Are ecstasy induced serotonergic alterations overestimated for the majority of users?
Balázs Szigeti, Adam Winstock, David Erritzøe, Larissa J. Maier
Journal of Psychopharmacology May 7, 2018 DOI: 10.1177/0269881118767646 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Population | Recreational ecstasy users enrolled in neuroimaging studies and participants in the Global Drug Survey |
| Topics | MDMA Serotonin |
| Keywords | Pharmacology |
| Citations | 17 |
| Key findings | Ecstasy users in neuroimaging studies are unusually heavy users, consuming 720% more pills per year than typical users, so conclusions from these studies likely overestimate serotonergic alterations for most users. |
Abstract
Background: Neuroimaging studies imply that the regular use of ±3,4-methylenedioxymethamphetamine (MDMA), the major constituent of ecstasy pills, alters the brain's serotonergic system in a dose-dependent manner. However, the relevance of these findings remains unclear due to limited knowledge about the ecstasy/MDMA use pattern of real-life users.
Aims: We examined the representativeness of ecstasy users enrolled in neuroimaging studies by comparing their ecstasy use habits with the use patterns of a large, international sample.
Methods: A systematic literature search revealed 10 imaging studies that compare serotonin transporter levels in recreational ecstasy users to matched controls. To characterize the ecstasy use patterns we relied on the Global Drug Survey, the world's largest self-report database on drug use. The basis of the dose comparison were the Usual Amount (pills/session), Use Frequency (sessions/month) and Dose Intensity (pills/year) variables.
Results: Both the average Usual Amount (pills/session) and Use Frequency (sessions/month) of neuroimaging study participants corresponded to the top 5-10% of the Global Drug Survey sample and imaging participants, on average, consumed 720% more pills over a year than the Global Drug Survey participants.
Conclusions: Our findings suggest that the serotonin brain imaging literature has focused on unusually heavy ecstasy use and therefore the conclusions from these studies are likely to overestimate the extent of serotonergic alterations experienced by the majority of people who use ecstays.