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Sun Y, Chebolu S, Skegrud S, Kamali S, Darmani NA. Effects of low-doses of methamphetamine on d-fenfluramine-induced head-twitch response (HTR) in mice during ageing and c-fos expression in the prefrontal cortex. BMC Neurosci 2023; 24:2. [PMID: 36631757 PMCID: PMC9835290 DOI: 10.1186/s12868-022-00766-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 12/12/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The head-twitch response (HTR) in mice is considered a behavioral model for hallucinogens and serotonin 5-HT2A receptor function, as well as Tourette syndrome in humans. It is mediated by 5-HT2A receptor agonists such as ( ±)- 2,5-dimethoxy-4-iodoamphetamine (DOI) in the prefrontal cortex (PFC). The 5-HT2A antagonist EMD 281014, can prevent both DOI-induced HTR during ageing and c-fos expression in different regions of PFC. Moreover, the nonselective monoamine releaser methamphetamine (MA) suppressed DOI-induced HTR through ageing via concomitant activation of inhibitory 5-HT1A receptors, but enhanced DOI-evoked c-fos expression. d-Fenfluramine is a selective 5-HT releaser and induces HTR in mice, whereas MA does not. Currently, we investigated whether EMD 281014 or MA would alter: (1) d-fenfluramine-induced HTR frequency in 20-, 30- and 60-day old mice, (2) d-fenfluramine-evoked c-fos expression in PFC, and (3) whether blockade of inhibitory serotonergic 5-HT1A- or adrenergic ɑ2-receptors would prevent suppressive effect of MA on d-fenfluramine-induced HTR. RESULTS EMD 281014 (0.001-0.05 mg/kg) or MA (0.1-5 mg/kg) blocked d-fenfluramine-induced HTR dose-dependently during ageing. The 5-HT1A antagonist WAY 100635 countered the inhibitory effect of MA on d-fenfluramine-induced HTR in 30-day old mice, whereas the adrenergic ɑ2 antagonist RS 79948 reversed MA's inhibitory effect in both 20- and 30- day old mice. d-Fenfluramine significantly increased c-fos expressions in PFC regions. MA (1 mg/kg) pretreatment significantly increased d-fenfluramine-evoked c-fos expression in different regions of PFC. EMD 281014 (0.05 mg/kg) failed to prevent d-fenfluramine-induced c-fos expression, but significantly increased it in one PFC region (PrL at - 2.68 mm). CONCLUSION EMD 281014 suppressed d-fenfluramine-induced HTR but failed to prevent d-fenfluramine-evoked c-fos expression which suggest involvement of additional serotonergic receptors in the mediation of evoked c-fos. The suppressive effect of MA on d-fenfluramine-evoked HTR is due to well-recognized functional interactions between stimulatory 5-HT2A- and the inhibitory 5-HT1A- and ɑ2-receptors. MA-evoked increases in c-fos expression in PFC regions are due to the activation of diverse monoaminergic receptors through increased synaptic concentrations of 5-HT, NE and/or DA, which may also account for the additive effect of MA on d-fenfluramine-evoked changes in c-fos expression. Our findings suggest potential drug receptor functional interaction during development when used in combination.
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Affiliation(s)
- Yina Sun
- grid.268203.d0000 0004 0455 5679Department of Basic Medical Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, 309 East Second Street, Pomona, CA 91766 USA
| | - Seetha Chebolu
- grid.268203.d0000 0004 0455 5679Department of Basic Medical Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, 309 East Second Street, Pomona, CA 91766 USA
| | - Stone Skegrud
- grid.268203.d0000 0004 0455 5679Department of Basic Medical Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, 309 East Second Street, Pomona, CA 91766 USA
| | - Setareh Kamali
- grid.268203.d0000 0004 0455 5679Department of Basic Medical Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, 309 East Second Street, Pomona, CA 91766 USA
| | - Nissar A. Darmani
- grid.268203.d0000 0004 0455 5679Department of Basic Medical Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, 309 East Second Street, Pomona, CA 91766 USA
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Majić T, Brandt L, Montag C. Anxiety-related Symptoms following the Sporadic Use of Ecstasy - A Case Study. J Psychoactive Drugs 2021; 54:378-385. [PMID: 34823448 DOI: 10.1080/02791072.2021.2006372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
3,4-methylenedioxymethamphetamine (MDMA/"ecstasy") is widespread in the electronic club scene, but MDMA has also been suggested for the treatment of anxiety spectrum disorders like posttraumatic stress disorder (PTSD) and social anxiety in autistic adults. Here, we report a case of a high functioning 24-old student with a sporadic recreational use of ecstasy, and a history of a single episode of obsessive-compulsive disorder (OCD). A few days after using ecstasy during a period of stressful life events, he developed a complex depersonalization/derealization syndrome (DDS) including intermittent distortions of time and very short intermittent episodes of misidentification of persons. Furthermore, obsessive thoughts reappeared and he suffered a panic attack for the first time in his life. Under combined pharmacological treatment and psychotherapy, symptoms gradually subsided until full remission after 14 months. Some months after discontinuation of escitalopram, however, panic attacks recurred, evolving into a regular pattern. Even if MDMA is a promising tool for the treatment of some anxiety spectrum disorders in the framework of substance-assisted psychotherapy, the use of ecstasy might be also harmful for some patients with a history of anxiety or dissociative symptoms, when used recreationally or as a self-medication outside of a controlled clinical setting.
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Affiliation(s)
- Tomislav Majić
- Department of Psychiatry and Neurosciences, Berlin Institute of Health, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Campus Charité Mitte, Berlin, Germany.,Research Group Psychotropic Substances, Psychiatric University Clinic at Hospital St. Hedwig, Charité Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Lasse Brandt
- Department of Psychiatry and Neurosciences, Berlin Institute of Health, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Campus Charité Mitte, Berlin, Germany
| | - Christiane Montag
- Department of Psychiatry and Neurosciences, Berlin Institute of Health, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Campus Charité Mitte, Berlin, Germany
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Mead J, Parrott A. Mephedrone and MDMA: A comparative review. Brain Res 2020; 1735:146740. [PMID: 32087112 DOI: 10.1016/j.brainres.2020.146740] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 02/13/2020] [Accepted: 02/18/2020] [Indexed: 01/10/2023]
Abstract
Mephedrone and MDMA are both constituents of party drugs, with mephedrone being relatively new compared to MDMA. This review compares current knowledge regarding the patterns of usage and neuropsychobiological effects of both mephedrone and MDMA. Both drugs share common psychoactive effects, the duration of which is significantly shorter with mephedrone use, attributing towards a pattern of binge use among users. Both drugs have also been associated with adverse health, psychiatric, and neurocognitive problems. Whilst there is extensive research into the psychobiological problems induced by MDMA, the evidence for mephedrone is comparatively limited. The adverse effect profile of mephedrone appears to be less severe than that of MDMA. Users often believe it to be safer, although both drugs have been associated with overdoses. The neurotoxic potential of mephedrone appears to be low, whereas MDMA can cause long-term damage to the serotonergic system, although this needs further investigation. The abuse liability of mephedrone is significantly greater than that of MDMA, raising concerns regarding the impact of lifetime usage on users. Given that mephedrone is relatively new, the effects of long-term exposure are yet to be documented. Future research focused on lifetime users may highlight more severe neuropsychobiological effects from the drug.
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Affiliation(s)
- Jessica Mead
- Department of Psychology, School of Human and Health Sciences, Swansea University, Swansea, Wales, United Kingdom.
| | - Andrew Parrott
- Department of Psychology, School of Human and Health Sciences, Swansea University, Swansea, Wales, United Kingdom
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Betzler F, Viohl L, Romanczuk-Seiferth N. Decision-making in chronic ecstasy users: a systematic review. Eur J Neurosci 2016; 45:34-44. [PMID: 27859780 DOI: 10.1111/ejn.13480] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 11/09/2016] [Accepted: 11/10/2016] [Indexed: 11/30/2022]
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.
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Affiliation(s)
- Felix Betzler
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Leonard Viohl
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Nina Romanczuk-Seiferth
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
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Downey LA, Sands H, Jones L, Clow A, Evans P, Stalder T, Parrott AC. Reduced memory skills and increased hair cortisol levels in recent Ecstasy/MDMA users: significant but independent neurocognitive and neurohormonal deficits. Hum Psychopharmacol 2015; 30:199-207. [PMID: 25900184 DOI: 10.1002/hup.2474] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 01/26/2015] [Accepted: 02/12/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The goals of this study were to measure the neurocognitive performance of recent users of recreational Ecstasy and investigate whether it was associated with the stress hormone cortisol. METHODS The 101 participants included 27 recent light users of Ecstasy (one to four times in the last 3 months), 23 recent heavier Ecstasy users (five or more times) and 51 non-users. Rivermead paragraph recall provided an objective measure for immediate and delayed recall. The prospective and retrospective memory questionnaire provided a subjective index of memory deficits. Cortisol levels were taken from near-scalp 3-month hair samples. RESULTS Cortisol was significantly raised in recent heavy Ecstasy users compared with controls, whereas hair cortisol in light Ecstasy users was not raised. Both Ecstasy groups were significantly impaired on the Rivermead delayed word recall, and both groups reported significantly more retrospective and prospective memory problems. Stepwise regression confirmed that lifetime Ecstasy predicted the extent of these memory deficits. CONCLUSIONS Recreational Ecstasy is associated with increased levels of the bio-energetic stress hormone cortisol and significant memory impairments. No significant relationship between cortisol and the cognitive deficits was observed. Ecstasy users did display evidence of a metacognitive deficit, with the strength of the correlations between objective and subjective memory performances being significantly lower in the Ecstasy users.
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Affiliation(s)
- Luke A Downey
- Department of Psychology, Swansea University, Swansea, UK; Centre for Human Psychopharmacology (CHP), Swinburne University, Melbourne, Australia
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Effects of long-term exposure of 3,4-methylenedioxymethamphetamine (MDMA; "ecstasy") on neuronal transmitter transport, brain immuno-regulatory systems and progression of experimental periodontitis in rats. Neurochem Int 2014; 72:30-6. [PMID: 24726767 DOI: 10.1016/j.neuint.2014.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 03/05/2014] [Accepted: 04/03/2014] [Indexed: 11/23/2022]
Abstract
The present study was designed to investigate the effects of long-term exposure (4 weeks) to the widely used narcotic drug and putative neurotoxicant 3,4-methylenedioxymetamphetamine (MDMA; "ecstasy") on neuronal transmitter transport and progression of experimental periodontitis in male Wistar rats. The rats were exposed to MDMA (10mg/kg/day i.p.) or saline five days a week for four consecutive weeks. Exposure to MDMA induced a significant reduction in the synaptosomal reuptake of serotonin, while the uptake of dopamine was significantly increased 24h after the last injection of MDMA. In contrast, the synaptosomal uptake of noradrenaline and the vesicular uptake through the vesicular monoamine transporter 2 were not affected. In the experiments of periodontitis development, ligature-induced periodontitis was induced three days prior to MDMA administration. Compared to controls, MDMA-treated rats developed significantly more periodontitis. In conclusion, our results show that long-term exposure to MDMA affects the serotonergic and dopaminergic transport systems in the rat brain and increased the susceptibility to the psychosomatic ailment periodontitis following disturbances of brain immune-regulatory systems. These results are interesting with respect to recent research showing that changes in neurotransmitter signalling may alter the reactivity of brain-controlled immunoregulatory systems controlling pathogenic microorganisms colonizing mucosal surfaces.
