Anxiety-related Symptoms following the Sporadic Use of Ecstasy – A Case Study
Tomislav Majić, Lasse Brandt, Christiane Montag
Journal of Psychoactive Drugs November 25, 2021 DOI: 10.1080/02791072.2021.2006372 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | High-functioning 24-year-old student with a history of obsessive-compulsive disorder and sporadic recreational ecstasy use |
| Intervention | pharmacological treatment and psychotherapy |
| Duration | 14-month treatment and follow-up, with additional follow-up after escitalopram discontinuation |
| Topics | Anxiety MDMA |
| Keywords | Depersonalization Panic Discontinuation Derealization Dissociative Escitalopram Clinical psychology Antidepressant |
| Citations | 3 |
| Key findings | A patient with a history of OCD developed depersonalization/derealization syndrome, panic attacks, and recurrent obsessive thoughts after recreational ecstasy use during a stressful period, with symptoms remitting after 14 months of treatment but panic attacks recurring after escitalopram discontinuation. |
Abstract
3,4-methylenedioxymethamphetamine (MDMA/"ecstasy") is widespread in the electronic club scene, but MDMA has also been suggested for the treatment of anxiety spectrum disorders like posttraumatic stress disorder (PTSD) and social anxiety in autistic adults. Here, we report a case of a high functioning 24-old student with a sporadic recreational use of ecstasy, and a history of a single episode of obsessive-compulsive disorder (OCD). A few days after using ecstasy during a period of stressful life events, he developed a complex depersonalization/derealization syndrome (DDS) including intermittent distortions of time and very short intermittent episodes of misidentification of persons. Furthermore, obsessive thoughts reappeared and he suffered a panic attack for the first time in his life. Under combined pharmacological treatment and psychotherapy, symptoms gradually subsided until full remission after 14 months. Some months after discontinuation of escitalopram, however, panic attacks recurred, evolving into a regular pattern. Even if MDMA is a promising tool for the treatment of some anxiety spectrum disorders in the framework of substance-assisted psychotherapy, the use of ecstasy might be also harmful for some patients with a history of anxiety or dissociative symptoms, when used recreationally or as a self-medication outside of a controlled clinical setting.
Comparable studies
Other case reports and case series on MDMA for anxiety, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| The treatment of abandonment anxiety with MDMA and LSD Young woman in her mid-twenties with abandonment-related anxiety | 2023 | Retrospective case study | n = 1 |
| MDMA, Internal Family Systems therapy, and the Minnesota model in the resolution of C-PTSD-induced alcohol and diazepam addiction—A retrospective case study Man in his forties with alcohol and diazepam addiction and complex PTSD from childhood... | 2023 | Case study | n = 1 |
| Utilizing In Vivo and Imaginal Exposure in the Context of MDMA-Assisted Therapy for Social Anxiety Disorder: A Case Report Man in his late 30s with generalized social anxiety disorder | Case report | n = 1 | |
| Substance-induced anxiety disorder after one dose of 3,4-methylenedioxymethamphetamine: a case report. 35-year-old Hispanic man with no significant prior mental health history and no prior... | 2018 | Case study | n = 1 |
| MDMA ("ecstasy") and panic disorder: induction by a single dose. One individual with no prior psychiatric history who ingested a single typical dose of... | 1992 | Case study | n = 1 |
Citations in the library
Cited by 2
Cites 34
- The safety and efficacy of {+/-}3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study. Journal of Psychopharmacology July 19, 2010
- Differences Between the Mechanism of Action of MDMA, MBDB, and the Classic Hallucinogens. Identification of a New Therapeutic Class: Entactogens Journal of Psychoactive Drugs October 1, 1986
- 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for post-traumatic stress disorder in military veterans, firefighters, and police officers: a randomised, double-blind, dose-response, phase 2 clinical trial. The Lancet Psychiatry May 1, 2018
- MDMA-assisted psychotherapy for treatment of PTSD: study design and rationale for phase 3 trials based on pooled analysis of six phase 2 randomized controlled trials. Psychopharmacology September 1, 2019
- MDMA enhances emotional empathy and prosocial behavior Social Cognitive and Affective Neuroscience October 4, 2013
and 29 more in the library