Decision‐making in chronic ecstasy users: a systematic review

@article{Betzler2017DecisionmakingIC,
  title={Decision‐making in chronic ecstasy users: a systematic review},
  author={Felix Betzler and Leonard Viohl and Nina Romanczuk-Seiferth},
  journal={European Journal of Neuroscience},
  year={2017},
  volume={45}
}
Different cognitive impairments have been reported as a result of long‐term MDMA/ecstasy use. Increased impulsivity and altered decision‐making have been shown to be associated with the development and maintenance of addictive disorders pointing toward the necessity to understand a potential impairment of decision‐making due to MDMA use. Thus, assessing the long‐term effects of MDMA is crucial in order to evaluate its controversially discussed therapeutic use. The aim of this systematic review… 
MDMA – hopes and fears associated with therapeutic use in mental disorders
TLDR
It seems that further studies are needed to determine the long-term safety and effectiveness of MDMA assisted psychotherapy, as data available in the literature suggest that psychoactive substances may be safely administered in clinical settings.
Cognitive Effects of MDMA in Laboratory Animals: A Systematic Review Focusing on Dose
TLDR
No evidence that doses of less than 3 mg/kg MDMA—the dose range that users typically take—produce cognitive deficits in animals is found, and the short-term, infrequent, therapeutic use of ultra low-dose MDMA is unlikely to pose significant cognitive risks.
MDMA for the Treatment of Negative Symptoms in Schizophrenia
TLDR
This review provides a rationale for the use of MDMA in the treatment of negative symptoms by reviewing the literature on negative symptoms, their treatment, MDMA, and MDMA-assisted therapy and concludes with considerations regarding safety and possible mechanisms of action.
Chapter 2-Impulsive behavior in drug addiction: Clinical, cognitive, and neural correlates
Our ability to exercise self-control and to adjust our behavior when evaluating potential negative consequences of our actions is essential for our overall quality of life, development of healthy
Preliminary Results on the Long-Term Effects of Dextromethorphan on MDMA-Mediated Serotonergic Deficiency and Volumetric Changes in Primates Based on 4-[18F]-ADAM PET/MRI
TLDR
Evaluated the long-term neurotoxicity of MDMA after 66 months abstinence and explored whether Dextromethorphan, a non-competitive N-methyl-D-aspartate (NMDA) receptor, could attenuate MDMA-induced neurotoxicity using 4-[18F]-ADAM, an imaging ligand that selectively targets SERT, with positron emission tomography technology (PET).
‘Higher education’ – substance use among Berlin college students
TLDR
Students in Berlin appear to show higher rates of illicit substance use than was previously reported for age‐matched individuals in the general German population and college students in other cities, and are a relevant target group for early prevention and intervention concerning substance use and abuse.
Cannabis Use, Use Motives and Cannabis Use Disorder Among Berlin College Students
This study described cannabis use behavior among college students in Berlin, in particular, differences in use motives between subjects with frequent use and those with signs of cannabis use disorder
The Emerging MDMA Pandemic
TLDR
A new wave of epidemic is emerging that is posing serious mental health risks to people all around the world caused by a club or party drug 3,4-methylenedioxymethamphetamine (MDMA), used primarily as a recreational drug associated with the “rave” culture and, as yet, has no accepted medical uses.
...
...

References

SHOWING 1-10 OF 137 REFERENCES
Decision making as a predictor of first ecstasy use: a prospective study
TLDR
Decision-making strategy on a gambling task was predictive for future use of ecstasy in female subjects, and differences in decision-making time between future ecstasy users and persistent ecstasy-naive subjects may point to lower punishment sensitivity or higher impulsivity in futurestasy users.
Prospective memory, everyday cognitive failure and central executive function in recreational users of Ecstasy
TLDR
The three studies reported here suggest that Ecstasy users have impaired PM that cannot be explained by an increased propensity to exaggerate cognitive failures, and may be attributable, in part, to central executive deficits that are due to frontal lobe damage associated with Ecstasy use.
Elevated impulsivity and impaired decision-making cognition in heavy users of MDMA (“Ecstasy”)
TLDR
The results suggest that heavy use of MDMA may elevate behavioral impulsivity and impair decision-making cognition possibly mediated by a selective impairment of the 5-HT system.
Cognition in novice ecstasy users with minimal exposure to other drugs: a prospective cohort study.
TLDR
It is suggested that even a first low cumulative dose of Ecstasy is associated with decline in verbal memory and the immediate clinical relevance of the observed deficits is limited, but long-term negative consequences cannot be excluded.
Neuropsychological function in ecstasy users: a study controlling for polydrug use
TLDR
Trait impulsiveness was significantly correlated with impairment on a number of neuropsychological outcome measures in the MDMA users, but not in the controls, suggesting that impulsive individuals may be those most at risk for the development of cognitive impairment following chronic ecstasy use.
Decision-making in Polydrug Amphetamine-type Stimulant Users: an fMRI Study
TLDR
The hypothesis that neuronal activation patterns might even differ between drug users and healthy controls when no behavioral deficits are apparent is supported, as the probability of the occurrence of an event has more influence on neuronal activation than on the actual magnitude of reinforcing properties of this event.
Ecstasy (MDMA): are the psychological problems associated with its use reversed by prolonged abstinence?
TLDR
Selective impairments of neuropsychological performance associated with regular ecstasy use are not reversed by prolonged abstinence, consistent with evidence that ecstasy has potent and selective neurotoxic effects on brain serotonergic systems in humans.
Cognitive performance and serotonergic function in users of ecstasy
TLDR
Evidence is provided that use of ecstasy may be associated with impairment of memory and of serotonergic function, compatible with neurotoxicity of ecstasy as shown in animals.
Elevated Impulsivity and Impaired Decision-Making in Abstinent Ecstasy (MDMA) Users Compared to Polydrug and Drug-Naïve Controls
TLDR
The ecstasy group displayed significantly elevated MFF20 impulsivity, and showed reduced discrimination between magnitudes of prospective gains and losses when making risky decisions, compared to the ‘polydrug’ and ‘drug-naïve’ control groups.
Memory deficits associated with recreational use of “ecstasy” (MDMA)
TLDR
The present findings provide the first evidence that deficits in memory performance in recreational ecstasy users are primarily associated with past exposure to ecstasy, rather than with the other legal and illicit drugs consumed by these individuals, and are consistent with reduced serotonergic modulation of mnemonic function as a result of long-term neurotoxic effects of MDMA in humans.
...
...