ILLEGAL DRUG ECSTASY SEEN AS POTENTIAL PROZAC ALTERNATIVE

Like marijuana before it, MDMA -- ecstasy to its users -- is being touted
as a potential therapy, and a handful of psychiatrists are agitating for
permission and money to study the illegal drug in controlled settings.

"This substance is a potent, immediate-acting antidepressant, and there is
no such thing right now in psychiatry," said Dr. Julie Holland, a
psychiatrist at Bellevue Hospital in New York and editor of the forthcoming
book, "Ecstasy: The Complete Guide."

But the idea of giving a medicinal sheen to what has become a much-abused
street drug scares federal drug officials and some in the psychiatric
community.

"My concern -- and I think that of most psychiatrists -- is that this is a
potentially very dangerous drug," said Dr. Marc Graff, a Southern
California psychiatrist and member of the American Psychiatric
Association's Joint Commission on Public Affairs.

Government drug policy officials point to mounting scientific evidence that
MDMA (methylenedioxymethamphetamine) causes permanent changes in brain
cells and is known to interfere with the body's internal temperature
regulation system, sometimes causing death.

Still, the potential use of ecstasy as a therapy will be among the topics
on the table today at a first-of-its-kind conference on the drug at the
Presidio in San Francisco. The conference is organized by the Drug Policy
Foundation, which works to reform drug laws and end the government's war on
drugs.

Ecstasy's popularity is growing at an alarming rate among young people, and
it is a regular part of the scene at all-night dance parties known as
raves. Conference chair Steve Heilig of the San Francisco Medical Society
said there isn't enough research to know whether it is as wonderful as its
proponents claim -- or as terrible as government anti-drug messages warn.

"This drug has been characterized by a lack of rationality on all fronts,"
Heilig said. "What we're trying to do is sort it, to figure out what is
really known at this point."

A Boston organization called the Multidisciplinary Association for
Psychedelic Studies has worked for years to encourage research on the
psychological benefits of psychedelic drugs, including ecstasy, LSD and
psilocybin mushrooms.

A study in Spain funded by the association is using MDMA to treat
post-traumatic stress disorder in women who have been raped. A University
of California at Los Angeles psychiatrist is seeking approval to use it to
reduce anxiety and improve quality of life for people with terminal cancer.

A proposal to use the drug for people with the stress disorder in South
Carolina is expected to be submitted to the Food and Drug Administration in
March, said Rick Doblin, head of the psychedelic studies association. He
has outlined a 5-year, $4 million strategy to get federal approval for the
drug.

In fact, a handful of psychotherapists used MDMA in the 1960s and 1970s as
an adjunct to counseling before it was outlawed in 1985. It is said to have
helped people feel empathy with others and to make important psychological
breakthroughs.

"It's helped me reduce my fear of death. It's helped me prepare for
parenthood. It helped me address the essential loneliness of being," Doblin
said.

Antidepressants such as Prozac and Paxil increase the amount of the
neurotransmitter serotonin available in the brain, although they typically
take weeks to become effective. MDMA goes further, giving the user an
almost immediate sense of euphoria.

But that dramatic effect on the brain may have long-term effects on brain
cells. A single dose of ecstasy given to monkeys resulted in changes in the
brain's serotonin system that could be detected weeks later.

Physical effects of the drug include increased blood pressure and heart
rate. It also interferes with the body's ability to regulate temperature.
Some young people who have taken the drug danced all night in a hot,
confined space,

failed to drink water, and then died from organ failure.

John Mendelson, associate professor of medicine and psychiatry at the
University of California at San Francisco, is one of only a handful of U.S.
researchers who have studied the drug's effects on humans. He has found
that it is neither as bad as some claim nor as good as proponents wish.

Mendelson gave a dose of MDMA to people who had already tried it on their
own. Heart rate and blood pressure went up, but there were no adverse
reactions.

Even if it is shown to have some clinical benefit, market forces may keep
the drug from ever reaching pharmacy shelves.

That's because proponents envision using it just once or twice to get past
a crisis or make a psychological breakthrough. Users typically develop a
tolerance for the drug fairly quickly, which cannot be overcome with higher
doses.

"It's definitely my belief that the magic goes away with repeated use," Dr.
Holland said. "There's no profit margin in a drug that you take once or
twice and you're done."

- - Proceedings of "The State of Ecstasy" conference at the Presidio will be
Webcast at www.drugpolicy.org/ecstasy.

Teen Ecstasy Use Rising

Use of the drug ecstasy by American adolescents rose sharply last year.
Percentage of students reporting use of the drug in the previous 12 months:

Figures are based on an annual survey of 45,000 students nationwide.

Grade, 1999 %, 2000 %

Eighth-graders, 1.7, 3.1

Tenth-graders, 4.4, 5.4

Twelfth-graders, 5.6, 8.2

Chronicle Graphic

Source: Monitoring the Future, University of Michigan EC: