Abstract

Rationale: There is evidence that serotonergic processes may modulate the processing of fearful facial expressions. It is therefore possible that the recreational drug ‘ecstasy’ (MDMA), which has marked serotonergic effects, may affect people's ability to recognise human facial expressions portraying fear. Objective: The present study therefore aimed to determine whether ecstasy users differed from controls in fear recognition at two time points: shortly after taking the drug and a few days later. Methods: Sixteen ecstasy users and 21 controls were compared on a facial expression recognition task involving the 6 basic emotions (happiness, surprise, sadness, anger, fear and disgust) and on self-ratings of mood on the night of drug use (day 0) and 4 days later (day 4). Results: In recognising fearful facial expressions, ecstasy users were more accurate than controls on day 0 but less accurate than them on day 4 when compared with their overall ability to recognise other basic emotions. Accuracy of fear recognition on day 4 was negatively correlated with both years of ecstasy use and number of ecstasy tablets taken on a typical session. On self-rated aggression scales, ecstasy users scored lower than controls on day 0 and higher on day 4. Conclusions: These results support the notion that 5-HT plays a role in modulating the recognition of fearful facial expressions. Increased accuracy of fear recognition may relate to 5-HT release following ecstasy use on day 0, and decreased accuracy may reflect subsequent depletion of 5-HT mid-week.

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