Chronic Ecstasy Use Research Articles

Cognitive disorders after sporadic ecstasy use? A case report

Memory problems and changes in hippocampal structures after chronic ecstasy use are well described in the literature. Cognitive problems after incidental ecstasy use are rare, and the few patients described in case reports returned to their normal cognitive level after a relative short period. FV is a 39-year-old man who used an ecstasy tablet in 2005. This resulted in severe confusion for a few days. The confusion was followed by persistent memory complaints and difficulties orientating in new surroundings. An extensive neuropsychological examination 7 years after the ecstasy use revealed a severe memory disorder. Furthermore, his performance on a virtual reality test of navigation showed serious problems navigating in new surroundings. In comparison with matched control subjects (Bayesian approach for single case studies) his scores were significantly impaired on several subtasks of the navigation test. On a magnetic resonance imaging (MRI) scan of the brain bilateral hippocampal atrophy and sclerosis were visible, comparable to previous MRI studies describing hippocampal damage following ecstasy ingestion. This case report describes persistent memory and navigation disorders after sporadic ecstasy use, supported by structural brain abnormalities seen on the MRI scan. These findings revive the debate on whether sporadic ecstasy use can cause persistent cognitive deficits.

MET Plus CBT for Ecstasy Use When Clients Are Depressed: A Case Series

The second most commonly used group of illicit substances are amphetamine-type stimulants, which includes ecstasy. Chronic ecstasy use is associated with dependence, as well as cognitive and psychological impairments. When taken for self-medication purposes, chronic use may be supported by ecstasy’s immediate antidepressant-like effects. Interestingly, the most common outcome of ecstasy users seeking treatment is an antidepressant prescription. Psychological treatment may be a better option, as concurrently using antidepressants and ecstasy may have detrimental health effects. Unfortunately, the effectiveness of brief psychological treatment for ecstasy use has not been systematically examined for depressed clients. The present study describes an ecstasy use treatment comprised of three sessions of integrated motivational enhancement therapy and cognitive behavioral therapy and reports on its potential effectiveness with 2 depressed participants. In both cases, ecstasy use reduced to abstinence over 6months follow-up, and these changes were associated with increases in URICA action subscale scores. One participant reported substantially reduced depressive symptomology after treatment, while the other sought additional treatment for depression. Results suggest that focusing on the relationship between ecstasy use and depression may lead to reductions in ecstasy use for depressed clients; however, clients who use ecstasy more frequently may require more extensive treatment that also targets depression directly. In addition, findings suggest that focusing on depression as a causal agent of ecstasy use may increase ambivalent clients’ motivation to reduce their ecstasy use.

Chronic ecstasy use increases neurotrophin-4 gene expression and protein levels in the rat brain

Ecstasy is a widely abused psychoactive recreational drug that is known to induce neuroplastic effects. The molecular basis of addiction remains poorly understood, but diverse lines of evidence suggest that neurotrophins (BDNF, NT-3 and NT-4) play a role in the regulation of synaptic plasticity. The present study was designed to evaluate the alteration of NT-4 protein levels and gene expression in the brain stem, cerebellum and cerebral hemisphere of rat brains in the context of ecstasy dependence. Ecstasy addiction was induced by intraperitoneal injection of ecstasy (10mg/kg) for 5 days. After chronic ecstasy treatment, the NT-4 levels in the above-mentioned areas of the brain were determined by ELISA. There was a significant increase in the NT-4 protein concentration in the brain stem, cerebellum and cerebral hemisphere when compared with control group. Additionally, these regions were assayed for the transcription of NT-4 using semi-quantitative RT-PCR normalized to β-actin gene transcription. The results show that chronic administration of ecstasy significantly increased NT-4 gene expression in the abovementioned areas of brain. The current work demonstrates that ecstasy induced-maladaptations may be regulated by NT-4.

Enhanced intensity dependence and aggression history indicate previous regular ecstasy use in abstinent polydrug users

Intensity dependence is an electrophysiological measure of intra-individual stability of the augmenting/reducing characteristic of N1/ P2 event-related potential amplitudes in response to stimuli of varying intensities. Abstinent ecstasy users typically show enhanced intensity dependence and higher levels of impulsivity and aggression. Enhanced intensity dependence and high impulsivity and aggression levels may be due to damage in the brain's serotonergic neurons as a result of ecstasy use. The present study investigated whether intensity dependence, impulsivity and aggression history can be used as indictors of previous chronic ecstasy usage. Forty-four abstinent polydrug users (8 women; age 19 to 61 years old) were recruited. All participants were currently residents at a local substance abuse facility receiving treatment and had been free of all drugs for a minimum of 21 days. The study found significantly enhanced intensity dependence of tangential dipole source activity and a history of more aggressive behavior in those who had previously been involved in chronic ecstasy use. Intensity dependence of the tangential dipole source and aggressive behavior history correctly identified 73.3% of those who had been regular ecstasy users and 78.3% of those who had not. Overall, 76.3% of the participants were correctly classified.