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Parrott AC, Sands HR, Jones L, Clow A, Evans P, Downey LA, Stalder T. Increased cortisol levels in hair of recent Ecstasy/MDMA users. Eur Neuropsychopharmacol 2014; 24:369-74. [PMID: 24333019 DOI: 10.1016/j.euroneuro.2013.11.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 10/22/2013] [Accepted: 11/17/2013] [Indexed: 01/11/2023]
Abstract
Previous research has revealed an acute 8-fold increase in salivary cortisol following self-administrated Ecstasy/MDMA in dance clubbers. It is currently not known to what extent repeated usage impacts upon activity of the hypothalamic-pituitary-adrenal axis over a more prolonged period of time. This study investigated the integrated cortisol levels in 3-month hair samples from recent Ecstasy/MDMA users and non-user controls. One hundred and one unpaid participants (53 males, 48 females; mean age 21.75 years) completed the University of East London recreational drug use questionnaire, modified to cover the past 3-months of usage. They comprised 32 light recent Ecstasy/MDMA users (1-4 times in last 3 months), 23 recent heavy MDMA users (+5 times in last 3 months), and 54 non-user controls. Volunteers provided 3 cm hair samples for cortisol analysis. Hair cortisol levels were observed to be significantly higher in recent heavy MDMA users (mean = 55.0 ± 80.1 pg/mg), compared to recent light MDMA users (19.4 ± 16.0 pg/mg; p=0.015), and to non-users (13.8 ± 6.1 pg/mg; p<0.001). Hence the regular use of Ecstasy/MDMA was associated with almost 4-fold raised hair cortisol levels, in comparison with non-user controls. The present results are consistent with the bio-energetic stress model for Ecstasy/MDMA, which predicts that repeated stimulant drug use may increase cortisol production acutely, and result in greater deposits of the hormone in hair. These data may also help explain the neurocognitive, psychiatric, and other psychobiological problems of some abstinent users. Future study design and directions for research concerning the psychoneuroendocrinological impact of MDMA are also discussed.
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Affiliation(s)
- A C Parrott
- Department of Psychology, Swansea University, Swansea SA2 8PP, Wales, UK; Centre for Human Psychopharmacology (CHP), Swinburne University, Australia.
| | - H R Sands
- Department of Psychology, Swansea University, Swansea SA2 8PP, Wales, UK
| | - L Jones
- Department of Psychology, Swansea University, Swansea SA2 8PP, Wales, UK
| | - A Clow
- Psychophysiology and Stress Research Group, Westminster University, London, UK
| | - P Evans
- Psychophysiology and Stress Research Group, Westminster University, London, UK
| | - L A Downey
- Department of Psychology, Swansea University, Swansea SA2 8PP, Wales, UK; Centre for Human Psychopharmacology (CHP), Swinburne University, Australia
| | - T Stalder
- Department of Psychology, Technical University of Dresden, Dresden, Germany
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Parrott AC, Moore DG, Turner JJD, Goodwin J, Min MO, Singer LT. MDMA and heightened cortisol: a neurohormonal perspective on the pregnancy outcomes of mothers used 'Ecstasy' during pregnancy. Hum Psychopharmacol 2014; 29:1-7. [PMID: 24424703 PMCID: PMC10187755 DOI: 10.1002/hup.2342] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 06/05/2013] [Accepted: 06/15/2013] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The illicit recreational drug 3,4-methylenedioxymethamphetamine (MDMA) or Ecstasy has strong neurohormonal effects. When taken by recreational users at dance clubs and raves, it can generate an 800% increase in the stress hormone cortisol, whereas drug-free users show chronically raised levels of cortisol. The aim here is to critically debate this neurohormonal influence for the children of pregnant MDMA-using mothers. METHODS High levels of cortisol are known to be damaging for neuropsychobiological well-being in adult humans. MDMA can damage foetal development in laboratory animals, and the prospective Drugs and Infancy Study was established to monitor the effects of MDMA taken recreationally by pregnant women. RESULTS The Drugs and Infancy Study revealed that young mothers, who took MDMA during the first trimester of pregnancy, gave birth to babies with significant gross psychomotor retardation. These mothers would have experienced high levels of cortisol due to Ecstasy/MDMA use, and since cortisol can cross the placenta, this is likely to have also occurred in the foetus. CONCLUSIONS In terms of causation, the developmental problems may reflect a combination of neurotransmitter and neurohormonal effects on the hypothalamic-pituitary-adrenal axis, with serotonergic activity being influenced by the high levels of cortisol.
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Affiliation(s)
- Andrew C Parrott
- Swansea University, Swansea, UK; Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia
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Roberts CA, Fairclough S, Fisk JE, Tames FT, Montgomery C. Electrophysiological indices of response inhibition in human polydrug users. J Psychopharmacol 2013; 27:779-89. [PMID: 23803689 DOI: 10.1177/0269881113492899] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Previous research in ecstasy users suggests impairment of various executive functions. In general, the executive function of response inhibition appears unaffected by ecstasy use. Nonetheless, it remains a possibility that cognitive tasks alone are not sensitive enough to pick up subtle changes in function. The current study sought to investigate behavioural measures of response inhibition and their electrophysiological correlates in drug users. Twenty ecstasy polydrug users, 20 non-ecstasy polydrug users and 20 drug naïve controls were recruited. Participants completed questionnaires about their background drug use, sleep quality, fluid intelligence and mood state. Each individual also completed a Go/NoGo response inhibition task whilst electroencephalography (EEG) measures were recorded. Analysis of variance (ANOVA) revealed that there were no between-group differences on the behavioural measure of response inhibition. Multivariate analysis of variance (MANOVA) revealed no main effect of group across midline electrodes for the P3, N2 and P2 components. Univariate ANOVA revealed significant between-group differences in the P2 component with the ecstasy user group having a significantly higher mean amplitude than drug naïve controls at two midline frontal electrodes: at Fz and significantly higher mean amplitude than both control groups at FCz. The present study provides evidence of atypical early processing in ecstasy users that is suggestive of compensatory mechanisms ameliorating any behavioural differences.
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Affiliation(s)
- C A Roberts
- School of Natural Sciences and Psychology, Liverpool John Moores University, Liverpool, UK
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Kuypers KPC, de la Torre R, Farre M, Pujadas M, Ramaekers JG. Inhibition of MDMA-induced increase in cortisol does not prevent acute impairment of verbal memory. Br J Pharmacol 2013; 168:607-17. [PMID: 22946487 PMCID: PMC3579237 DOI: 10.1111/j.1476-5381.2012.02196.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Revised: 07/31/2012] [Accepted: 08/08/2012] [Indexed: 01/20/2023] Open
Abstract
Background Ecstasy use is commonly linked with memory deficits in abstinent ecstasy users. Similar impairments are being found during ecstasy intoxication after single doses of ± 3,4 metylenedioxymethamphetamine (MDMA). The concordance of memory impairments during intoxication and abstinence suggests a similar neuropharmacological mechanism underlying acute and chronic memory impairments. The mechanism underlying this impairment is to date not known. We hypothesized that cortisol might play an important role in this mechanism as cortisol, implicated in the regulation of memory performance, can be brought out of balance by stressors like MDMA. Methods In the present study, we aimed to block the MDMA-induced acute memory defect by giving participants a cortisol synthesis inhibitor (metyrapone) together with a single dose of MDMA. Seventeen polydrug MDMA users entered this placebo-controlled within subject study with four treatment conditions. The treatments consisted of MDMA (75 mg) and metyrapone (750 mg), alone and in combination, and double placebo. Pre-treatment with metyrapone or Placebo occurred 1 h prior to MDMA or Placebo administration. Memory performance was tested at peak drug concentrations by means of several memory tests. Cortisol levels were determined in blood and oral fluid; this served as a control measure to see whether manipulations were effective. Results Main findings indicated that whereas treatment with metyrapone blocked the expected MDMA-induced increase in cortisol levels in blood, it did not prevent the MDMA-induced memory deficit from happening. Conclusion We therefore conclude that MDMA-induced increments in cortisol concentrations are not related to MDMA-induced memory impairments.
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Affiliation(s)
- K P C Kuypers
- Department of Neuropsychology & Psychopharmacology, Faculty of Psychology & Neuroscience, Maastricht University, Maastricht, The Netherlands.
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Parrott AC. MDMA, serotonergic neurotoxicity, and the diverse functional deficits of recreational 'Ecstasy' users. Neurosci Biobehav Rev 2013; 37:1466-84. [PMID: 23660456 DOI: 10.1016/j.neubiorev.2013.04.016] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 04/19/2013] [Accepted: 04/28/2013] [Indexed: 11/18/2022]
Abstract
Serotonergic neurotoxicity following MDMA is well-established in laboratory animals, and neuroimaging studies have found lower serotonin transporter (SERT) binding in abstinent Ecstasy/MDMA users. Serotonin is a modulator for many different psychobiological functions, and this review will summarize the evidence for equivalent functional deficits in recreational users. Declarative memory, prospective memory, and higher cognitive skills are often impaired. Neurocognitive deficits are associated with reduced SERT in the hippocampus, parietal cortex, and prefrontal cortex. EEG and ERP studies have shown localised reductions in brain activity during neurocognitive performance. Deficits in sleep, mood, vision, pain, psychomotor skill, tremor, neurohormonal activity, and psychiatric status, have also been demonstrated. The children of mothers who take Ecstasy/MDMA during pregnancy have developmental problems. These psychobiological deficits are wide-ranging, and occur in functions known to be modulated by serotonin. They are often related to lifetime dosage, with light users showing slight changes, and heavy users displaying more pronounced problems. In summary, abstinent Ecstasy/MDMA users can show deficits in a wide range of biobehavioral functions with a serotonergic component.
