The Neurobiological Mechanisms Underpinning MDMA and Impaired Psychological Functioning

Abstract

An extensive body of literature now exists regarding the relationship of human ecstasy (MDMA) consumption to impairments (or not) across a broad range of cognitive functions. Knowledge of the neurobiological mechanisms underpinning these effects has also developed over the past 20 years with regard to, for example, SERT (a neuronal membrane transporter molecule) availability, neuronal death and damage, and haemodynamic responses in cerebral regions associated with the performance of specific tasks. However, the time course of such neurobiological changes is not always consistent with the presence of impaired psychological functioning. Other inconsistencies can exist regarding the presence of neurobiological anomalies and changes in psychological functioning. This chapter will critically review the literature on neurobiological anomalies in human ecstasy consumers, and their relationship to psychological functioning. As ecstasy users have frequently also ‘experimented’ with other stimulant drugs, and also tend generally to have used cannabis, the complications for research arising from the concomitant use of other drugs will be included as important elements in the review. The implications of research findings for practitioners and policy makers will also be discussed in an international context.