Apparent Transient Effects of Recent ???Ecstasy??? Use on Cognitive Performance and Extrapyramidal Signs in Human Subjects

Our purpose is to investigate cognitive performance and extrapyramidal function early after ecstasy use. Ecstasy, containing 3,4 methylenedioxymethamphetamine, has shown evidence of causing cognitive deficits and parkinsonian signs. Previous research has examined cognitive performance after a period of prolonged abstinence, but research assessing the early effects of ecstasy after recent use is limited despite temporal neurochemical differences demonstrated in nonhuman models. This study compared task performance between 13 ecstasy users (10 to 15 h postdrug use) and a control group on a battery of neuropsychologic assessments while matching for education level, sleep deprivation, and premorbid IQ. The groups were also compared on measures relating to parkinsonian signs. The ecstasy subjects showed impairments on measures of executive function as evaluated by Raven's Standard Progressive Matrices (SPM) and the Wisconsin Card Sorting Task (WCST). Short-delay free recall memory was also impaired in ecstasy subjects on the California Verbal Learning Test (CVLT-II). No extrapyramidal motor impairments were detected. These deficits resemble deficits previously reported in chronic ecstasy use but also seem to reveal transient impairments in executive function. Future research is needed to better understand the neurologic and neuropsychologic implications of ecstasy use across time and extent of use.

A review of the acute subjective effects of MDMA/ecstasy

Although several relatively recent reviews have summarized the neuropsychiatric effects associated with chronic ecstasy use, there is no published comprehensive review of studies on the acute subjective effects (ASEs) of MDMA/ecstasy. The present study reviewed the prevalence, intensity and duration of ASEs collected from 24 studies that provided frequency data on the prevalence of self-reported ecstasy effects and/or provided data on the intensity of ecstasy effects. Although hundreds of ASEs have been reported following MDMA consumption, we identified a subset of effects reported repeatedly by meaningful proportions and large numbers of participants across multiple investigations, most of which were either emotional (e.g. anxiety, depression, closeness, fear, euphoria, calmness) or somatic (e.g. nausea/vomiting, bruxism, muscle aches/headache, sweating, numbness, body temperature changes, fatigue, dizziness, dry mouth, increased energy). Only one sexual ASE (sexual arousal/increased sensual awareness), one cognitive ASE (confused thought), one sensory-perceptual ASE (visual effects/changes in visual perception), one sleep-related ASE (sleeplessness) and one appetite-related ASE (decreased appetite) were reported across five or more investigations. Three factors-number of hours between ingestion and assessment, dose level, and gender-have been associated with the acute subjective experience of MDMA/ecstasy. This review provides useful information for clinicians and researchers who want to understand the desirable and undesirable ASEs that may motivate and restrain ecstasy use, for public health advocates who seek to reduce biomedical harms (e.g. fainting, dehydration, shortness of breath, bruxism) associated with recreational use of MDMA/ecstasy, and for educators who wish to design credible prevention messages that neither underestimate nor exaggerate users' experiences of this drug.

Neuropsychological function in ecstasy users: a study controlling for polydrug use

A number of studies have compared ecstasy users to control groups on various measures of neuropsychological function in order to determine whether ecstasy use results in lasting cognitive deficits. However, few of those studies controlled adequately for non-ecstasy illicit drug use. The aim of this study was to investigate neuropsychological function in chronic ecstasy users while controlling for polydrug use. Neuropsychological function was assessed in four groups-30 current 3,4-methylenedioxymethamphetamine (MDMA) users with a little history of illicit drug use other than ecstasy and cannabis, 30 polydrug controls, 30 drug-naïve controls and 20 ex-MDMA users-using a battery of well-validated, computerized neuropsychological tests. The battery focused on memory, executive function, impulsivity and risk-taking. Few differences were apparent between the groups, and on no measure were the current MDMA users impaired significantly relative to the polydrug controls. However, within the current MDMA users, questionnaire-measured impulsivity correlated with performance on a number of tests-a relationship that was not apparent in the controls. These data highlight the complexity in understanding the current ecstasy literature and suggest that some individuals may be particularly vulnerable to cognitive impairment following chronic use. Although no differences were identified between the current MDMA users and the controls, trait impulsiveness was significantly correlated with impairment on a number of neuropsychological outcome measures in the MDMA users, but not in the controls. These data suggest that impulsive individuals may be those most at risk for the development of cognitive impairment following chronic ecstasy use.

