Ecstasy Acute Effects on Social Cognition

MDMA (Ecstasy) Chemical Structure

Anecdotal reports suggest that some users of ecstasy (3,4-methlenedioxymethamphetamine-MDMA) experience increased feelings of empathy and are more social while under influence of the drug.  Such effects may contribute to the timing and frequency of ecstasy use and may also contribute to risk of abuse or dependence.  Understanding this phenomenon in more detail might provide clinicians with better strategies to reduce use and the associated complications of ecstasy use.

Studying acute effects of illicit drugs is difficult under natural conditions.  Users of ecstasy commonly also use alcohol, nictoine and other illicit drugs in the context of ecstasy use.  Isolating psychological effects of one agent in this type of environment is difficult if not impossible.  One alternative is to admiinster ecstasy in a laboratory setting with subjects blind to whether ecstasy or placebo is being administered.  However, this approach poses significant ethical challenges.  One approach, is to limit human study in the lab to those who have previously use ecstasy and intend to continue using.  Although imperfect, this approach limits risk of exposing ecstasy naive individuals to an illicit drug that may have reinforcing effects and increase risk of future drug use.

Chemical Structure of Methamphetamine

A study in Biological Psychiatry took this approach when over four sessions, healthy ecstasy using volunteers received either a low or high dose of MDMA, a dose of methamphetamine (METH) or placebo.  MDMA and methamphetamine share chemical (see chemical structures), pharmacological as well as psychological features.  Methamphetamine is typically considered a compound that increases CNS dopamine and norepinephrine while MDMA is felt to also increase CNS serotonin.   Ratings on a series of psychometric measures were obtained over a period of six hours after drug administration.  Visual analog scales (VAS) rated subjective feelings in a variety of domains: stimulated, bored, sedated, anxious, insightful, nauseated, loving, dizzy, sociable, confused, lonely, elated, playful, blank and restless.  Additionally, the rated themselves on the 72-item Profile of Mood States (POMS).  Subjects also completed a facial affect recognition task where they were asked to identify four facial emotions: anger, fear, happiness, sadness.

Here is a summary of the study findings for active agents compared to placebo:
MDMA (high dose) increased subjective VAS ratings of feeling "loving" and "friendly"
MDMA (low dose) increased subjective VAS ratings of "lonely"
MDMA (high dose) and METH increased VAS ratings of "playful"
METH alone increased VAS ratings of "sociability"
MDMA (high dose) reduced the accuracy of recognizing angry faces

So there is some support in this study for the anecdotal reports of increased prosocial cognition with MDMA.  The authors note their findings suggest MDMA increases social approach (sociability) rather thanThe authors note the study supports the possibility that increased social behavior with MDMA might be due to a reduced sensitivity to negative emotions of others rather than increasing recognition of positive emotions in others.  There also might be danger with this effect as social risk taking might increase potential for adverse consequences (connecting with someone you would be unlikely to connect with when not under the influence of MDMA).

Chemical structures of MDMA and methamphetamine from Wikipedia Creative Commons authored by Harbin.

Bedi G, Hyman D, & de Wit H (2010). Is ecstasy an "empathogen"? Effects of ±3,4-methylenedioxymethamphetamine on prosocial feelings and identification of emotional states in others. Biological psychiatry, 68 (12), 1134-40 PMID: 20947066

Anxiety as a Gut Feeling: Understanding Interoception

Marcus Paulus presented the April 2011 Warren Neuroscience Frontiers in Neuroscience Lecture.  The presentation was titled: Interoception and Anxiety.

Interoception is the summation of a variety of bodily perceptions that make up the integrated sense of our own physiological state.  Perceptions included in interoception include: pain, temperature, tickle, sensual touch, stomach discomfort to due acidity, air hunger and muscle tension.  Here are my notes from Dr. Paulus' presentation and his research manuscript on this topic area.

• Anxiety proneness is a trait that can be measured and is associated with high risk of later development of an anxiety disorder
• Anxiety proneness linked to increased activation of the dorsal amygdala and the anterior insula in brain fMRI tasks such as the Emotion Face Assessment task of Hariri
• Patients with anxiety also show insular hyperactivation in anticipation of negative cues
• Benzodiazepines like Valium reduce activation of the insula as well as the amygdala in response to angry faces

• There is growing awareness the brain insular cortex plays a key role in interoception--receiving signals from the body and integrating these signals with emotional response and regulation (see a previous post summarizing the function of the insula and possible roles in clinical neuroscience disorders)
• The insula also connects to a central pathway important in anxiety involving the anterior cingulate cortex and the dorsolateral prefrontal cortex--these areas provide input to the insula for planning and acting in the face of

• Key properties of the interoception include the signals from internal organs including the lungs, heart, gastrointestinal tract and genitourinary systems
• Many of these signals provide awareness of body and help promote homeostasis
• These signals also are involved in our sense of self and the passing of time

• A new area of understanding is the important role of personal beliefs in emotional processing--personal beliefs may modulate interoception and the perception of emotional cues
• A belief that a situation or cue is more dangerous than it really is, i.e. I will embarrass myself at the party, can modulate how emotion is processed, and can amplify a anxious response to the situation

Future research in the area of interoception and anxiety will target:

• Genetic influences on interoception
• How cognitive interventions may influence dysfunctional beliefs related to anxiety
• How interoception may help with more biological classification of types of anxiety
• Can people be trained to up or down regulate the insular cortex to reduce anxiety?
• How treatments for anxiety effect the elements of interoception

Brain Tutor iPad Screenshot of Insular Cortex in Green Courtesy of Author

Paulus MP, & Stein MB (2010). Interoception in anxiety and depression. Brain structure & function, 214 (5-6), 451-63 PMID: 20490545