Human psychopharmacology of Ecstasy (MDMA): a review of 15 years of empirical research
Human Psychopharmacology: Clinical and Experimental December 1, 2001 DOI: 10.1002/hup.351 (opens in new tab)
Study at a glance
AI-extracted from the abstractAbstract
Abstract MDMA (3,4‐methylenedioxymethamphetamine) or ‘Ecstasy’ was scheduled as an illegal drug in 1986, but since then its recreational use has increased dramatically. This review covers 15 years of research into patterns of use, its acute psychological and physiological effects, and the long‐term consequences of repeated use. MDMA is an indirect monoaminergic agonist, stimulating the release and inhibiting the reuptake of serotonin (5‐HT) and, to a lesser extent, other neurotransmitters. Single doses of MDMA have been administered to human volunteers in double‐blind placebo‐controlled trials, although most findings are based upon recreational MDMA users. The ‘massive’ boost in neurotransmitter activity can generate intense feelings of elation and pleasure, also hyperactivity and hyperthermia. This psychophysiological arousal may be exacerbated by high ambient temperatures, overcrowding, prolonged dancing and other stimulant drugs. Occasionally the ‘serotonin syndrome’ reactions may prove fatal. In the days after Ecstasy use, around 80% of users report rebound depression and lethargy, due probably to monoaminergic depletion. Dosage escalation and chronic pharmacodynamic tolerance typically occur in regular users. Repeated doses of MDMA cause serotonergic neurotoxicity in laboratory animals, and there is extensive evidence for long‐term neuropsychopharmacological damage in humans. Abstinent regular Ecstasy users often display reduced levels of 5‐HT, 5‐HIAA, tryptophan hydroxylase and serotonin transporter density; functional deficits in learning/memory, higher cognitive processing, sleep, appetite and psychiatric well‐being, and, most paradoxically, ‘loss of sexual interest/pleasure’. These psychobiological deficits are greatest in heavy Ecstasy users and may reflect serotonergic axonal loss in the higher brain regions, especially the frontal lobes, temporal lobes and hippocampus. These problems seem to remain long after the recreational use of Ecstasy has ceased, suggesting that the neuropharmacological damage may be permament. Copyright © 2001 John Wiley & Sons, Ltd.
Comparable studies
Other narrative reviews on MDMA, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Human Pharmacology of MDMA | 2004 | Review | |
| 3,4‐Methylenedioxymethamphetamine (MDMA, “Ecstasy”): pharmacology and toxicology in animals and humans | 1994 | Review | |
| (±)3,4-Methylenedioxymethamphetamine (‘Ecstasy’)-Induced Serotonin Neurotoxicity: Studies in Animals | 2000 | Review | |
| Amphetamine toxicities | 2010 | Review | |
| Hallucinogens in Mental Health: Preclinical and Clinical Studies on LSD, Psilocybin, MDMA, and Ketamine | 2020 | Review |
Citations in the library
Cited by 139
- Psychobiology of Altered States of Consciousness. Psychological Bulletin 2005
- Chronic tolerance to recreational MDMA (3,4-methylenedioxymethamphetamine) or Ecstasy Journal of Psychopharmacology 2005
- Psychedelics in Psychiatry: Neuroplastic, Immunomodulatory, and Neurotransmitter Mechanisms Pharmacological Reviews December 16, 2020
- Psychological and cognitive effects of long-term peyote use among Native Americans. Biological Psychiatry October 15, 2005
- Human psychobiology of MDMA or ‘Ecstasy’: an overview of 25 years of empirical research Human Psychopharmacology: Clinical and Experimental July 1, 2013
and 134 more in the library
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and 46 more in the library