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Affiliation(s)
- Andrew C Parrott
- Department of Psychology, Swansea University, Swansea, SA2 8PP, South Wales, United Kingdom; Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia.
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Altered pain responses in abstinent (±)3,4-methylenedioxymethamphetamine (MDMA, "ecstasy") users. Psychopharmacology (Berl) 2011; 217:475-84. [PMID: 21603895 DOI: 10.1007/s00213-011-2303-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Accepted: 04/04/2011] [Indexed: 01/14/2023]
Abstract
RATIONALE (±)3,4-Methylenedioxymethamphetamine (MDMA) is a popular recreational drug that has potential to damage brain serotonin (5-HT) neurons in humans. Brain 5-HT neurons play a role in pain modulation, yet little is known about long-term effects of MDMA on pain function. Notably, MDMA users have been shown to have altered sleep, a phenomenon that can lead to altered pain modulation. OBJECTIVES This study sought to assess pain processing in MDMA users using objective methods, and explore potential relationships between pain processing and sleep indices. METHODS Forty-two abstinent MDMA users and 43 age-matched controls participated in a 5-day inpatient study. Outcome measures included standardized measures of pain, sleep polysomnograms, and power spectral measures of the sleep EEG. When differences in psychophysiological measures of pain were found, the relationship between pain and sleep measures was explored. RESULTS MDMA users demonstrated lower pressure pain thresholds, increased cold pain ratings, increased pain ratings during testing of diffuse noxious inhibitory control, and decreased Stage 2 sleep. Numerous significant relationships between sleep and pain measures were identified, but differences in sleep between the two groups were not found to mediate altered pain perception in MDMA users. CONCLUSIONS Abstinent MDMA users have altered pain perception and sleep architecture. Although pain and sleep outcomes were related, differences in sleep architecture in MDMA users did not mediate altered pain responses. It remains to be determined whether alterations in pain perception in MDMA users are secondary to neurotoxicity of 5-HT-mediated pain pathways or alterations in other brain processes that modulate pain perception.
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Mohamed WM, Hamida SB, Cassel JC, de Vasconcelos AP, Jones BC. MDMA: Interactions with other psychoactive drugs. Pharmacol Biochem Behav 2011; 99:759-74. [DOI: 10.1016/j.pbb.2011.06.032] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Revised: 05/10/2011] [Accepted: 06/28/2011] [Indexed: 10/18/2022]
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Methylenedioxymethamphetamine (MDMA, 'Ecstasy'): Neurodegeneration versus Neuromodulation. Pharmaceuticals (Basel) 2011. [PMCID: PMC4058674 DOI: 10.3390/ph4070992] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The amphetamine analogue 3,4-methylenedioxymethamphetamine (MDMA, ‘ecstasy’) is widely abused as a recreational drug due to its unique psychological effects. Of interest, MDMA causes long-lasting deficits in neurochemical and histological markers of the serotonergic neurons in the brain of different animal species. Such deficits include the decline in the activity of tryptophan hydroxylase in parallel with the loss of 5-HT and its main metabolite 5-hydoxyindoleacetic acid (5-HIAA) along with a lower binding of specific ligands to the 5-HT transporters (SERT). Of concern, reduced 5-HIAA levels in the CSF and SERT density have also been reported in human ecstasy users, what has been interpreted to reflect the loss of serotonergic fibers and terminals. The neurotoxic potential of MDMA has been questioned in recent years based on studies that failed to show the loss of the SERT protein by western blot or the lack of reactive astrogliosis after MDMA exposure. In addition, MDMA produces a long-lasting down-regulation of SERT gene expression; which, on the whole, has been used to invoke neuromodulatory mechanisms as an explanation to MDMA-induced 5-HT deficits. While decreased protein levels do not necessarily reflect neurodegeneration, the opposite is also true, that is, neuroregulatory mechanisms do not preclude the existence of 5-HT terminal degeneration.
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Are ecstasy users biased toward endorsing somatic mental health symptoms? Results from a general community sample. Psychopharmacology (Berl) 2011; 214:901-9. [PMID: 21140259 DOI: 10.1007/s00213-010-2100-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Accepted: 11/08/2010] [Indexed: 10/18/2022]
Abstract
RATIONALE Whether the reported poorer mental health of ecstasy users is due to a bias in endorsement of somatic symptoms has been postulated, but rarely examined. OBJECTIVES The purpose of this study is to investigate whether levels of ecstasy use were associated with differential probabilities of endorsing somatic mental health symptoms. METHODS Current ecstasy users aged 24-30 years (n = 316) were identified from a population-based Australian study. Measures included frequency of ecstasy, meth/amphetamine, and cannabis use and the Goldberg anxiety/depression symptom scales. RESULTS Multiple indicator, multiple cause models demonstrated no bias towards endorsing somatic symptoms with higher ecstasy use, both with and without adjustment for gender, cannabis, and meth/amphetamine use. CONCLUSIONS Other studies using alternate measures of mental health should adopt this approach to determine if there is a bias in the endorsement of somatic symptoms among ecstasy users.
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Hanson KL, Luciana M. Neurocognitive impairments in MDMA and other drug users: MDMA alone may not be a cognitive risk factor. J Clin Exp Neuropsychol 2010; 32:337-49. [PMID: 20397296 DOI: 10.1080/13803390903042361] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND MDMA (3,4-methylenedioxymethamphetamine; "Ecstasy") is an amphetamine derivative with mild hallucinogenic and stimulant qualities. MDMA leads to serotonin (5-hydroxytryptamine; 5-HT) neurotoxicity and has been linked to cognitive impairments. It remains unclear whether these impairments are due to MDMA versus other drug use. METHOD Neurocognitive functioning was measured in a sample of abstinent polydrug users (n = 52) with a range of MDMA use and healthy nondrug controls (n = 29). Participants completed a comprehensive neuropsychological battery and self-report measures of drug use. RESULTS Polydrug users performed worse than controls on spatial span and spatial working memory (ps < .05). Among polydrug users, lifetime marijuana use significantly predicted verbal learning and memory performance (p < .01), while MDMA use was not predictive of cognitive impairment. CONCLUSIONS This study and our previous report (Hanson, Luciana, & Sullwold, 2008) suggest that moderate MDMA use does not lead to persistent impairments above and beyond that associated with generally heavy drug use, but polydrug use may lead to dose-related temporal and frontoparietal dysfunction. Marijuana use may be particularly problematic. Cause-effect relations are unclear.
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Affiliation(s)
- Karen L Hanson
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
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Roderique-Davies G, Shearer D. Estimated lifetime drug use, impulsivity, and psychopathology in recreational ecstasy users. JOURNAL OF SUBSTANCE USE 2010. [DOI: 10.3109/14659890903271616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Egan ST, Kambouropoulos N, Staiger PK. Rash-impulsivity, reward-drive and motivations to use ecstasy. PERSONALITY AND INDIVIDUAL DIFFERENCES 2010. [DOI: 10.1016/j.paid.2010.01.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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GEORGE JESSICA, KINNER STUARTA, BRUNO RAIMONDO, DEGENHARDT LOUISA, DUNN MATTHEW. Contextualising psychological distress among regular ecstasy users: The importance of sociodemographic factors and patterns of drug use. Drug Alcohol Rev 2010; 29:243-9. [DOI: 10.1111/j.1465-3362.2009.00159.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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McCann UD, Sgambati FP, Schwartz AR, Ricaurte GA. Sleep apnea in young abstinent recreational MDMA ("ecstasy") consumers. Neurology 2009; 73:2011-7. [PMID: 19955499 DOI: 10.1212/wnl.0b013e3181c51a62] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Methylenedioxymethamphetamine (MDMA, "ecstasy") is a popular recreational drug of abuse and a selective brain serotonin neurotoxin. Functional consequences of MDMA neurotoxicity have defied ready characterization. Obstructive sleep apnea (OSA) is a common form of sleep-disordered breathing in which brain serotonin dysfunction may play a role. The present study sought to determine whether abstinent recreational MDMA users have an increased prevalence of OSA. METHODS We studied 71 medically healthy recreational MDMA users and 62 control subjects using all-night sleep polysomnography in a controlled inpatient research setting. Rates of apneas, hypopneas, and apnea hypopnea indices were compared in the 2 groups, controlling for body mass index, age, race, and gender. RESULTS Recreational MDMA users who had been drug free for at least 2 weeks had significantly increased rates of obstructive sleep apnea and hypopnea compared with controls. The odds ratio (95% confidence interval) for sleep apnea (mild, moderate, and severe combined) in MDMA users during non-REM sleep was 8.5 (2.4-30.4), which was greater than that associated with obesity [6.9 (1.7-28.2)]. Severity of OSA was significantly related to lifetime MDMA exposure. CONCLUSIONS These findings suggest that prior recreational methylenedioxymethamphetamine use increases the risk for obstructive sleep apnea and lend support to the notion that brain serotonin neuronal dysfunction plays a role in the pathophysiology of sleep apnea.
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Affiliation(s)
- Una D McCann
- Department of Psychiatry, The Johns Hopkins School of Medicine, Baltimore, MD 21224, USA.
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Parrott A. Cortisol and 3,4-methylenedioxymethamphetamine: neurohormonal aspects of bioenergetic stress in ecstasy users. Neuropsychobiology 2009; 60:148-58. [PMID: 19893332 PMCID: PMC2826870 DOI: 10.1159/000253551] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
AIMS 3,4-Methylenedioxymethamphetamine (MDMA) can affect both neurotransmitter and neurohormonal activity. This review will debate the role of the metabolic activation hormone cortisol for the psychobiological effects of ecstasy/MDMA. METHODS The empirical literature on cortisol release following acute MDMA administration and cortisol functioning in drug-free recreational ecstasy/MDMA users will be reviewed. This will be followed by an overview of cortisol as a bioenergetic stress neurohormone, and a debate on how it could be modulating the acute and chronic psychobiological effects of MDMA. RESULTS Cortisol release is increased by stimulatory factors, including physical activity, thermal stress and stimulant drugs. In laboratory studies MDMA leads to an acute cortisol increase of around 150% in sedentary humans. In MDMA-using dance clubbers, the cortisol levels are increased by around 800%, possibly due to the combined factors of stimulant drug, physical exertion and psychosocial stimulation. Regular ecstasy/MDMA users also demonstrate changes in baseline cortisol levels and cortisol reactivity, with compromised hypothalamic-pituitary-adrenal activity. Nonpharmacological research has shown how cortisol is important for psychological aspects such as memory, cognition, sleep, impulsivity, depression and neuronal damage. These same functions are often impaired in recreational ecstasy/MDMA users, and cortisol may be an important modulatory co-factor. CONCLUSIONS The energizing hormone cortisol is involved in the psychobiology of MDMA, probably via its effects on energy metabolism. Acute cortisol release may potentiate the stimulating effects of MDMA in dance clubbers. Chronically, cortisol may contribute to the variance in functional and structural consequences of repeated ecstasy usage.
