MDMA ("ecstasy") and panic disorder: induction by a single dose.
Una D. Mccann, George A. Ricaurte
Biological Psychiatry November 15, 1992 DOI: 10.1016/0006-3223(92)90185-3 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | One individual with no prior psychiatric history who ingested a single typical dose of MDMA |
| Intervention | MDMA |
| Dose | a single typical dose |
| Topics | Anxiety MDMA |
| Key findings | The authors report an individual with no prior psychiatric history who developed panic disorder after a single typical dose of MDMA, which they describe as the first such report. They suggest that some people may have increased susceptibility to MDMA's adverse psychiatric effects, though they note that earlier reports of lasting sequelae mostly involved repeated high doses and individuals with prior psychiatric histories. |
Abstract
( +_ )3,4-Methylenedioxymethamphetamine (MDMA) is a synthetic amphetamine analogue used recreationally by humans in the United States (Pcroutka 1987) and Western Europe (Anon 1992), and is thought by some to have potential utility as a psychotherapoutic adjunct (Grinspoon and Bakalar 1986). It is generally believed that MDMA acts via central monoamines, primariJy by inducing transmitter release and interfering with monoamine reuptake inactivation (Johnson et al 1991; McKenna and Peroutka 1990). In animals, MDMA has been shown to damage brain serotonin neurons, and in the monkey the neurotoxic dose closely approximates the dose typically ingested by humans (Ricaurte et al 1988). Concern that MDMA may damage serotonin neurons in the human brain is largely responsible for MDMA's Schedule I status in the United States, and consequently, the dearth of controlled studies comparing the risks of MDMA to its possible benefit as a therapeutic adjunct. There have been several recent reports of lasting adverse neuropsychiatric sequelae in humans who have taken repeated (usually high) doses of MDMA (Crcighton et al 1991; Benazzi and Mazzoli 1991; McGuir¢ and Fahy 1991; Schifano 1991; McCann and Ricaurte 1991). These reports suggest that individuals with prior psychiatric histories may have an increased susceptibility to MDMA's adverse effects. Lingering psychiatric syndromes associated with MDMA ingestion have included chronic paranoid psychosis (Schifano 1991; McGuir¢ and Fahy 1991), recurrent acute paranoid psychosis (Crcighton et al 1991), depression with suicidality (Benazzi and Mazzoli 1991), and panic disorder with secondary depression (McCann and Ricaurte 1991). Although untoward effects of high neurotoxic doses of MDMA might be anticipated, particularly in vulnerable individuals, enduring psychiatric illness following a single moderate dose of MDMA in a healthy individual has not been reported. We describe an individual with no prior psychiatric history who developed panic disorder after ingesting a single typical dose of MDMA.
Comparable studies
Other case reports and case series on MDMA for anxiety, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Anxiety-related Symptoms following the Sporadic Use of Ecstasy – A Case Study High-functioning 24-year-old student with a history of obsessive-compulsive disorder... | 2021 | Case study | n = 1 |
| 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 |
Citations in the library
Cited by 22
- 3,4‐Methylenedioxymethamphetamine (MDMA, “Ecstasy”): pharmacology and toxicology in animals and humans Addiction May 1, 1994
- Psychopathological, neuroendocrine and autonomic effects of 3,4-methylenedioxyethylamphetamine (MDE), psilocybin and d -methamphetamine in healthy volunteers Psychopharmacology February 18, 1999
- Is MDMA (‘Ecstasy’) Neurotoxic in Humans? An Overview of Evidence and of Methodological Problems in Research Neuropsychobiology 2000
- Agony and ecstasy: a review of MDMA effects and toxicity European Psychiatry August 1, 2000
- Potential Human Neurotoxicity of MDMA (‘Ecstasy’): Subjective Self-Reports, Evidence from an Italian Drug Addiction Centre and Clinical Case Studies Neuropsychobiology 2000
and 17 more in the library
Cites 4
- Can Drugs Be Used to Enhance the Psychotherapeutic Process? American Journal of Psychotherapy July 1, 1986
- Lasting Neuropsychiatric Sequelae of (??)Methylenedioxymethamphetamine (???Ecstasy???) in Recreational Users Journal of Clinical Psychopharmacology October 1, 1991
- Chronic paranoid psychosis after misuse of MDMA ("ecstasy") BMJ March 23, 1991
- Toxic effects of MDMA on central serotonergic neurons in the primate: importance of route and frequency of drug administration. Brain Research April 12, 1988