Recreational ecstasy use and the neurotoxic potential of MDMA: current status of the controversy and methodological issues
Drug and Alcohol Review May 1, 2006 DOI: 10.1080/09595230600657758 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Critical review Peer reviewed |
|---|---|
| Topics | Cannabis MDMA Serotonin |
| Keywords | Neurotoxicity Cognition Hallucinogen Recreational drug |
| Citations | 41 |
| Key findings | The evidence for MDMA-induced serotonergic neurotoxicity and cognitive deficits in human ecstasy users remains equivocal due to inconsistent findings, confounding drug use, methodological shortcomings, and the retrospective nature of studies. |
Abstract
The controversy over possible MDMA-induced serotonergic neurotoxicity in human recreational ecstasy users is examined critically in light of recent research findings. Although the designs of such studies have improved considerably since the 1990s, the evidence to date remains equivocal for a number of reasons, including (1) inconsistent findings on the existence and reversibility of persistent ecstasy-related serotonergic and cognitive deficits; (2) lack of clear association between changes in brain imaging measures and functional deficits attributed to MDMA-induced neurotoxicity; (3) the contribution of concomitant cannabis or other drug use to both brain imaging abnormalities and cognitive deficits; (4) methodological shortcomings such as failure to adequately match samples of ecstasy users and controls; (5) the questionable relevance of animal models of MDMA-induced neurotoxicity to typical human patterns of ecstasy use; and (6) the potential role of inherent pre-drug deficits in serotonergic systems, impulse control and executive cognitive function that may predispose to excessive use of drugs including ecstasy. Given the retrospective nature of nearly all studies of ecstasy users to date, the controversy over whether MDMA has ever caused neurotoxicity or cognitive deficit in human ecstasy users is likely to continue for some time without resolution.
Comparable studies
Other narrative reviews on MDMA, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Human Pharmacology of MDMA | 2004 | Review | |
| Human psychopharmacology of Ecstasy (MDMA): a review of 15 years of empirical research | 2001 | 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 |
Citations in the library
Cited by 11
- A direct comparison of the behavioral and physiological effects of methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA) in humans Psychopharmacology June 30, 2011
- Safety and Side Effects of Ayahuasca in Humans—An Overview Focusing on Developmental Toxicology Journal of Psychoactive Drugs 2013
- Executive Working Memory Deficits in Abstinent Ecstasy/MDMA Users: A Critical Review Neuropsychobiology 2009
- Development and Characterization of a Novel Animal Model of Intermittent MDMA (“Ecstasy”) Exposure during Adolescence Annals of the New York Academy of Sciences October 1, 2008
- Comparative potencies of 3,4‐methylenedioxymethamphetamine (MDMA) analogues as inhibitors of [3H]noradrenaline and [3H]5‐HT transport in mammalian cell lines British Journal of Pharmacology September 24, 2007
and 6 more in the library
Cites 29
- NMDA Antagonist Neurotoxicity: Mechanism and Prevention Science December 6, 1991
- Positron emission tomographic evidence of toxic effect of MDMA (“Ecstasy”) on brain serotonin neurons in human beings The Lancet October 1, 1998
- Memory impairment in abstinent MDMA ("Ecstasy") users Neurology December 1, 1998
- Gender differences in the subjective effects of MDMA Psychopharmacology March 5, 2001
- Human psychopharmacology of Ecstasy (MDMA): a review of 15 years of empirical research Human Psychopharmacology: Clinical and Experimental December 1, 2001
and 24 more in the library