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Affiliation(s)
- A.C. Parrott
- *Prof. A.C. Parrott, Department of Psychology, Swansea University, Swansea SA2 8PP (UK), Tel. +44 1792 295 271, E-Mail
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Allott K, Canny BK, Broadbear JH, Stepto NK, Murphy B, Redman J. Neuroendocrine and subjective responses to pharmacological challenge with citalopram: a controlled study in male and female ecstasy/MDMA users. J Psychopharmacol 2009; 23:759-74. [PMID: 18562414 DOI: 10.1177/0269881108092336] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Despite evidence that +/-3,4-methylenedioxymethamphetamine (MDMA; 'ecstasy') causes persistent alterations to the serotonergic system of animals, evidence for long-term neurological effects of ecstasy/MDMA in humans remains equivocal. The current study assessed serotonin functioning of nine male and 11 female recreational ecstasy polydrug users by measuring neuroendocrine (prolactin, cortisol) responses to pharmacological challenge with the selective serotonin reuptake inhibitor citalopram, compared with nine male and five female cannabis polydrug users and 11 male and 11 female non-drug using controls. A single-blind, randomised, placebo-controlled design was used. Subjective responses, other substance use, mood, personality traits and demographic variables were measured to control for potentially confounding variables. There were no significant differences between ecstasy polydrug users, cannabis polydrug users and non-drug using controls in neuroendocrine or subjective responses to serotonergic challenge, and there were no sex by drug group interactions. There was no relationship between extent of ecstasy use and neuroendocrine functioning, alone or in combination with potential confounding variables. Subjective responses to the pharmacological challenge (nausea, tremor, dry mouth), novelty seeking and lifetime dose of alcohol were the only variables that contributed to one or more of the neuroendocrine outcome variables. These data do not support the premise that recreational ecstasy/MDMA use results in measurable impairment of serotonergic control of endocrine activity.
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Affiliation(s)
- K Allott
- School of Psychology, Psychiatry and Psychological Medicine, Monash University, Melbourne, Victoria, Australia.
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Long-term neurobiological consequences of ecstasy: a role for pre-existing trait-like differences in brain monoaminergic functioning? Pharmacol Biochem Behav 2009; 94:227-33. [PMID: 19699758 DOI: 10.1016/j.pbb.2009.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2009] [Revised: 07/31/2009] [Accepted: 08/13/2009] [Indexed: 11/24/2022]
Abstract
This study investigated whether trait-like differences in brain monoaminergic functioning relate to differential vulnerability for the long-term neurochemical depletion effects of MDMA. Genetically selected aggressive (SAL) and non-aggressive (LAL) house-mice differing in baseline serotonergic and dopaminergic neurotransmission were administered MDMA. An acute binge-like MDMA injection protocol (three times, using either of the dosages of 0, 5, 10 and 20mg/kg i.p. with 3h interval) was employed. Three and 28 days after treatment with MDMA induced a dose-dependent depletion of striatal dopamine and its metabolites that did not differ between SAL and LAL mice. Similarly, the dose-dependent MDMA-induced serotonergic depletion did not differ between lines 3 days after treatment. Interestingly, 28 days after MDMA in LAL mice, 5-HT and 5-HIAA levels were still significantly depleted after treatment with 3x10 mg/kg, while in SAL mice 5-HT depletion was only seen after the highest dosage. Surprisingly, LAL mice did not show any long-term 5-HT depletion after treatment with the highest dose. In conclusion, only LAL mice are able to restore initial severe loss of MDMA-evoked 5-HT and 5-HIAA levels. SAL and LAL mice are differentially susceptible for the long-term but not short-term MDMA-induced serotonergic depletion in the striatum. The differentiation between both lines in the long-term striatal serotonergic response to MDMA seems to depend on the capacity of the brain to adapt to the short-term depletion of monoaminergic levels and may somehow be related to individual, trait-like characteristics of brain monoaminergic systems.
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Baumann MH, Rothman RB. Neural and cardiac toxicities associated with 3,4-methylenedioxymethamphetamine (MDMA). INTERNATIONAL REVIEW OF NEUROBIOLOGY 2009; 88:257-96. [PMID: 19897081 DOI: 10.1016/s0074-7742(09)88010-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
(+/-)-3,4-Methylenedioxymethamphetamine (MDMA) is a commonly abused illicit drug which affects multiple organ systems. In animals, high-dose administration of MDMA produces deficits in serotonin (5-HT) neurons (e.g., depletion of forebrain 5-HT) that have been viewed as neurotoxicity. Recent data implicate MDMA in the development of valvular heart disease (VHD). The present paper reviews several issues related to MDMA-associated neural and cardiac toxicities. The hypothesis of MDMA neurotoxicity in rats is evaluated in terms of the effects of MDMA on monoamine neurons, the use of scaling methods to extrapolate MDMA doses across species, and functional consequences of MDMA exposure. A potential treatment regimen (l-5-hydroxytryptophan plus carbidopa) for MDMA-associated neural deficits is discussed. The pathogenesis of MDMA-associated VHD is reviewed with specific reference to the role of valvular 5-HT(2B) receptors. We conclude that pharmacological effects of MDMA occur at the same doses in rats and humans. High doses of MDMA that produce 5-HT depletions in rats are associated with tolerance and impaired 5-HT release. Doses of MDMA that fail to deplete 5-HT in rats can cause persistent behavioral dysfunction, suggesting even moderate doses may pose risks. Finally, the MDMA metabolite, 3,4-methylenedioxyamphetamine (MDA), is a potent 5-HT(2B) agonist which could contribute to the increased risk of VHD observed in heavy MDMA users.
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Affiliation(s)
- Michael H Baumann
- Clinical Psychopharmacology Section, Intramural Research Program (IRP), National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH), Baltimore, Maryland 21224, USA
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Scheier LM, Abdallah AB, Inciardi JA, Copeland J, Cottler LB. Tri-city study of Ecstasy use problems: a latent class analysis. Drug Alcohol Depend 2008; 98:249-63. [PMID: 18674872 PMCID: PMC2630416 DOI: 10.1016/j.drugalcdep.2008.06.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2007] [Revised: 05/30/2008] [Accepted: 06/05/2008] [Indexed: 10/21/2022]
Abstract
This study used latent class analysis to examine distinctive subtypes of Ecstasy users based on 24 abuse and dependence symptoms underlying standard DSM-IV criteria. Data came from a three site, population-based, epidemiological study to examine diagnostic nosology for Ecstasy use. Subject inclusion criteria included lifetime Ecstasy use exceeding five times and once in the past year, with participants ranging in age between 16 and 47 years of age from St. Louis, Miami, U.S. and Sydney, Australia. A satisfactory model typified four latent classes representing clearly differentiated diagnostic clusters including: (1) a group of sub-threshold users endorsing few abuse and dependence symptoms (negatives), (2) a group of 'diagnostic orphans' who had characteristic features of dependence for a select group of symptoms (mild dependent), (3) a 'transitional group' mimicking the orphans with regard to their profile of dependence also but reporting some abuse symptoms (moderate dependent), and (4) a 'severe dependent' group with a distinct profile of abuse and dependence symptoms. A multinomial logistic regression model indicated that certain latent classes showed unique associations with external non-diagnostic markers. Controlling for demographic characteristics and lifetime quantity of Ecstasy pill use, criminal behavior and motivational cues for Ecstasy use were the most efficient predictors of cluster membership. This study reinforces the heuristic utility of DSM-IV criteria applied to Ecstasy but with a different collage of symptoms that produced four distinct classes of Ecstasy users.
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Affiliation(s)
- Lawrence M. Scheier
- LARS Research Institute, Inc., Las Vegas, Nevada USA 89135,Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Arbi Ben Abdallah
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - James A. Inciardi
- Center for Drug and Alcohol Studies, University of Delaware, 2131 Ponce de Leon Blvd., Suite 430, Coral Gables, FL 33134
| | - Jan Copeland
- National Drug and Alcohol Research Center, University of New South Wales, 2052 Randwick Campus, 23 – 32 King Street, Randwick NSW 2031 Australia
| | - Linda B. Cottler
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA,Address Correspondence to: Washington University School of Medicine, Department of Psychiatry, Epidemiology and Prevention Research Group (EPRG), 40 North Kingshighway, Suite 4, St. Louis, Missouri, 63108 USA. Tel.: (314) 286-2252, Fax: (314) 286-2265, E-mail:
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Keyes KM, Martins SS, Hasin DS. Past 12-month and lifetime comorbidity and poly-drug use of ecstasy users among young adults in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Drug Alcohol Depend 2008; 97:139-49. [PMID: 18524499 PMCID: PMC3771490 DOI: 10.1016/j.drugalcdep.2008.04.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2008] [Revised: 04/02/2008] [Accepted: 04/09/2008] [Indexed: 11/20/2022]
Abstract
BACKGROUND Ecstasy use is prevalent among young people and often co-occurs with other drug use, but little is known about the past 12-month and lifetime psychiatric comorbidity and specific additional drug abuse among young adult ecstasy users in the general population. To provide this information, we compared current ecstasy users to former users, other illicit drug users, and non-illicit drug users. METHOD Data were gathered in a face-to-face survey of the United States conducted in the 2001-2002 (NESARC). Participants were household and group quarters residents aged 18-29 years (n=8666). We measured current ecstasy use defined as any use in the past year; former ecstasy use as use prior to the past year only; other lifetime drug use included any drug other than ecstasy; lifetime non-illicit drug use as no illicit drug use. Associations were determined for nine other classes of illicit drugs, eight personality disorders, and seven mood and anxiety disorders. RESULTS Of current ecstasy users, 44% used >3 other classes of illicit drugs in the past year, compared to 1.6% of non-ecstasy drug users. Current ecstasy use was associated with current anxiety (OR=3.7), specifically panic disorder (OR=7.7) and specific phobia (OR=4.1), also alcohol abuse (OR=21.6) and dependence (OR=4.1) and any personality disorder (OR=5.1) compared to non-illicit drug users. CONCLUSIONS Results indicate important differences in comorbidities of current and former ecstasy users compared to other drug users and lifetime non-illicit drug users that may affect phenotype definitions and etiologic studies. Ecstasy use may represent a distinct population of drug users for which unique treatments may be necessary.