Association of a Functional Polymorphism in the Serotonin Transporter Gene With Abnormal Emotional Processing in Ecstasy Users

The long-term effects of the use of 3,4-methylenedioxymethamphetamine (MDMA, or Ecstasy) in humans are controversial and unclear. The authors' goal was to assess the contribution of a functional polymorphism in the gene encoding serotonin transporter to changes in emotional processing following chronic Ecstasy use. They investigated Beck Depression Inventory scores and performance on the Affective Go/No-Go test, a computerized neuropsychological test sensitive to emotional processing, in Ecstasy users and comparison subjects, stratifying the results by serotonin transporter genotype. Ecstasy use was associated with higher Beck Depression Inventory score and abnormalities in the Affective Go/No-Go test in individuals with the ss and ls genotype but not those with the ll genotype. Ecstasy users carrying the s allele, but not comparison subjects carrying the s allele, showed abnormal emotional processing. On the basis of a comparison with acute tryptophan depletion, the authors hypothesize that chronic Ecstasy use may cause long-term changes to the serotonin system, and that Ecstasy users carrying the s allele may be at particular risk for emotional dysfunction.

Ecstasy: pharmacology and neurotoxicity

In part because it is amphetamine derived, ecstasy has inherited some of its parent compound's reputation for being neurotoxic. However, whereas amphetamine and methamphetamine undoubtedly cause irreversible brain damage with long-term use, the jury is still out on the party drug ecstasy. The deadly reputation of ecstasy has been fuelled by the tragic fates of healthy young clubbers who have died after taking the drug. However, compared with other recreational drugs, there have been very few ecstasy-related deaths. Further, there is little evidence for short-term neurotoxicity of ecstasy at recreational doses. That is not to say that ecstasy leaves the user neutral. Chronic ecstasy use causes depletion of serotonin, which has subtle but important long-term effects on cognition and mood. Although it seems unlikely that we will be faced with a generation of party goers who suffer from premature Parkinson's disease, so little is known about the long-term effects of ecstasy on mood, emotional states and cognitive function that at present we cannot predict what impact their use of ecstasy will have on the middle-age of the average ecstasy user.

Prospective memory, everyday cognitive failure and central executive function in recreational users of Ecstasy.

Chronic use of MDMA (3,4-methylenedioxymethamphetamine), or Ecstasy, is believed to lead to impaired psychological performance, including well-documented decrements in laboratory and field tests of retrospective memory. Less is known about the impact of Ecstasy on aspects of 'everyday' memory, despite obvious concerns about such effects. The three studies reported here focused on the impact of chronic Ecstasy use on prospective memory (PM), associated central executive function and other aspects of day-to-day cognition. In study 1 46 regular Ecstasy users were compared with 46 Ecstasy-free controls using the Prospective Memory Questionnaire (PMQ). Ecstasy users reported significantly more errors in PM (remembering to do something in the future); these findings persisted after controlling for other drug use and the number of strategies used to aid memory. No difference was found between representative subgroups on the Lies Scale of the Eysenck Personality Questionnaire. In study 2 a different group of 30 regular Ecstasy users and 37 Ecstasy-free controls was assessed on the PMQ and on a central executive task comprising verbal fluency measures. The results confirmed the significant impairments in long- and short-term PM and revealed corresponding impairments in verbal fluency. In study 3 15 Ecstasy users, 15 cannabis users and 15 non-drug users were assessed using the Cognitive Failures Questionnaire, which requires participants to provide ratings of the frequency of various day-to-day cognitive slips. The results indicate that the Ecstasy users did not perceive their general cognitive performance to be worse than that of controls. Taken together, these results suggest that Ecstasy users have impaired PM that cannot be explained by an increased propensity to exaggerate cognitive failures. These may be attributable, in part, to central executive deficits that are due to frontal lobe damage associated with Ecstasy use. Copyright 2001 John Wiley & Sons, Ltd.