Phenomenology and sequelae of 3,4-methylenedioxymethamphetamine use.

3,4-Methylenedioxymethamphetamine (MDMA) has been at the center of a debate over its potential benefits as an adjunct to psychotherapy versus its capability for neurotoxic effects and is currently classified as a Schedule 1 drug by the Drug Enforcement Administration (DEA). However, as yet, there is very little methodological data on the subjective experience of the MDMA-induced state or its psychological and behavioral sequelae. The present study was, therefore, designed to obtain this kind of information. Twenty psychiatrists who had taken MDMA previously were evaluated using a semistructured interview. Subjective experience of the actual MDMA-induced state, as well as both short-term (less than 1 week) and relatively longer term (greater than 1 week) sequelae, were examined retrospectively. Side effects, insight gained, pleasure, and intensity of the MDMA experience were evaluated as were the influence of set and setting at the time the MDMA was taken and the dosage utilized. Finally, the authors discuss methodological problems and limitations of a study of this type.

Modulation of red cell metabolism by states of decreased activation: comparison between states.

Marked decline of red cell metabolism has been described during the acute state of decreased activation associated with the stylized mental technique of transcendental meditation (TM) in long-term meditators (5-10 years regular elicitation, TM instructors). It is not known whether unstylized rest is accompanied by a similar effect and it is not known what effector(s) may contribute to red cell metabolic changes in these states. In the present study ordinary, unstylized rest was found to be accompanied by small increase of red cell glycolytic rate. Apparently, either repeated elicitation of TM behavior or some special feature of this practice become associated with new mechanisms of metabolic control than those previously in operation. Although the data of this study do not permit isolation of the precise psychological determinants of this effect, the range of possible physiological effectors can be delimited. Blood pH, PCO2, PO2, and phosphate can be eliminated as significant for red cell metabolic control during both TM and rest, and based upon related studies, several known hormones such as insulin, T3, T4, arginine vasopressin, oxytocin, prolactin and growth hormone can also be eliminated as responsible effector(s).

Hormonal control in a state of decreased activation: potentiation of arginine vasopressin secretion.

Behaviorally induced stress is associated with increased arginine vasopressin (AVP) secretion. In this report we describe a phasic conditioned response of AVP secretion yielding 2.6-7.1 times normal plasma concentration of this hormone in association with a physiological state of decreased activation, that associated with the mental technique of "transcendental meditation" (TM) in long-term practitioners (6-8 years of regular elicitation). Such a very large phasic response of AVP was previously unknown in the normal physiology of AVP. This elevation was not accompanied by elevation of plasma osmolality. Unstylized ordinary eyes closed rest in a separate group of subjects studied in the same manner was associated with normal plasma AVP concentration. Galvanic skin resistance (GSR) increased during both TM and rest with significantly larger increase associated with TM. Other measures of activation, including muscle metabolism, and the Spielberger Anxiety Inventory indicated marked relaxation in association with TM. In previous research it has been shown that blood pressure does not change acutely during this behavior. These observations indicate that neither stress nor operation of other usual homeostatic control mechanisms are responsible for elevated for AVP in the meditators. It is speculated that the apparently unique mechanism of TM-induced AVP secretion may be more specifically related to the behavioral effects of meditation.

Metabolic control in a state of decreased activation: modulation of red cell metabolism.

Very little is known in depth of the biochemical and physiological changes induced at the cellular level by human behavioral states. For study of the physiology of behavior at this level, the erythrocyte may be useful, because it is readily available and its metabolism and metabolic control are comparatively well understood. In this report we describe a marked decline of red cell glycolytic rate induced by the transcendental meditation technique (TM). This decline was significantly correlated with decreased plasma lactate concentration and with relaxation as indicated by electrodermal response. The occurrence of sleep was not correlated with the metabolic changes. The observed lack of variation of blood pH, blood gases, glucose, and hematocrit in this behavior implies that the decrease of erythrocyte metabolism is not an epiphenomenon of respiratory change or substrate availability. Based upon further measurements indicating persisting alteration of the red blood cell, we suggest the possibility of attachment of a humoral agent(s) to the cell in the mechanism of this effect. This behavioral effect is unique, and the effector(s) responsible may increase our understanding of metabolic control of the erythrocyte and of TM.

Forearm blood flow and metabolism during stylized and unstylized states of decreased activation.

We have measured forearm oxygen consumption and blood flow changes during two wakeful rest behaviors. We have observed acute reduction of forearm respiration (28%) during an acute stylized rest state (TM) and a nonsignificant small decline (11%) during unstylized ordinary eyes-closed rest. These changes were not associated with significant change of forearm blood flow or glycolytic metabolism. Hence, forearm oxygen consumption decline was due almost solely to decreased rate of oxygen extraction. Small variation of forearm blood flow implies that little of the previous findings of increased nonrenal, nonhepatic circulation during TM or increased nonrenal circulation during ordinary rest can be accounted for by altered muscle blood flow, which therefore is consistent with possible increased cerebral blood flow. However, reduced muscle metabolism was a likely contributor to the forearm metabolic decline. The lack of coupling between metabolic and blood flow changes during TM indicates limitation of obligatory coupling between cardiovascular and metabolic function in the rest state of TM.