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Affiliation(s)
- Katherine M. Keyes
- New York State Psychiatric Institute, New York, NY 10032, United States
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, United States
| | - Silvia S. Martins
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States
| | - Deborah S. Hasin
- New York State Psychiatric Institute, New York, NY 10032, United States
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, United States
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, United States
- Corresponding author at: Columbia University, New York State Psychiatric Institute, 1051 Riverside Drive #123, New York, NY 10032, United States. Tel.: +1 212 543 5035; fax: +1 212 543 5913
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Camarasa J, Marimón JM, Rodrigo T, Escubedo E, Pubill D. Memantine prevents the cognitive impairment induced by 3,4-methylenedioxymethamphetamine in rats. Eur J Pharmacol 2008; 589:132-9. [DOI: 10.1016/j.ejphar.2008.05.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2008] [Revised: 04/15/2008] [Accepted: 05/13/2008] [Indexed: 11/26/2022]
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Hanson KL, Luciana M, Sullwold K. Reward-related decision-making deficits and elevated impulsivity among MDMA and other drug users. Drug Alcohol Depend 2008; 96:99-110. [PMID: 18384979 PMCID: PMC2492887 DOI: 10.1016/j.drugalcdep.2008.02.003] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2007] [Revised: 02/02/2008] [Accepted: 02/06/2008] [Indexed: 11/16/2022]
Abstract
BACKGROUND The recreational drug, 3,4-methylenedioxymethamphetamine (MDMA; 'Ecstasy'), is a synthetic amphetamine derivative and a serotonin neurotoxin. MDMA use is associated with cognitive dysfunction and impulsivity, but since polydrug abuse is common among users it is difficult to attribute these problems specifically to MDMA. Moreover, few studies have examined reward-related cognitive processes. Our aim was to examine reward-related decision-making and impulsivity among MDMA users while controlling for polydrug use via appropriate comparison groups. METHODS We examined decision-making [Iowa Gambling Task, IGT; Bechara, A., Damasio, A.R., Damasio, H., Anderson, S.W., 1994. Insensitivity to future consequences following damage to human prefrontal cortex. Cognition 50, 7-15], self-reported impulsivity (Multidimensional Personality Questionnaire-Brief Form [constraint subscale]; Barratt Impulsiveness Scale; Zuckerman Sensation Seeking Scale), and drug use among 22 abstinent MDMA users, 30 other drug users, and 29 healthy non-drug controls. RESULTS MDMA and other drug users showed comparable patterns of decision-making and impulsivity. However, both drug groups demonstrated poorer IGT performance and elevated self-reported impulsivity relative to controls. Poorer decision-making was related to heavier drug use in the past year, heavier weekly alcohol use, and meeting lifetime substance use disorder (SUD) criteria for more drug classes. Elevated impulsivity was associated with heavier drug use, heavier weekly alcohol use, more lifetime SUDs, and higher self-reported depression levels. CONCLUSIONS These findings contradict the idea that MDMA is specifically associated with deficient decision-making. Drug users, in general, may be at risk for decision-making deficits and elevated impulsivity. Such behaviors may represent trait factors that lead to the initiation of drug and alcohol use, and/or they may represent behavior patterns that are exacerbated by extensive use.
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Affiliation(s)
- Karen L. Hanson
- University of California San Diego, Department of Psychiatry, San Diego, CA 92193, United States,San Diego State University, Department of Psychology, 92182, United States,VA San Diego Healthcare System, San Diego, CA 92161, United States,Corresponding author at: VA San Diego Healthcare System, 3350 La Jolla Village Drive (151B), San Diego, CA 92151, United States. Telephone: 1-858-552-8585 ext. 2663, Fax: 1-858-642-6340, (K.L. Hanson)
| | - Monica Luciana
- University of Minnesota, Department of Psychology, N218 Elliott Hall, 75 East River Road, Minneapolis, MN 55455, United States
| | - Kristin Sullwold
- University of Minnesota, Department of Psychology, N218 Elliott Hall, 75 East River Road, Minneapolis, MN 55455, United States
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Durdle H, Lundahl LH, Johanson CE, Tancer M. Major depression: the relative contribution of gender, MDMA, and cannabis use. Depress Anxiety 2008; 25:241-7. [PMID: 17345601 DOI: 10.1002/da.20297] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Previous research has suggested that 3,4-methylenedioxymethamphetamine (MDMA; ecstasy) users have elevated depressive symptomatology, although it is not clear whether this is due to MDMA or other drug use. This study aimed to investigate the contributions of MDMA and cannabis use to Major Depressive Disorder in MDMA users. A total of 226 MDMA users were studied. Participants (65% male) reported an average number of 35.8 uses of MDMA (SD = 45.6, range = 2-400). Participants were administered a Structured Clinical Interview for DSM-IV. Twenty-six individuals (11.5%) met lifetime criteria for Major Depressive Disorder. High rates of lifetime Cannabis Abuse (30.1%) and Cannabis Dependence (12.4%) were reported. No association was found between number of uses of MDMA and Major Depressive Disorder. Those with lifetime major depression were found, however, to have higher rates of lifetime cannabis use disorder (adjusted OR = 2.40). A logistic regression indicated that lifetime cannabis use disorder, but not MDMA use, was significantly associated with lifetime Major Depressive Disorder. Stratified analyses suggested that for males, neither drug use variable was associated with major depression. For females, a lifetime cannabis use disorder (adjusted OR = 4.99), but not MDMA use, was associated with lifetime Major Depressive Disorder. Results of this study suggest that although MDMA use was not found to be significantly associated with major depression for either gender, a lifetime cannabis use disorder was significantly associated with lifetime major depression for female, but not male, users of MDMA.
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Affiliation(s)
- Heather Durdle
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan 48207, USA
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Thompson MR, Callaghan PD, Hunt GE, McGregor IS. Reduced sensitivity to MDMA-induced facilitation of social behaviour in MDMA pre-exposed rats. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32:1013-21. [PMID: 18302974 DOI: 10.1016/j.pnpbp.2008.01.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2007] [Revised: 01/24/2008] [Accepted: 01/24/2008] [Indexed: 10/22/2022]
Abstract
The acute effects of the party drug 3,4-methylenedioxymethamphetamine (MDMA, "Ecstasy") in humans include feelings of love, closeness towards other people and an increased acceptance of others views and feelings. Some evidence suggests that regular MDMA users develop a subsensitivity to the positive effects of the drug and escalate their intake of the drug over time as a result. The current study investigated whether brief exposure to relatively high doses of MDMA in rats produces a subsequent attenuation in the ability of MDMA to enhance social interaction. Male Wistar rats were exposed to either MDMA (4 x 5 mg/kg over 4 h) or vehicle on two consecutive days. Twelve weeks later, MDMA pre-exposed rats displayed a significantly shorter period of time spent in social interaction than controls when tested in the drug-free state. MDMA pre-exposed rats also showed a blunted prosocial response to MDMA (2.5 mg/kg) relative to controls. This difference was overcome by increasing the MDMA dose to 5 mg/kg. The 5-HT(1A) agonist 8-OH-DPAT (250 microg/kg but not 125 microg/kg) increased social interaction and this effect did not differ in MDMA and vehicle pre-exposed rats. HPLC analysis showed a small but significant depletion of prefrontal 5-HT and 5-HIAA in MDMA pre-exposed rats. Prefrontal 5-HIAA concentrations were also reduced in the subset of vehicle and MDMA pre-exposed rats that received additional testing with MDMA. These results indicate that treatment with MDMA not only causes lasting reductions in social interaction in rats but causes an attenuation of the prosocial effects of subsequent MDMA administration. The lack of a differential response to 8-OH-DPAT agrees with other findings that the 5-HT(1A) receptor system remains functionally intact following MDMA pre-exposure and suggests that other neuroadaptations may underlie the lasting social deficits caused by MDMA.
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Affiliation(s)
- Murray R Thompson
- School of Psychology, University of Sydney, A18, Sydney, NSW 2006, Australia
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Baumann MH, Clark RD, Franken FH, Rutter JJ, Rothman RB. Tolerance to 3,4-methylenedioxymethamphetamine in rats exposed to single high-dose binges. Neuroscience 2008; 152:773-84. [PMID: 18313226 PMCID: PMC2390896 DOI: 10.1016/j.neuroscience.2008.01.007] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2007] [Revised: 01/02/2008] [Accepted: 01/18/2008] [Indexed: 11/16/2022]
Abstract
3,4-Methylenedioxymethamphetamine (MDMA or ecstasy) stimulates the transporter-mediated release of monoamines, including 5-HT. High-dose exposure to MDMA causes persistent 5-HT deficits (e.g. depletion of brain 5-HT) in animals, yet the functional and clinical relevance of such deficits are poorly defined. Here we examine functional consequences of MDMA-induced 5-HT depletions in rats. Male rats received binges of three i.p. injections of MDMA or saline, one injection every 2 h; MDMA was given at a threshold pharmacological dose (1.5 mg/kgx3, low dose) or at a fivefold higher amount (7.5 mg/kgx3, high dose). One week later, jugular catheters and intracerebral guide cannulae were implanted. Two weeks after binges, rats received acute i.v. challenge injections of 1 and 3 mg/kg MDMA. Neuroendocrine effects evoked by i.v. MDMA (prolactin and corticosterone secretion) were assessed via serial blood sampling, while neurochemical effects (5-HT and dopamine release) were assessed via microdialysis in brain. MDMA binges elevated core temperatures only in the high-dose group, with these same rats exhibiting approximately 50% loss of forebrain 5-HT 2 weeks later. Prior exposure to MDMA did not alter baseline plasma hormones or dialysate monoamines, and effects of i.v. MDMA were similar in saline and low-dose groups. By contrast, rats pretreated with high-dose MDMA displayed significant reductions in evoked hormone secretion and 5-HT release when challenged with i.v. MDMA. As tolerance developed only in rats exposed to high-dose binges, hyperthermia and 5-HT depletion are implicated in this phenomenon. Our results suggest that MDMA tolerance in humans may reflect 5-HT deficits which could contribute to further dose escalation.
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Affiliation(s)
- M H Baumann
- Clinical Psychopharmacology Section, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, DHHS, 333 Cassell Drive, Suite 4500, Baltimore, MD 21224, USA.
