Dr. Julie Holland Interview Archive

My real objection is with cosmetic psychopharmacology. So many people are on antidepressants, SSRIs above all, when the thing they're wrestling with could be handled another way. There are more holistic routes, healthier ones, more integrative approaches to the general malaise, the anxiety, the stress, rather than simply papering over it with a pill.

Erik: That's helpful. Some people will still worry about the risks, though. There were studies suggesting that MDMA use causes brain damage. Is there any truth to that?

Dr. Holland: It's fair to say that under the medical model, where you take the drug only a handful of times, you know it's genuine MDMA, you're careful not to over-hydrate and not to overheat, you're on the safer end of things. The recreational model is a different story. When you have no idea what you've actually bought, you're taking large amounts, and you're doing it often, you've moved into much riskier territory. Whether that becomes brain damage or a psychiatric problem depends on the individual: their baseline chemistry, what else they've been putting in their body, how frequently, and whether they tend to steer themselves into trouble.

A few people have found their way to my private practice over this, though surprisingly few given who I am and the work I'm known for. Over the past twenty years, a couple of patients came to me after using an enormous amount of Ecstasy, and they did appear to have trouble with anxiety or depression. They needed treatment for a while. Not permanently, though.

Here's what stays with me. Ecstasy is the most widely used illegal drug after cannabis, and it's been around since the mid-1980s. If it produced serious brain damage on a broad scale, we'd expect a visible population of Ecstasy casualties by now. We don't really see that. So yes, I believe very heavy use causes problems in some cases. The sensible advice is to be careful about how often you use it, to confirm purity wherever you can, and to keep hydration and body temperature in check.

Erik: Thanks. Earlier you also brought up the idea that some people take low-dose MDMA as a daily medication for Attention Deficit?