imgspot.com/u/04/241/18/160019.jpg Fall and Ruin: Candidate Ewin
http://standrews.facebook.com/profile.php?id=37100090

[nighteyes]

oh dear sweet lucifer. fucking hell - there goes the stress levels.

[hr]

i didnt say i was consistant, just right!

[Amorphous]

Quoting Midget from 19:58, 6th Apr 2006
Surprise exams! Yay!

Just when I thought there was no way of making them any worse.

(Well, clearly they could be worse in the sense that maybe a tiny man could stick pins into you during the exam every time you paused writing, but speaking in slightly more realistic terms.)

[Manic23]

Quoting munchingfoo from 19:41, 6th Apr 2006
Na, its from Roger Smith explaining what will happen if the strikes go on through to exams. He basically is suggesting that we might have to check our e-mails everyday then just get told that we have an exam the next day at short notice. (aye that'll be fucking right)

Please tell me you're taking the piss

[Nicole]

Roger Smith? But he's the Resbus man, why's he involved?

[ribs]

Quoting munchingfoo from 19:41, 6th Apr 2006
Na, its from Roger Smith explaining what will happen if the strikes go on through to exams. He basically is suggesting that we might have to check our e-mails everyday then just get told that we have an exam the next day at short notice. (aye that'll be fucking right)

[hr]

If they want to loose student support for their strikes that's the way to guarantee it!

[hr]

Riddick: Remember that favorite game of yours?
Kyra: "Who's the Better Killer?"
Riddick: Let's play.

[A66]

Quoting ribs from 23:02, 6th Apr 2006

If they want to loose student support for their strikes that's the way to guarantee it!

[hr]

Riddick: Remember that favorite game of yours?
Kyra: "Who's the Better Killer?"

Riddick: Let's play.

Sounds to me more like the University want to drive a wedge between students and strikers to remove our support. The strike action shouldn't really result in surprise exams. Very clever from the University, mind.

[Bonnie]

This should only affect those students whose lecturers are on strike, though. Don't get all worried if your lecturers aren't on strike.

Of course this is the University trying to make the strike the lecturers fault. Havne't you ever seen industrial action before? Each side blames the other. These lecturers, though, don't have the advantage of sending a letter to every student like the University does. They have to rely on press releases from their national body.

Even if your lecturers are on strike, don't worry. You know you will have an exam eventually, so study for it as if it were going to be the first day of exams. Then remind yourself of what you revised for an hour every day. I think this strike might make you the best prepared body of students ever seen by an examiner.

[hr]

I love cheese.

[Bonnie]

I like how we went from ecstacy to revision to industrial action.

[hr]

I love cheese.