Article

Cognitive performance in recreational ecstasy polydrug users: A two-year follow-up study

Behavioral Neurology and Dementia Research Group, Neuropsychopharmacology Program, IMIM-Hospital del Mar, Barcelona, Spain.
Journal of Psychopharmacology (Impact Factor: 2.81). 02/2008; 22(5):498-510. DOI: 10.1177/0269881107081545
Source: PubMed

ABSTRACT There is important preclinical evidence of long lasting neurotoxic and selective effects of ecstasy MDMA on serotonin systems in non-human primates. In humans long-term recreational use of ecstasy has been mainly associated with learning and memory impairments. The aim of the present study was to investigate the neuropsychological profile associated with ecstasy use within recreational polydrug users, and describe the cognitive changes related to maintained or variable ecstasy use along a two years period. We administered cognitive measures of attention, executive functions, memory and learning to three groups of participants: 37 current polydrug users with regular consumption of ecstasy and cannabis, 23 current cannabis users and 34 non-users free of illicit drugs. Four cognitive assessments were conducted during two years. At baseline, ecstasy polydrug users showed significantly poorer performance than cannabis users and non-drug using controls in a measure of semantic word fluency. When ecstasy users were classified according to lifetime use of ecstasy, the more severe users (more than 100 tablets) showed additional deficits on episodic memory. After two years ecstasy users showed persistent deficits on verbal fluency, working memory and processing speed. These findings should be interpreted with caution, since the possibility of premorbid group differences cannot be entirely excluded. Our findings support that ecstasy use, or ecstasy/cannabis synergic effects, are responsible for the sub-clinical deficits observed in ecstasy polydrug users, and provides additional evidence for long-term cognitive impairment owing to ecstasy consumption in the context of polydrug use.

