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Serotonin neurotoxicity after (+/-)3,4-methylenedioxymethamphetamine (MDMA; "Ecstasy"): a controlled study in humans.

U D McCann, A Ridenour, Y Shaham, George A. Ricaurte

Neuropsychopharmacology April 1994 DOI: 10.1038/npp.1994.15 (opens in new tab)

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AI-extracted from the abstract
Characteristics Observational case-control study Peer reviewed
Sample size 58
Population 30 MDMA users and 28 controls admitted to a controlled inpatient setting
Duration At least 2 weeks of drug abstinence
Measures cerebrospinal fluid monoamine metabolites (5-HIAA), prolactin response to L-tryptophan, nociceptive responses to ischemic pain, personality measures of impulsivity and aggression
Topics MDMA Serotonin
Key findings MDMA users had lower cerebrospinal fluid 5-HIAA levels than controls and lower scores on impulsivity and indirect hostility, while prolactin response to L-tryptophan and ischemic pain responses were similar. The authors suggest serotonin neurotoxicity may be a potential complication of MDMA use and that serotonin systems are involved in modulating impulsive and aggressive personality traits.

Abstract

(+/-)3,4-Methylenedioxymethamphetamine (MDMA; "Ecstasy"), an increasingly popular recreational drug, is known to damage brain serotonin 5-hydroxytryptamine (5-HT) neurons in experimental animals. Whether MDMA is neurotoxic in humans has not been established. Thirty MDMA users and 28 controls were admitted to a controlled inpatient setting for measurement of biologic and behavioral indexes of central 5-HT function. Outcome measures obtained after at least 2 weeks of drug abstinence included concentrations of monoamine metabolites in cerebrospinal fluid (CSF), prolactin responses to L-tryptophan, nociceptive responses to ischemic pain, and personality characteristics in which 5-HT has been implicated (i.e., impulsivity and aggression). Subjects with a history of MDMA exposure had lower levels of CSF 5-hydroxyindoleacetic acid (the major metabolite of 5-HT) than controls (p = .001). Although they resembled controls in their prolactin response to L-tryptophan and their response to ischemic pain, MDMA users had lower scores on personality measures of impulsivity (p = .004) and indirect hostility (p = .009). The CSF findings suggest that 5-HT neurotoxicity may be a potential complication of MDMA use. Further, differences in personality support the view that 5-HT systems are involved in modulating impulsive and aggressive personality traits. Additional studies of MDMA-exposed individuals are needed to confirm and extend the present findings. Such studies could help elucidate the role of 5-HT in normal brain function as well as in neuropsychiatric disease states.

Comparable studies

Other observational and cohort studies on MDMA, most cited first.

Study Year Design Participants
Subjective Reports of the Effects of MDMA in a Clinical Setting Individuals who took MDMA in a clinical setting 1986 Observational study
Memory impairment in abstinent MDMA ("Ecstasy") users Abstinent MDMA users 1998 Observational cohort
Impaired cognitive performance in drug free users of recreational ecstasy (MDMA) Otherwise healthy young people 2000 Observational
The Psychological and Physiological Effects of MDMA on Normal Volunteers Older, more educated, drug-experienced individuals 1986 Observational cohort
Cognitive performance in recreational users of MDMA or 'ecstasy': evidence for memory deficits Young people who were regular or novice MDMA users, or non-users 1998 Observational cohort n = 30

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MDMA Serotonin