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a Department of
Psychiatry and Psychotherapy, Medical Faculty of the University of
Technology (RWTH), Pauwelsstrasse 30, D-52074 Aachen, Germany, b Department of Neurology
Correspondence to: Dr E Gouzoulis-Mayfrank, Department of Psychiatry and Psychotherapy, Medical Faculty of the University of Technology (RWTH), Pauwelsstrasse 30, D-52074 Aachen, Germany email egouzoulis{at}post.klinikum.rwth-aachen.de
Received 8 July 1999 and in revised form 4 November 1999;
Accepted 11 November
1999
OBJECTIVES
Ecstasy
(3,4-methylenedioxymethamphetamine (MDMA) and related congerers:
MDA, MDEA) is the name given to a group of popular recreational drugs.
Animal data raise concern about neurotoxic effects of high doses of
ecstasy on central serotonergic systems. The threshold dose for
neurotoxicity in humans is not clear and serotonin is involved in
several functions including cognition. The purpose of this study was to
investigate cognitive performance in a group of typical recreational
ecstasy users.
METHODSA
comprehensive cognitive test battery was administered to 28 abstinent
ecstasy users with concomitant use of cannabis only and to two equally
sized matched groups of cannabis users and non-users. The sample
consisted of ecstasy users with a typical recreational use pattern and
did not include very heavy users.
RESULTSEcstasy users
were unimpaired in simple tests of attention (alertness). However, they
performed worse than one or both control groups in the more complex
tests of attention, in memory and learning tasks, and in tasks
reflecting aspects of general intelligence. Heavier ecstasy and heavier
cannabis use were associated with poorer performance in the group of
ecstasy users. By contrast, the cannabis users did not differ
significantly in their performance from the non-users.
CONCLUSIONSThe
present data raise concern that use of ecstasy possibly in conjunction
with cannabis may lead to cognitive decline in otherwise healthy young
people. Although the nature of the emerging cognitive disturbance is
not yet clear, an impairment of working memory might be the common
denominator underlying or contributing to declines of performance in
various tasks. The cognitive disturbance is likely to be related to the
well recognised neurotoxic potential of ecstasy. The data suggest that
even typical recreational doses of ecstasy are sufficient to cause
neurotoxicity in humans.
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