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Title: Memory Impairment from Ecstasy Use May Not Be Reversible

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Archives of General Psychiatry, 2001; 58: 901-906.
10/16/2001 08:05:43 AM
By Elda Hauschildt

Even a year after they have stopped using, people who take 3,4 methylenedioxymethamphetamine (MDMA or ecstasy) still have impaired memory function. This indicates that the functional consequences on cortical brain serotonin (5-HT) neurons of MDMA use may not be reversible, Dutch researchers say. They suggest that neurotoxic changes seen in cortical 5-HT brain neurons from MDMA use may be reversible, however. "In individuals who stopped using MDMA more than one year earlier, cortical 5-HT transporter (SERT) densities did not differ from those of control subjects, whereas recent MDMA users showed global decreases in SERTs," investigators explain. "Our findings also indicate that individuals who stopped using MDMA had a deficit in verbal memory, similar to that of current MDMA users, and that higher lifetime doses of MDMA are associated with greater decrements in immediate verbal memory function." Investigators add that the observed decreases in cortical SERT densities in recent-users most likely reflect MDMA-induced brain 5-HT neurotoxic effects. "Absence of decreases in SERT densities in ex-MDMA users suggests reversibility of MDMA-induced changes in brain SERTS in MDMA users," they point out. Researchers from the Graduate School of Neurosciences, the Amsterdam Institute for Addiction Research and Leiden University Medical Centre in the Netherlands say the implications of their findings are relevant to anyone deciding to take MDMA. "We identified that MDMA use is associated not only with short-term consequences but also with long-term consequences as well. "These findings will provide a cogent argument for consumers to make informed decisions about recreational drug use." They also suggest studying MDMA-exposed people with highly selective brain SERT deficits "adds to our knowledge about a neurotransmission system thought to be involved in the cause and treatment of very common psychiatric illnesses, such as depression." Investigators studied 22 recent MDMA users, 16 ex-MDMA users and 13 controls. They defined ex-users as people who had stopped using the drug more than one year earlier. They used single-photon emission computer tomography to examine the effects of MDMA use on cortical 5-HT neurons. They measured verbal memory performance with the Rey Auditory Verbal Learning Test. "Recent and ex-MDMA users recalled significantly fewer words than did controls on the immediate recall as well as the delayed recall," the researchers report. "Greater use of MDMA was associated with greater impairment in immediate verbal memory." Researchers say the consequences of lost serotonergic reserve later in life are difficult to predict but could be clinically significant. That makes prospective studies of psychiatric morbidity in MDMA users necessary so that future demands on health care can be estimated.

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