Serotonin transporter availability, neurocognitive function and their correlation in abstinent 3,4‐methylenedioxymethamphetamine users
Foke L. Van de Blaak, Glenn Dumont
Human Psychopharmacology: Clinical and Experimental 2022 DOI: 10.1002/hup.2811 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Population | MDMA (Ecstasy) users, predominantly teenagers and adolescents |
| Topics | MDMA Serotonin |
| Key findings | MDMA use is associated with an acute decrease in serotonin transporter availability and impairment in cognitive functions, mostly memory. SERT availability recovers with sustained abstinence, but memory function does not, and no significant correlation was found between SERT availability and memory function. The authors argue that SERT availability is therefore not a biomarker for MDMA-induced cognitive impairment and likely not for MDMA-induced neurotoxicity. |
Abstract
AbstractRationaleMDMA or Ecstasy has made a resurgence in popularity and the majority of users consist of teenagers and adolescents. Therefore, it is important to determine whether MDMA causes long‐term damage and what this damage entails. There is an ongoing debate about possible neurocognitive changes in 3,4‐methylenedioxymethamphetamine (MDMA) users related to MDMA's neurotoxic potential. Multiple neuroimaging studies have shown that Ecstasy use leads to lower serotonin transporter (SERT) availability in multiple brain regions. This may express itself in a loss of cognitive functions like memory, attention and executive function. However, there is increasing evidence reporting that MDMA's induced serotonergic adaptations are reversible over time. The question we thus address is whether the recovery of SERT function predicts a recovery of cognitive function.ObjectivesThis review aims to investigate MDMA's long‐term effects on SERT availability and cognitive functioning.MethodsA literature search was performed in PubMed. Studies that investigated the effects of MDMA on both SERT availability and cognitive performance were eligible for inclusion.ResultsSERT availability positively correlated with time of abstinence, whereas memory performance did not show this correlation, but remained impaired in MDMA users. No significant correlation between SERT availability and memory function was found (r = 0.232, p = 0.581; r = 0.176, p = 0.677).ConclusionsThe main findings of this review are that MDMA‐use leads to an acute decrease in SERT availability and causes an impairment in cognitive functions, mostly memory. However, SERT availability recovers with sustained abstinence while memory function does not. This suggests that SERT availability is not a biomarker for MDMA‐induced cognitive impairment and likely also not for MDMA‐induced neurotoxicity.
Comparable studies
Other systematic reviews and meta-analyses on MDMA, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| A review of the acute subjective effects of MDMA/ecstasy | 2006 | Systematic review | |
| Adverse events in clinical treatments with serotonergic psychedelics and MDMA: A mixed-methods systematic review Patients in clinical trials with MDMA or serotonergic psychedelics | 2022 | Systematic review | n = 598 |
| Treating posttraumatic stress disorder with MDMA-assisted psychotherapy: A preliminary meta-analysis and comparison to prolonged exposure therapy Patients with PTSD | 2016 | Meta-analysis | |
| The neuropsychology of ecstasy (MDMA) use: a quantitative review MDMA users | 2007 | Meta-analysis | |
| Drug-drug interactions between psychiatric medications and MDMA or psilocybin: a systematic review | 2022 | Systematic review |
Citations in the library
Cited by 5
- Serotonin 2C receptors are also important in head-twitch responses in male mice. Psychopharmacology July 1, 2025
- Psychedelics in the Treatment of Substance Use Disorders Psychiatric Annals September 1, 2022
- 3,4-Methylenedioxymethamphetamine (MDMA) impairs cognitive function during withdrawal via activation of the arachidonic acid cascade in the hippocampus. Drug and Alcohol Dependence April 1, 2024
- Long-term neurocognitive side effects of MDMA in recreational ecstasy users following sustained abstinence: A systematic review and meta-analysis. Journal of Psychopharmacology November 19, 2025
- Striatal Iron Deposition in Recreational MDMA (Ecstasy) Users. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging September 2023
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and 19 more in the library