Psychological and neuropsychological effects of MDMA use during adolescence: a structured review.
Rocco Miazzi, Clara Cestonaro, Silvia Righetto, Giulia Petroni, Claudio Terranova
Frontiers in Psychiatry 2025 DOI: 10.3389/fpsyt.2025.1644599 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Structured review Longitudinal Peer reviewed |
|---|---|
| Population | Adolescents |
| Interventions | MDMA (3 4-methylenedioxymethamphetamine) |
| Topics | MDMA |
| Keywords | Adolescence Cognitive impairment Neuroimpact Substance use |
| Key findings | Adolescent MDMA use is consistently associated with psychological disturbances and neuropsychological impairments, including deficits in memory, attention, and executive functioning. |
Abstract
This structured review critically examines the psychological and neuropsychological effects of MDMA (3,4-methylenedioxymethamphetamine) use during adolescence, focusing exclusively on human studies. MDMA is a widely consumed psychoactive substance among adolescents, particularly in social and recreational contexts. Drawing on 14 eligible studies identified through a comprehensive literature search in MEDLINE/PubMed and through reference screening, this review synthesizes evidence concerning MDMA's impact on adolescent mental health and cognitive function. The findings reveal consistent associations between adolescent MDMA use and a range of psychological disturbances, including increased depressive and anxious symptoms, as well as more severe manifestations such as suicidal ideation and attempts. Neuropsychological impairments are also commonly reported, with deficits in memory, attention, and executive functioning linked to early exposure. Neuroimaging evidence indicates that MDMA disrupts serotonergic pathways, potentially leading to persistent alterations in brain function. Although the evidence suggests significant risks, the review highlights several methodological limitations in the current literature, including small sample sizes, high rates of polydrug use, and the lack of longitudinal designs. These factors complicate causal interpretations and underscore the need for further, more robust research. The review emphasizes the urgency of targeted prevention strategies and harm reduction efforts aimed at adolescents. Understanding the specific vulnerabilities of the adolescent brain to MDMA's neuropsychological effects is essential for clinicians, educators, and policymakers. Overall, this review provides a focused and human-centered perspective on the psychological and neuropsychic consequences of MDMA use in adolescence, reinforcing the call for greater public health awareness and scientific investigation.
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
Cites 21
- MDMA-assisted psychotherapy for PTSD: Are memory reconsolidation and fear extinction underlying mechanisms? Progress in Neuro-Psychopharmacology and Biological Psychiatry June 8, 2018
- Neurotoxicity of methylenedioxyamphetamines (MDMA; ecstasy) in humans: how strong is the evidence for persistent brain damage? Addiction February 27, 2006
- MDMA (Ecstasy) and the Rave: A Review Pediatrics October 1, 1997
- Long-Term Neuropsychiatric Consequences of "Ecstasy" (MDMA): A Review Harvard Review of Psychiatry 2002
- Symptoms of anxiety and depression in childhood and use of MDMA: prospective, population based study BMJ February 24, 2006
and 16 more in the library