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Cadet JL, Krasnova IN, Jayanthi S, Lyles J. Neurotoxicity of substituted amphetamines: Molecular and cellular mechanisms. Neurotox Res 2007; 11:183-202. [PMID: 17449459 DOI: 10.1007/bf03033567] [Citation(s) in RCA: 194] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The amphetamines, including amphetamine (AMPH), methamphetamine (METH) and 3,4-methylenedioxymethamphetamine (MDMA), are among abused drugs in the US and throughout the world. Their abuse is associated with severe neurologic and psychiatric adverse events including the development of psychotic states. These neuropsychiatric complications might, in part, be related to drug-induced neurotoxic effects, which include damage to dopaminergic and serotonergic terminals, neuronal apoptosis, as well as activated astroglial and microglial cells in the brain. The purpose of the present review is to summarize the toxic effects of AMPH, METH and MDMA. The paper also presents some of the factors that are thought to underlie this toxicity. These include oxidative stress, hyperthermia, excitotoxicity and various apoptotic pathways. Better understanding of the cellular and molecular mechanisms involved in their toxicity should help to generate modern therapeutic approaches to prevent or attenuate the long-term consequences of amphetamine use disorders in humans.
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Affiliation(s)
- Jean Lud Cadet
- Molecular Neuropsychiatry Branch, DHHS/NIH/NIDA, Intramural Research Program, 5500 Nathan Shock Drive, Baltimore, Maryland 21224, USA.
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McCann UD, Peterson SC, Ricaurte GA. The effect of catecholamine depletion by alpha-methyl-para-tyrosine on measures of cognitive performance and sleep in abstinent MDMA users. Neuropsychopharmacology 2007; 32:1695-706. [PMID: 17203011 DOI: 10.1038/sj.npp.1301302] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
(+/-) 3, 4-Methylenedioxymethamphetamine (MDMA) is a popular recreational drug of abuse and a brain serotonin (5-HT) neurotoxin in animals. Growing evidence suggests that humans who use MDMA recreationally can also develop 5-HT neurotoxic injury, although functional consequences have been difficult to identify. Twenty-five abstinent MDMA users and 23 non-MDMA using controls were studied to determine whether pharmacologic depletion of brain catecholamines by alpha-methyl-para-tyrosine (AMPT) would differentially effect MDMA users on measures of cognition and sleep, two processes dually modulated by brain serotonergic and catecholaminergic neurons. During a 5-day in-patient study, all subjects underwent formal neuropsychiatric testing, repeated computerized cognitive testing, and all-night sleep studies. At baseline, MDMA users had performance deficits on tasks of verbal and visuospatial working memory and displayed increased behavioral impulsivity on several computerized tasks, reflecting a tendency to perform quickly at the expense of accuracy. Baseline sleep architecture was also altered in abstinent MDMA users compared to controls. AMPT produced differential effects in MDMA users compared to controls on several cognitive and sleep measures. Differences in cognitive performance, impulsivity, and sleep were significantly correlated with MDMA use. These data extend findings from earlier studies demonstrating cognitive deficits, behavioral impulsivity, and sleep alterations in abstinent MDMA users, and suggest that lasting effects of MDMA lead to alterations in the ability to modulate behaviors reciprocally influenced by 5-HT and catecholamines. More research is needed to determine potential relationships between sleep abnormalities, cognitive deficits and impulsive behavior in abstinent MDMA users.
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Affiliation(s)
- Una D McCann
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine, Baltimore, MD 21224, USA.
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Guillot C. Is recreational ecstasy (MDMA) use associated with higher levels of depressive symptoms? J Psychoactive Drugs 2007; 39:31-9. [PMID: 17523583 DOI: 10.1080/02791072.2007.10399862] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Due to potential serotonergic deficits, 3,4-methylenedioxymethamphetamine (MDMA or Ecstasy) may cause long-term mood disruptions in recreational Ecstasy users. The purpose of this review is to evaluate the evidence for a relationship between recreational Ecstasy use and higher levels of depressive symptoms. Eleven out of 22 studies initially have reported significantly higher depression scores in Ecstasy users in comparison to control participants. However, only three studies ultimately have revealed significantly higher depression scores in comparison to cannabis or polydrug controls. Furthermore, most studies have suffered from methodological weaknesses, and the levels of depressive symptoms that have been found in Ecstasy users have not been shown to be much higher than those found in normative groups. The evidence for an association specifically between Ecstasy use and higher levels of depressive symptoms is currently unconvincing, but the frequent concomitant use of Ecstasy and other illicit drugs has been shown to be associated with higher levels of depressive symptoms. Possible causes include polydrug use in general, MDMA-induced serotonergic deficits, individual effects of illicit drugs besides Ecstasy, combined effects of MDMA and other illicit drugs, and preexisting differences in the levels of depressive symptoms in Ecstasy users.
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Affiliation(s)
- Casey Guillot
- University of Southern Mississippi Hattiesburg, MS, USA.
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Jans LAW, Riedel WJ, Markus CR, Blokland A. Serotonergic vulnerability and depression: assumptions, experimental evidence and implications. Mol Psychiatry 2007; 12:522-43. [PMID: 17160067 DOI: 10.1038/sj.mp.4001920] [Citation(s) in RCA: 277] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In recent years, the term serotonergic vulnerability (SV) has been used in scientific literature, but so far it has not been explicitly defined. This review article attempts to elucidate the SV concept. SV can be defined as increased sensitivity to natural or experimental alterations of the serotonergic (5-HTergic) system. Several factors that may disrupt the 5-HTergic system and hence contribute to SV are discussed, including genetic factors, female gender, personality characteristics, several types of stress and drug use. It is explained that SV can be demonstrated by means of manipulations of the 5-HTergic system, such as 5-HT challenges or acute tryptophan depletion (ATD). Results of 5-HT challenge studies and ATD studies are discussed in terms of their implications for the concept of SV. A model is proposed in which a combination of various factors that may compromise 5-HT functioning in one person can result in depression or other 5-HT-related pathology. By manipulating 5-HT levels, in particular with ATD, vulnerable subjects may be identified before pathology initiates, providing the opportunity to take preventive action. Although it is not likely that this model applies to all cases of depression, or is able to identify all vulnerable subjects, the strength of the model is that it may enable identification of vulnerable subjects before the 5-HT related pathology occurs.
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Affiliation(s)
- L A W Jans
- Faculty of Psychology, Department of Neurocognition, Maastricht University, Maastricht, The Netherlands.
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36
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Roiser JP, Rogers RD, Sahakian BJ. Neuropsychological function in ecstasy users: a study controlling for polydrug use. Psychopharmacology (Berl) 2007; 189:505-16. [PMID: 16163532 PMCID: PMC2653936 DOI: 10.1007/s00213-005-0101-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2005] [Accepted: 06/03/2005] [Indexed: 11/26/2022]
Abstract
RATIONALE 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. OBJECTIVE The aim of this study was to investigate neuropsychological function in chronic ecstasy users while controlling for polydrug use. METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Jonathan P Roiser
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 2QQ, UK
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37
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Allott K, Redman J. Are there sex differences associated with the effects of ecstasy/3,4-methylenedioxymethamphetamine (MDMA)? Neurosci Biobehav Rev 2007; 31:327-47. [PMID: 17109962 DOI: 10.1016/j.neubiorev.2006.09.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2006] [Revised: 09/28/2006] [Accepted: 09/28/2006] [Indexed: 11/25/2022]
Abstract
Sex has been identified as an important factor in moderating the effects of several drugs of abuse. Given the increasing popularity of ecstasy (3,4-methylenedioxymethamphetamine [MDMA]) use, it is important for researchers and clinicians to understand the factors that may influence its pharmacological actions to improve education, harm reduction and treatment efforts. This review focuses on preclinical and clinical research that examines the role of sex as an independent variable in the effects of ecstasy/MDMA. A systematic search of PsycINFO and MEDLINE electronic databases from 1966 to April 2006 was conducted. Both preclinical and clinical studies show a sexually dimorphic pattern in the acute, subacute and possibly long-term effects of ecstasy/MDMA. Specifically, adult females are more sensitive than males to the acute and subacute physical and psychological effects of ecstasy/MDMA and long-term alterations in aspects of 5-HT functioning. Conversely, males are more sensitive to the acute physiological effects of ecstasy/MDMA. These findings are consistent with research outcomes reported for other substances such as amphetamines and cocaine. Potential reasons for these sex differences and directions for future research are discussed.
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Affiliation(s)
- Kelly Allott
- Department of Psychology, Monash University, Vic. 3800, Australia.
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Baumann MH, Wang X, Rothman RB. 3,4-Methylenedioxymethamphetamine (MDMA) neurotoxicity in rats: a reappraisal of past and present findings. Psychopharmacology (Berl) 2007; 189:407-24. [PMID: 16541247 PMCID: PMC1705495 DOI: 10.1007/s00213-006-0322-6] [Citation(s) in RCA: 181] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2005] [Accepted: 01/07/2006] [Indexed: 12/30/2022]
Abstract
RATIONALE 3,4-Methylenedioxymethamphetamine (MDMA) is a widely abused illicit drug. In animals, high-dose administration of MDMA produces deficits in serotonin (5-HT) neurons (e.g., depletion of forebrain 5-HT) that have been interpreted as neurotoxicity. Whether such 5-HT deficits reflect neuronal damage is a matter of ongoing debate. OBJECTIVE The present paper reviews four specific issues related to the hypothesis of MDMA neurotoxicity in rats: (1) the effects of MDMA on monoamine neurons, (2) the use of "interspecies scaling" to adjust MDMA doses across species, (3) the effects of MDMA on established markers of neuronal damage, and (4) functional impairments associated with MDMA-induced 5-HT depletions. RESULTS MDMA is a substrate for monoamine transporters, and stimulated release of 5-HT, NE, and DA mediates effects of the drug. MDMA produces neurochemical, endocrine, and behavioral actions in rats and humans at equivalent doses (e.g., 1-2 mg/kg), suggesting that there is no reason to adjust doses between these species. Typical doses of MDMA causing long-term 5-HT depletions in rats (e.g., 10-20 mg/kg) do not reliably increase markers of neurotoxic damage such as cell death, silver staining, or reactive gliosis. MDMA-induced 5-HT depletions are accompanied by a number of functional consequences including reductions in evoked 5-HT release and changes in hormone secretion. Perhaps more importantly, administration of MDMA to rats induces persistent anxiety-like behaviors in the absence of measurable 5-HT deficits. CONCLUSIONS MDMA-induced 5-HT depletions are not necessarily synonymous with neurotoxic damage. However, doses of MDMA which do not cause long-term 5-HT depletions can have protracted effects on behavior, suggesting even moderate doses of the drug may pose risks.
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Affiliation(s)
- Michael H Baumann
- Clinical Psychopharmacology Section, Intramural Research Program (IRP), National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH), 5500 Nathan Shock Drive, Baltimore, MD 21224, USA.