The menstrual cycle, personality, and academic performance.

Considerable research supports the widespread complaint of mood and behavioral changes during the menstrual cycle. However, there is little evidence of effects on intellectual performance, even though students commonly complain of it. We studied the results obtained by 244 female medical and paramedical students in all examinations taken during one year. In view of suspected correlations between personality characteristics and degree of dysmenorrhea, an Eysenck Personality Inventory, measuring extroversion and neuroticism, was administered. The examination results of high and low scorers on these personality scales and of those women with prolonged (greater than or equal to six days) menses were reanalyzed. Not one of these analyses revealed significant menstrual-cycle effects on examination performance. Thus, while some persons may suffer, it does not seem that menstrual cycle effects are sufficient to handicap significantly the examination performance of the majority of female students.

Effects of environmental complexity and deprivation on brain anatomy and histology: a review.

During the last 20 years the anatomical plasticity of the brain in response to sensory stimulation has been clearly demonstrated. This paper reviews the effects of environments rich in sensory stimulation versus those which are stimulus poor. Effects have been noted at all levels from the gross anatomical to the electromicroscopic. As compared to their stimulus-deprived counterparts, animals reared in complex environments tend to display greater cerebral weight and length and cortical depth. The greatest effects occur in the occipital cortex where histological studies have revealed expanded neuron perikaryonal and nuclear size and dendritic branching, more dendritic spines, alterations in synaptic numbers and morphology, and greater numbers of neuroglia. Different cortical areas and layers respond to different degrees. Some responses have also been noted in the underlying hippocampus, particularly in the dentate gyrus. The emerging data present a picture of a dynamic, plastic brain adapting homeostatically to the demands of its environment.

A flow chart model for crisis intervention.

It is a truism that when people experience distress or disease, they frequently seek out trusted help to comfort them and to cure their ailment. It is also generally accepted that the personal perception of distress or disease relies on a number of contextual factors such as personality, education, cultural background, situation, and availability of support, as well as the nature of the particular agent which provokes the perception itself. This paper suggests that attention given to these factors, and to their interaction in producing a 'crisis', is essential for effective intervention. Further, the particular role of the general practitioner requires of him or her an ability to deal creatively with persons who are locked in a 'crisis system'.

Effects of environmental complexity and deprivation on brain chemistry and physiology: a review.

Within the last two decades it has become evident that the brain exhibits a wide range of chemical and physiological responses to its sensory environment. Comparison of the brains of animals reared in relatively complex as opposed to deprived sensory environments has yielded significant insight into the nature of these effects, which are reviewed in this paper. Greater complexity of the sensory environment results in increased total cholinesterase and acetylcholinesterase enzyme activity, while other neurotransmitter related substances, the catecholamines, show more variable responses. RNA concentration is slightly greater as is DNA transcriptional activity, while protein precursor uptake shows a variety of regional and temporal patterns. In general, responses for most substances tend to show regional and temporal specificity with the largest effects most often in the occipital cortex. Electrophysiological measures have revealed shorter visual cortex evoked potential latencies and greater amounts of sleep in the complexity-reared subjects. The wide range of environmentally responsive parameters is consistent with an adaptive functioning of brain chemistry and physiology and with recent models in the physical sciences which view the universe as composed of dynamic webs of relationships rather than isolated independent units.

Changes in hippocampal neuronal nuclei in response to environmental stimulation.

The diameter of cortical neuronal nuclei has been reported to increase when animals are reared in enriched, as opposed to deprived, sensory environments. The present study investigated whether analogous neuronal changes occur in the hippocampus. Male Wistar rats were reared in either an enriched or a deprived environment for 80 days after weaning. At the completion of this rearing period both brain weights and hippocampal neuronal nuclear diameters were measured. The enriched subjects exhibited a greater forebrain:hindbrain ratio (3.7% p less than 0.05) when compared to the isolated subjects. No significant differences in mean hippocampal nuclear dimensions could be detected but variability in nuclear size was greater in the stratum granulosum of the isolated subjects (p less than 0.01). It is proposed that this increased variability reflects an environmentally restricted development of these neurons.

Drug-modulated behavioural responses to environmental enrichment.

The home-cage activity of mice housed in either social or enriched sensory environments was continuously recorded for 23 days. During this period the mice were given daily injections of either strychnine, chlorpromazine, or saline. Both chlorpromazine and social rearing depressed home-cage activity. Strychnine also depressed activity, but only in the social group.