Decision-making in chronic ecstasy users: a systematic review.
Felix Betzler, Leonard Viohl, Nina Romanczuk-Seiferth
European Journal of Neuroscience January 2017 DOI: 10.1111/ejn.13480 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Longitudinal Cross-sectional Peer reviewed |
|---|---|
| Population | Human MDMA/ecstasy users in the drug-free interval, with drug-naive and/or polydrug control groups |
| Topics | MDMA |
| Keywords | Amphetamines Cognitive functions Drugs Executive functions |
| Key findings | The authors conclude that the current state of research does not allow the conclusion that long-term MDMA use affects decision-making behavior in general. Seven of 12 cross-sectional studies reported increased risky decisions in MDMA users, while five found no MDMA-specific effects; increased impulsivity appeared in both MDMA and (poly)drug control groups in almost all studies. |
Abstract
Different cognitive impairments have been reported as a result of long-term MDMA/ecstasy use. Increased impulsivity and altered decision-making have been shown to be associated with the development and maintenance of addictive disorders pointing toward the necessity to understand a potential impairment of decision-making due to MDMA use. Thus, assessing the long-term effects of MDMA is crucial in order to evaluate its controversially discussed therapeutic use. The aim of this systematic review was to summarize the scientific literature on potential effects of chronic MDMA use on higher order decision-making processes in humans. Therefore, a systematic search for controlled trials relevant to the topic has been performed. Only studies using specific tasks on decision-making were included that involved subjects in the drug-free interval with drug-naïve, and/or polydrug control groups. A total of 12 studies could be identified that met the inclusion criteria, all of which were cross-sectional studies. The findings on decision-making disturbances in MDMA users were heterogeneous. Seven studies reported increased risky decisions, whereas five studies did not find MDMA-specific influences on decision-making. Increased impulsivity was observed both in MDMA groups and in (poly)drug control groups in almost all studies. Thus, the current state of research does not allow for the conclusion that long-term use of MDMA affects decision-making behavior in general. More detailed specifications as well as further investigations of the relevant processes are needed. Significant tendencies toward risky decision-making among long-term MDMA use have been observed, but need to be confirmed by studies using a longitudinal design.
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 6
- MDMA for the Treatment of Negative Symptoms in Schizophrenia Journal of Clinical Medicine June 7, 2022
- Dextromethorphan moderates reward deficiency associated with central serotonin transporter availability in 3,4-methylenedioxy-methamphetamine-treated animals. Journal of the Chinese Medical Association : JCMA May 1, 2024
- Demographic and health characteristics of 3,4-methylenedioxymethamphetamine users (MDMA, ecstasy). Psychiatria Polska October 31, 2022
- Striatal Iron Deposition in Recreational MDMA (Ecstasy) Users. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging September 2023
- MDMA – hopes and fears associated with therapeutic use in mental disorders Pharmacotherapy in Psychiatry and Neurology 2020
and 1 more in the library
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