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Abdallah AB, Scheier LM, Inciardi JA, Copeland J, Cottler LB. A psycho-economic model of ecstasy consumption and related consequences: a multi-site study with community samples. Subst Use Misuse 2007; 42:1651-84. [PMID: 17934989 DOI: 10.1080/10826080701208905] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Becker and Murphy's (1988) theory of rational behavior suggests that economic factors play an influential role in the decision leading to drug consumption and possibly dependence. Psychological models, on the other hand, emphasize internal regulatory cues that motivate drug use and play a contributory role in dependence. Until now, the confluence of both economic and psychological models has not been tested empirically. The present study used latent-variable structural equation modeling (SEM) to examine the influence of both economic (social anomie, unit price, and time spent acquiring drugs) and psychological risk factors (motivation, depression, and sexual risk behaviors) on self-reported ecstasy use. Data were obtained from 612 recreational ecstasy users in the United States and Australia participating in a NIDA-funded epidemiological study examining trends in ecstasy use. The sample was mainly white (61%), male (58%), and young (mean age = 23 yrs [5.25]). All of the hypothesized latent constructs were statistically reliable and correlated in the expected direction. A saturated SEM indicated that monetary and opportunity cost, but not income, significantly predicted ecstasy use. Among the psychological measures, motivational cues were the strongest predictor of both use and dependence. Inclusion of gender, age, race, education, and site variables did not appreciably alter the final model parameters. The implications of incorporating the role of economic factors in shaping a more refined understanding of addiction are discussed. Suggestions for future research and study limitations are also noted.
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Affiliation(s)
- Arbi Ben Abdallah
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri 63108, USA.
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40
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Martins SS, Mazzotti G, Chilcoat HD. Recent-onset ecstasy use: association with deviant behaviors and psychiatric comorbidity. Exp Clin Psychopharmacol 2006; 14:275-86. [PMID: 16893270 DOI: 10.1037/1064-1297.14.3.275] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Despite increases in ecstasy (MDMA) use in the United States, little is known about characteristics linked with recent-onset ecstasy use, especially psychiatric symptoms and deviant behaviors. AIMS To test whether individuals with high levels of other drug use are more likely to be recent-onset ecstasy users; to test whether psychiatric symptoms in adults are associated with recent-onset ecstasy use; to explore the association between recent-onset ecstasy use and concomitant deviant behaviors in adolescents and adults. METHODS Data from the 2001 National Survey on Drug Use and Health. FINDINGS Recent-onset ecstasy use was significantly more likely to occur among adolescents and adults (18-34 years old) who engaged in deviant behaviors during the past year as compared with those who did not engage in deviant behaviors during the past year. Higher levels of deviancy indicated a higher likelihood of being a recent-onset ecstasy user, and associations were strongest with nonviolent deviant behaviors such as selling illegal drugs and stealing. Associations between deviant behaviors and recent-onset ecstasy use were similar in strength to associations between deviant behaviors and recent-onset cocaine and marijuana use, respectively. Adults who had past-year psychiatric symptoms (both depressive and panic symptoms) were twice as likely to be recent-onset ecstasy users as compared with those without past-year psychiatric symptoms. Greater levels of drug involvement increased the odds of being a recent-onset ecstasy user. CONCLUSION Recent-onset ecstasy use seems to be associated with a range of other behavioral problems and may reflect one aspect of a larger problem behavior syndrome.
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Affiliation(s)
- Silvia S Martins
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205-1900, USA.
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White B, Day C, Degenhardt L, Kinner S, Fry C, Bruno R, Johnston J. Prevalence of injecting drug use and associated risk behavior among regular ecstasy users in Australia. Drug Alcohol Depend 2006; 83:210-7. [PMID: 16343810 DOI: 10.1016/j.drugalcdep.2005.11.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2005] [Revised: 11/09/2005] [Accepted: 11/09/2005] [Indexed: 11/20/2022]
Abstract
BACKGROUND The aim of the study was to investigate the prevalence of injecting drug use and associated risk behaviour among a sentinel sample of ecstasy users. METHODS Cross-sectional surveys were conducted with regular ecstasy users as part of an annual monitoring study of ecstasy and related drug markets in all Australian capital cities. RESULTS Twenty-three percent of the sample reported having ever injected a drug and 15% reported injecting in the 6 months preceding interview. Independent predictors of lifetime injection were older age, unemployment and having ever been in prison. Completion of secondary school and identifying as heterosexual was associated with a lower likelihood of having ever injected. Participants who had recently injected typically did so infrequently; only 9% reported daily injecting. Methamphetamine was the most commonly injected drug. Prevalence of needle sharing was low (6%), although half (47%) reported sharing other injecting equipment in the preceding 6 months. CONCLUSIONS Ecstasy users who report having injected a drug at some time appear to be demographically different to ecstasy users who have not injected although neither are they typical of other drug injectors. The current investigation suggests that ongoing monitoring of injecting among regular ecstasy users is warranted.
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Affiliation(s)
- Bethany White
- National Drug and Alcohol Research Centre, University of New South Wales, NSW 2052, Australia.
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Brevard ME, Meyer JS, Harder JA, Ferris CF. Imaging brain activity in conscious monkeys following oral MDMA ("ecstasy"). Magn Reson Imaging 2006; 24:707-14. [PMID: 16824965 DOI: 10.1016/j.mri.2006.03.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2005] [Accepted: 03/12/2006] [Indexed: 11/27/2022]
Abstract
Recreational use of 3,4-methylenedioxymethamphetamine (MDMA;"ecstasy") poses worldwide potential health problems. Clinical studies show that repeated exposure to low oral doses of MDMA has toxic effects on the brain, altering cognitive and psychosocial behavior. Functional magnetic resonance imaging in conscious marmoset monkeys was used to evaluate the sensitivity of the brain to an oral dose of MDMA (1 mg/kg). Following MDMA administration, the midbrain raphe nuclei and substantia nigra, major sources of serotonin and dopamine, were activated as were the hippocampus, hypothalamus and amygdala. The corticostriatal circuit of dorsal thalamus, sensorimotor cortex and basal ganglia showed a robust, coherent activation pattern. Two key reward areas, the nucleus accumbens and prefrontal cortex, and most other cortical regions showed little activation. The visual cortex, however, showed intense activation without applied visual stimuli. These data identify brain areas and functional circuits sensitive to a recreational dose of MDMA, some of which may be vulnerable to long-term intermittent exposure to this drug.
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Affiliation(s)
- Mathew E Brevard
- Center for Comparative Neuroimaging, University of Massachusetts Medical School, Worcester, MA 01655, USA.
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Verdejo-García A, Bechara A, Recknor EC, Pérez-García M. Executive dysfunction in substance dependent individuals during drug use and abstinence: an examination of the behavioral, cognitive and emotional correlates of addiction. J Int Neuropsychol Soc 2006; 12:405-15. [PMID: 16903133 DOI: 10.1017/s1355617706060486] [Citation(s) in RCA: 192] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Increasing evidence indicates that substance-dependent individuals (SDI) are impaired in executive control tasks relying on different systems within the prefrontal cortex (PFC). Three different functional systems have been described: the dorsolateral prefrontal cortex (DLPC), orbitofrontal cortex (OFC), and anterior cingulate cortex (ACC) circuits. Dysfunction within each PFC system is associated with different behavioral, cognitive, and emotional abnormalities. Few studies have conducted an exhaustive examination of all these different factors in SDI. In this study, SDI (including alcohol, cocaine, and methamphetamine polysubstance users, n=35) were compared with healthy controls (n=36) on a series of behavioral (Frontal Systems Behaviour Scale, FrSBe), cognitive (N-back, Go-No Go, and Wisconsin Card Sorting Tasks), and emotional (International Affective Picture System, IAPS) tasks, each of which was thought to tax a different component of these PFC functional systems. SDI showed greater behavioral problems in the apathy, disinhibition, and executive dysfunction subscales of the FrSBe. Behavioral deficits were significantly associated with several real-life domains in which SDI typically have problems. SDI also showed poorer performance on cognitive tests of working memory, response inhibition and mental flexibility, and abnormal processing of affective images from the IAPS. Cognitive, behavioral, and emotional measures were moderately correlated.
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Thomasius R, Zapletalova P, Petersen K, Buchert R, Andresen B, Wartberg L, Nebeling B, Schmoldt A. Mood, cognition and serotonin transporter availability in current and former ecstasy (MDMA) users: the longitudinal perspective. J Psychopharmacol 2006; 20:211-25. [PMID: 16510479 DOI: 10.1177/0269881106059486] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although 3,4-methylenedioxymethamphetamine (MDMA, ecstasy) is a known serotonergic neurotoxin in different animal species, there is to date no conclusive evidence of its neurotoxicity in humans. MDMA use was associated with impairments of psychological well-being, verbal memory and altered serotonergic functioning in a number of cross-sectional studies. Due to inherent methodological limitations, such as the notorious polydrug use of ecstasy users and lack of control of possible pre-existing differences between ecstasy users and control participants, researchers have called for well-controlled, prospective longitudinal studies to shed more light on the issue of MDMA neurotoxicity to the human brain. This longitudinal study investigated whether mood, cognition and central serotonin transporters (SERT) would deteriorate with continued MDMA use and whether or not they would recover over increasing periods of MDMA abstinence. In a repeated-measures design, 11 current and ten ex-ecstasy users, and 11 polydrug (but not MDMA) and 15 drug-naive controls participated three times within approximately two years. Both ecstasy user groups reported a polydrug use pattern besides heavy ecstasy use. Subjective reports of ecstasy use or abstinence were verified by toxicological analyses. On each trial, the participants underwent a cognitive test battery and filled in the Symptom Check List. The availability of central SERT was assessed with positron emission tomography using the McN5652 ligand for all groups at t1, and only for the ecstasy user groups on follow-ups. The factor Group yielded significant results in the SCL-90 scales Global Severity Index, Anxiety, Obsessive/compulsive and Interpersonal sensitivity, with the ex-ecstasy users reporting the highest symptom scores. There were significant Group effects in all measures of verbal memory, with the lowest performance in the group of ex-ecstasy users. The repeated-measures analyses yielded no significant Group x Time interactions in any SCL-90 scales or measures of memory performance, with the exception of AVLT 1 immediate recall. Thus the ex-ecstasy users' psychopathological symptoms and memory performance failed to improve, and the current ecstasy users' failed to deteriorate, over time relative to the other groups. While there was a significant effect of Group in all brain regions examined (except the control region white matter), the current users' SERT availability seems to have recovered in the mesencephalon, as indicated by a significant Group x Time interaction. Reduced SERT availability might be a transient effect of heavy ecstasy use, since it partially recovered as the current users reduced their MDMA use. However, this measure may not necessarily be a valid indicator of the number or integrity of serotonergic neurons. Ex-ecstasy users' verbal memory showed no sign of improvement even after over 2.5 years of abstinence and thus may represent persistent functional consequences of MDMA neurotoxicity. However, alternative causes such as pre-existing group differences cannot be completely ruled out in spite of the longitudinal design.
