Neuropsychological Functioning and MDMA: A Review of the Literature
Jennifer Stanger
Central Connecticut State University
Neuropsychological Functioning and MDMA: A Review of the Literature
3,4-Methylenedioxymethamphetamine (MDMA) is a popular club drug that can produce long-lasting deficits among various brain functions. The Substance Abuse and Mental Health Services Administration reported that in 2009 it was estimated that 14.2 million individuals, ages 12 and up had used MDMA at least once in their lifetime (http://www.samhsa.gov/data/2k9/2k9Resultsweb/web/2k9ResultsApps.htm). This is an alarming percentage of the population that has used this drug considering all of the detrimental effects in can have on one’s health and neurological functioning. The following paper will examine the empirically researched impacts MDMA has on neuropsychological functions.
History and Drug Description
The National Institute on Drug Abuse describes 3,4-Methylenedioxymethamphetamine (MDMA) as a stimulant as well as a hallucinogenic drug, which causes enhanced sensations and perceptions as well as produces an energizing effect (http://www.drugabuse.gov/publications/research-reports/mdma-ecstasy-abuse). The chemical composition of MDMA resembles both that of an amphetamine and mescaline (Morgan, 2000). The route of administration is most commonly orally, with the user taking on average 60 to 120 milligrams per dose, and within 30 minutes of ingestion the MDMA is detected in the blood (Dumont et al., 2008). The acute effects of MDMA include euphoria, elevated self-confidence, heightened sensations and perceptions, increased anxiety, and heightened body temperature (Morgan, 2000).
MDMA was first synthesized in Germany in the early 1900s from sassafras trees, and became popular in American in the 1970’s at clubs and dance parties (http://www.drugabuse.gov/publications/research-reports/mdma-ecstasy-abuse). Some American psychiatrists used it in the 1970s as a psychotherapeutic medication because they believed it enhanced the patient-clinician relationship (http://www.drugabuse.gov/publications/research-reports/mdma-ecstasy-abuse; Chummun, Tilley, & Ibe, 2009). The drug did not undergo clinical trials to examine its safety for human use until the late 2000s. Although MDMA gained popularity among a small number of psychiatrists the Drug Enforcement Agency still placed MDMA on the list of Schedule I drugs, stating that it had no therapeutic use.
Neurotransmitters
The neurotransmitters that MDMA significantly affects are dopamine, serotonin, and norepinephrine (http://www.drugabuse.gov/publications/research-reports/mdma-ecstasy-abuse; Stough et al., 2012). MDMA has the greatest impact on serotonin, because it inhibits the reuptake as well as increases the release of the neurotransmitter (Curran, 2000). After extended use of MDMA individuals may experience a depletion of serotonin available for normal functioning and as a result they may become depressed and experience other neurological difficulties (Curran, 2000). This can also inhibit their ability to respond appropriately to antidepressant drugs because their serotonin sites have been overworked and damaged (See Figure 1). Some imaging studies have even shown that there is a decrease at which serotonin actually binds to the neurotransmitters (McCann et al., 2008). Curran (2000) reports that studies conducted on animals show the areas most significantly affected include the frontal cortex and the hippocampus because they are the areas of the brain with the most serotonin functioning. This, in theory, explains the memory issues and psychological changes that occur after long-term MDMA use. The effects MDMA has on the serotonin neurotransmitters has been shown in numerous species, including rats, guinea pigs, monkeys, and humans (Biezonski et al., 2013).
Although serotonin is often the neurotransmitter discussed in MDMA research today, the effect that MDMA has on dopamine is just