Cognitive performance and serotonergic function in users of ecstasy

Rationale: (+/-) 3,4-Methylenedioxymethamphetamine (MDMA or "ecstasy") has been shown to cause long term damage to serotonergic cerebral neurons in an imals. The neurotoxic effects in humans are less clear and little is known about the functional consequences, although some studies suggest memory imp airment. Given the widespread use of MDMA, our lack of knowledge raises con cerns. Objective: We investigated, in humans, the relation between past use of ecstasy and cognitive performance as well as serotonergic function. Met hods: Two groups of 21 males with moderate and heavy recreational use of MD MA, respectively, and a control group of 20 males without use of MDMA were compared. All were from the same subculture. Reaction time, direct recall, and recognition were assessed. Serotonergic function was measured by the ne uro-endocrine response to a placebo-controlled, crossover challenge with de xfenfluramine. Results: Ecstasy users showed a broad pattern of statistical ly significant, but clinically small, impairment of memory and prolonged re action times. Heavy users were affected stronger than moderate users. Relea se of cortisol but not of prolactin after dexfenfluramine administration wa s significantly reduced in both groups of ecstasy users compared with the c ontrols, Analyses of covariance showed that likely confounding variables in cluding recent exposure to ecstasy, psychosocial profiles and use of other drugs did not explain the differences found between the groups. Conclusions : These results provide further evidence that use of ecstasy may be associa ted with impairment of memory and of serotonergic function. These findings are compatible with neurotoxicity of ecstasy as shown in animals.