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Affiliation(s)
- R Thomasius
- Department of Psychiatry and Psychotherapy, University Hospital Hamburg-Eppendorf, Germany.
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Easton N, Marsden CA. Ecstasy: are animal data consistent between species and can they translate to humans? J Psychopharmacol 2006; 20:194-210. [PMID: 16510478 DOI: 10.1177/0269881106061153] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The number of 3,4-methylenedioxymethamphetamine (ecstasy or MDMA) animal research articles is rapidly increasing and yet studies which place emphasis on the clinical significance are limited due to a lack of reliable human data. MDMA produces an acute, rapid release of brain serotonin and dopamine in experimental animals and in the rat this is associated with increased locomotor activity and the serotonin behavioural syndrome in rats. MDMA causes dose-dependent hyperthermia, which is potentially fatal, in humans, primates and rodents. Subsequent serotonergic neurotoxicity has been demonstrated by biochemical and histological studies and is reported to last for months in rats and years in non-human primates. Relating human data to findings in animals is complicated by reports that MDMA exposure in mice produces selective long-term dopaminergic impairment with no effect on serotonin. This review compares data obtained from animal and human studies and examines the acute physiological, behavioural and biochemical effects of MDMA as well as the long-term behavioural effects together with serotonergic and dopaminergic impairments. Consideration is also given to the role of neurotoxic metabolites and the influence of age, sex and user groups on the long-term actions of MDMA.
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Affiliation(s)
- Neil Easton
- School of Biomedical Science, University of Nottingham, Queen's Medical Centre, UK.
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Huxster JK, Pirona A, Morgan MJ. The sub-acute effects of recreational ecstasy (MDMA) use: a controlled study in humans. J Psychopharmacol 2006; 20:281-90. [PMID: 16510486 DOI: 10.1177/0269881106060513] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
All previous studies of the sub-acute effects of ecstasy have failed to adequately control for group differences in psychopathology and past and concurrent substance use. The present study was designed to avoid these limitations. At an initial pre-drug baseline, a sample of 38 regular ecstasy users provided full substance histories and completed measures of personality and self-reported psychopathology. We then collected daily subjective measures of mood, cognitive impairment, restless sleep, sexual desire, craving for ecstasy and concomitant use of other substances for the next 9 days. The 20 participants who subsequently opted to take ecstasy during the 9-day assessment period reported modest sub-acute effects of ecstasy on negative mood and subjective cognitive impairment compared to those who did not after controlling for baseline group differences in psychopathology and frequency of ecstasy use. There were no significant sub-acute effects of ecstasy on interest in sexual activity or craving for ecstasy. After further controlling for co-use of alcohol with ecstasy, and the sub-acute effects of ecstasy on sleep, the sub-acute effect on mood remained marginally statistically significant but the subacute effect on cognitive impairment did not. The present findings suggest that the sub-acute effects of ecstasy in regular recreational users are relatively modest and transient but that such genuine effects may have been masked by, perhaps more clinically significant, chronic sequelae of regular ecstasy use in all previous studies of recreational ecstasy users.
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de Win MML, Schilt T, Reneman L, Vervaeke H, Jager G, Dijkink S, Booij J, van den Brink W. Ecstasy use and self-reported depression, impulsivity, and sensation seeking: a prospective cohort study. J Psychopharmacol 2006; 20:226-35. [PMID: 16510480 DOI: 10.1177/0269881106063275] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although there are indications that ecstasy users have higher levels of depression, impulsivity, and sensation seeking, it is unknown whether these are consequences of ecstasy use or predisposing factors for starting ecstasy use. We prospectively assessed the predictive value of depression, impulsivity, and sensation seeking on future first time ecstasy use. We also assessed whether depression, impulsivity, and sensation seeking had changed after first ecstasy use. Depression, impulsivity, and sensation seeking were assessed using self-report questionnaires in 188 ecstasy-naive volunteers with high probability for future ecstasy use. After a mean follow-up of 17 months, measurements were repeated in 59 incident ecstasy users (mean 6.0 tablets) and 61 matched persistent ecstasy-naive volunteers. Only experience seeking (subscale of the sensation seeking scale) predicted future ecstasy use (OR -- 1.05, 95% CI 1.00 to 1.10), but after adjustment for potential confounders this was not significant anymore. At follow-up, significant effects of ecstasy use on the general and the disinhibition subscale of the sensation seeking scale were observed (after adjustment for potential confounders: regression coefficient B 0.51, 95% CI 0.20 to 0.83 and B -- 3.25, 95% CI 1.74 to 4.76, respectively). These data indicate that depression, impulsivity, and sensation seeking do not predict first time ecstasy use in a population of young adults with the intention to start using ecstasy and that low level ecstasy use does not seem to cause depression or impulsivity. However, low level ecstasy use may increase (certain aspects of) sensation seeking.
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Affiliation(s)
- Maartje M L de Win
- Department of Radiology, University of Amsterdam, Academic Medical Center, The Netherlands.
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Gouzoulis-Mayfrank E, Daumann J. Neurotoxicity of methylenedioxyamphetamines (MDMA; ecstasy) in humans: how strong is the evidence for persistent brain damage? Addiction 2006; 101:348-61. [PMID: 16499508 DOI: 10.1111/j.1360-0443.2006.01314.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The popular dance drug ecstasy (3,4-methylenedioxymethamphetamine: MDMA and some analogues) causes selective and persistent neurotoxic damage of central serotonergic neurones in laboratory animals. Serotonin plays a role in numerous functional systems in the central nervous system (CNS). Consequently, various abnormalities including psychiatric, vegetative, neuroendocrine and cognitive disorders could be expected in humans following MDMA-induced neurotoxic brain damage. AIMS In recent years, the question of ecstasy-induced neurotoxicity and possible functional sequelae has been addressed in several studies with drug users. The aim of this paper was to review this literature and weigh the strength of the evidence for persistent brain damage in ecstasy users. METHODS We used Medline to view all available publications on 'ecstasy' or 'MDMA'. All available studies dealing with ecstasy users entered this analysis. FINDINGS AND CONCLUSIONS Despite large methodological problems the bulk of evidence suggests residual alterations of serotonergic transmission in MDMA users, although at least partial restitution may occur after long-term abstinence. However, functional sequelae may persist even after longer periods of abstinence. To date, the most consistent findings associate subtle cognitive, particularly memory, impairments with heavy ecstasy use. However, the evidence cannot be considered definite and the issues of possible pre-existing traits or the effects of polydrug use are not resolved. RECOMMENDATIONS Questions about the neurotoxic effects of ecstasy on the brain remain highly topical in light of its popularity among young people. More longitudinal and prospective studies are clearly needed in order to obtain a better understanding of the possible long-term sequelae of ecstasy use in humans.
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Thomasius R, Petersen KU, Zapletalova P, Wartberg L, Zeichner D, Schmoldt A. Mental disorders in current and former heavy ecstasy (MDMA) users. Addiction 2005; 100:1310-9. [PMID: 16128720 DOI: 10.1111/j.1360-0443.2005.01180.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Ecstasy use has often been found to be associated with psychopathology, yet this research has so far been based largely on subjective symptom ratings. AIMS To investigate whether ecstasy users suffered from long-term psychopathological consequences. MEASUREMENTS We compared the prevalence of Diagnostic and Statistical Manual version IV (DSM-IV) mental disorders in 30 current and 29 former ecstasy users, 29 polydrug and 30 drug-naive controls. Groups were approximately matched by age, gender and level of education. The current ecstasy users reported a life-time dose of an average of 821 and the former ecstasy users of 768 ecstasy tablets. FINDINGS Ecstasy users did not significantly differ from controls in the prevalence of mental disorders, except those related to substance use. Substance-induced affective, anxiety and cognitive disorders occurred more frequently among ecstasy users than polydrug controls. The life-time prevalence of ecstasy dependence amounted to 73% in the ecstasy user groups. More than half of the former ecstasy users and nearly half of the current ecstasy users met the criteria of substance-induced cognitive disorders at the time of testing. Logistic regression analyses showed the estimated life-time doses of ecstasy to be predictive of cognitive disorders, both current and life-time. CONCLUSIONS The motivation for ecstasy use is not likely to be self-medication of pre-existing depressive or anxiety disorders as these did not occur more frequently in the ecstasy users than in control groups or in the general population. Cognitive disorders still present after over 5 months of ecstasy abstinence may well be functional consequences of serotonergic neurotoxicity of 3,4-methylenedioxymethamphetamine (MDMA).
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Affiliation(s)
- R Thomasius
- Department of Psychiatry and Psychotherapy, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
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Casco C, Forcella M, Beretta G, Grieco A, Campana G. Long-term effects of MDMA (Ecstasy) on the human central nervous system revealed by visual evoked potentials. Addict Biol 2005; 10:187-95. [PMID: 16191672 DOI: 10.1080/13556210500123340] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Several studies indicate long-term cognitive impairment of MDMA (ecstasy) users. In the present study we attempted to establish whether electrophysiological correlates of low-level cognitive processes present a long-term alteration, dependent on the level of use of ecstasy. We addressed this issue by investigating amplitude and latency of VEPs related to a very simple discrimination task involving sustained attention (arousal). Eight heavy-MDMA users, eight moderate-MDMA users and 18 drug-free control subjects were asked to discriminate whether the digit at the centre of the screen was 1 or 2. None of the subjects (except one) had used MDMA in the 6 months previous testing. We measured psychophysical performance and EEG, recorded in Oz and Fz during task execution. The heavy-MDMA users made significantly more errors than the other two groups (p < .05). Moreover, they presented reduced amplitude but not latency of VEPs in both Oz and Fz. The effect in Oz is present in P200 (for heavy users only, p < .05) and in P300 components (for both MDMA groups; heavy users: p < .001, moderate users: p < .0.5). In Fz, the amplitude effect is present in N250 (for heavy users only, p < .05) and in P300 components (for both MDMA groups; heavy users: p < .05, moderate users: p < .05). The three groups do not differ in early components, reflecting low-level processing. These results provide evidence of long-term electrophysiological abnormality displayed by ecstasy users and agree with the suggestion that even typical recreational doses of ecstasy are sufficient to cause long-term altered cortical activity in humans.
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Affiliation(s)
- C Casco
- Dipartimento di Psicologia Generale, Universita' di Padova, Italy.
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