Increase in serious ecstasy-related incidents in the Netherlands

The Lancet (Impact Factor: 45.22). 10/2012; 380(9851):1385. DOI: 10.1016/S0140-6736(12)61800-5
Source: PubMed
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    ABSTRACT: This paper aimed to review how scientific knowledge about the human psychobiology of MDMA has developed over time. In this paper, the empirical findings from earlier and later studies will be reviewed. When MDMA was a 'novel psychoactive substance', it was not seen as a drug of abuse, as it displayed loss of efficacy. However, recreational users display a unique pattern of increasing doses, deteriorating cost-benefit ratios, and voluntary cessation. MDMA increases body temperature and thermal stress, with cortisol levels increased by 800% in dance clubbers. It can be extremely euphoric, although negative moods are also intensified. MDMA causes apoptosis (programmed cell death) and has been investigated for cancer therapy because of its anti-lymphoma properties. Recreational users show deficits in retrospective memory, prospective memory, higher cognition, problem solving, and social intelligence. Basic cognitive skills remain intact. Neuroimaging studies show reduced serotonin transporter levels across the cerebral cortex, which are associated with neurocognitive impairments. Deficits also occur in sleep architecture, sleep apnoea, complex vision, pain, neurohormones, and psychiatric status. Ecstasy/MDMA use during pregnancy leads to psychomotor impairments in the children. The damaging effects of Ecstasy/MDMA are far more widespread than was realized a few years ago, with new neuropsychobiological deficits still emerging. Copyright © 2013 John Wiley & Sons, Ltd.
    Human Psychopharmacology Clinical and Experimental 07/2013; 28(4):289-307. DOI:10.1002/hup.2318 · 1.85 Impact Factor
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    ABSTRACT: 3,4-Methylenedioxymethamphetamine (MDMA, ecstasy) use may have long-term neurotoxic effects. In the present study, positron emission tomography with the tracer alpha-[11C]Methyl-L-Tryptophan (11C-AMT) was used to compare human brain serotonin (5-HT) synthesis capacity in 17 currently drug-free MDMA polydrug users with that in 18 healthy matched controls. Gender differences and associations between regional 11C-AMT trapping and characteristics of MDMA use were also examined.MDMA polydrug users exhibited lower normalized 11C-AMT trapping in pre-frontal, orbitofrontal and parietal regions, relative to controls. These differences were more widespread in males than in females. Increased normalized 11C-AMT trapping in MDMA users was also observed, mainly in the brain stem and in frontal and temporal areas. Normalized 11C-AMT trapping in the brain stem and (pre)frontal regions correlated positively and negatively, respectively, with greater lifetime accumulated MDMA use, longer durations of MDMA use, and shorter time elapsed since the last MDMA use.Although the possibility of pre-existing 5-HT alterations predisposing people to use MDMA cannot be ruled out, regionally decreased 5-HT synthesis capacity in the forebrain could be interpreted as neurotoxicity of MDMA on distal (frontal) brain regions. On the other hand, increased 5-HT synthesis capacity in the raphe and adjacent areas could be due to compensatory mechanisms.This article is protected by copyright. All rights reserved.
    Journal of Neurochemistry 07/2014; DOI:10.1111/jnc.12826 · 4.24 Impact Factor
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