Download full-text

Full-text

Available from: Magí Farré, Jul 28, 2015
0 Followers
 · 
291 Views
  • Source
    • "Thus, it is difficult to determine whether the differences between controls and ecstasy users are actually based on MDMA use. Indeed, when groups of ecstasy users are compared with groups of participants who do not use ecstasy, but are matched with respect to use of marijuana or other drugs, several studies have found comparable cognitive deficits (e.g., Croft, Mackay, Mills, & Gruzelier, 2001; Dafters, Hoski, & Talbot, 2004; de Sola et al., 2008), although others have found more severe deficits in ecstasy users (Daumann et al., 2005; Nulsen et al., 2010). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The effects of acute and sub-chronic MDMA were assessed using a procedure designed to test rodent working memory capacity: the odor span task (OST). Rats were trained to select an odor that they had not previously encountered within the current session, and the number of odors to remember was incremented up to 24 during the course of each session. In order to separate drug effects on the OST from more general performance impairment, a simple olfactory discrimination was also assessed in each session. In Experiment 1, acute doses of MDMA were administered prior to select sessions. MDMA impaired memory span in a dose-dependent fashion, but impairment was seen only at doses (1.8 and 3.0 mg/kg) that also increased response omissions on both the simple discrimination and the OST. In Experiment 2, a sub-chronic regimen of MDMA (10.0 mg/kg, twice daily over four days) was administered after OST training. There was no evidence of reduced memory span following sub-chronic MDMA, but a temporary increase in omission errors on the OST was observed. In addition, rats exposed to sub-chronic MDMA showed delayed learning when the simple discrimination was reversed. Overall, the disruptive effects of both acute and sub-chronic MDMA appeared to be due to non-mnemonic processes, rather than effects on specific memory functions.
    Neurobiology of Learning and Memory 10/2014; DOI:10.1016/j.nlm.2014.06.012 · 4.04 Impact Factor
  • Source
    • "Favorable reports about cognitive function, memory, and concentration on the LTFU Questionnaire were consistent with findings from formal measures of cognitive function that were taken before and after psychotherapy with MDMA versus placebo, in the original study. Though reports from actual testing are more reliable than reports of perceived cognitive function, this long-term selfreported evidence is still important, because of the controversy surrounding theories that there are potential risks of neurocognitive decline resulting from MDMA administration, as has been suggested by animal studies and some retrospective studies in recreational drug users (Thomasius et al., 2006; Kalechstein et al., 2007; Laws and Kokkalis, 2007; Zakzanis et al., 2007; De Sola Llopis et al., 2008; Jager et al., 2008; Schilt et al., 2008; Brown et al., 2010; Kish et al., 2010; Verbaten, 2010) and one prospective "
    [Show abstract] [Hide abstract]
    ABSTRACT: We report follow-up data evaluating the long-term outcomes for the first completed trial of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for chronic, treatment-resistant post-traumatic stress disorder (PTSD) (Mithoefer et al., 2011). All of the 19 subjects who received MDMA-assisted treatment in the original trial participated in the long-term follow-up (LTFU), with 16 out of 19 completing all of the long-term outcome measures, which were administered from 17 to 74 months after the original study's final MDMA session (mean = 45.4; SD = 17.3). Our primary outcome measure used was the Clinician-Administered PTSD Scale (CAPS). Secondary outcome measures were the Impact of Events Scale-Revised (IES-R) and the Neuroticism Extroversion Oppenness Personality Inventory-Revised (NEO PI-R) Personality Inventory. We also collected a long-term follow-up questionnaire. Results for the 16 CAPS completers showed there were no statistical differences between mean CAPS score at LTFU (mean = 23.7; SD = 22.8) (t(matched) = 0.1; df = 15, p = 0.91) and the mean CAPS score previously obtained at Study Exit (mean = 24.6, SD = 18.6). On average, subjects maintained statistically and clinically-significant gains in symptom relief, although two of these subjects did relapse. It was promising that we found the majority of these subjects with previously severe PTSD who were unresponsive to existing treatments had symptomatic relief provided by MDMA-assisted psychotherapy that persisted over time, with no subjects reporting harm from participation in the study.
    Journal of Psychopharmacology 11/2012; 27(1). DOI:10.1177/0269881112456611 · 2.81 Impact Factor
  • Source
    • "MDMA typically causes heightened feelings of well-being and euphoria (Camí et al. 2000). Ecstasy is associated with acute medical complications , long-term psychiatric disorders, and neuropsychological deficits (Greene et al. 2003; de Sola Llopis et al. 2008; Martín-Santos et al. 2010; Cuyàs et al. 2011). Intensive ecstasy self-administration is often reported by experienced users. "
    [Show abstract] [Hide abstract]
    ABSTRACT: 3,4-Methylenedioxymethamphetamine (MDMA, ecstasy) is a popular psychostimulant, frequently associated with multiple administrations over a short period of time. Repeated administration of MDMA in experimental settings induces tolerance and metabolic inhibition. The aim is to determine the acute pharmacological effects and pharmacokinetics resulting from two consecutive 100mg doses of MDMA separated by 4h. Ten male volunteers participated in a randomized, double-blind, crossover, placebo-controlled trial. The four conditions were placebo plus placebo, placebo plus MDMA, MDMA plus placebo, and MDMA plus MDMA. Outcome variables included pharmacological effects and pharmacokinetic parameters. After a second dose of MDMA, most effects were similar to those after a single dose, despite a doubling of MDMA concentrations (except for systolic blood pressure and reaction time). After repeated MDMA administration, a 2-fold increase was observed in MDMA plasma concentrations. For a simple dose accumulation MDMA and MDA concentrations were higher (+23.1% Cmax and +17.1% AUC for MDMA and +14.2% Cmax and +10.3% AUC for MDA) and HMMA and HMA concentrations lower (-43.3% Cmax and -39.9% AUC for HMMA and -33.2% Cmax and -35.1% AUC for HMA) than expected, probably related to MDMA metabolic autoinhibition. Although MDMA concentrations doubled after the second dose, most pharmacological effects were similar or slightly higher in comparison to the single administration, except for systolic blood pressure and reaction time which were greater than predicted. The pharmacokinetic-effects relationship suggests that when MDMA is administered at a 4h interval there exists a phenomenon of acute tolerance to its effects. Copyright © 2015 Elsevier B.V. and ECNP. All rights reserved.
    Psychopharmacology 11/2012; 225(4). DOI:10.1007/s00213-012-2894-7 · 3.99 Impact Factor
Show more