Women Are at Greater Risk From Ecstasy Use

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Researchers at the Academic Medical Center, Amsterdam, Netherlands found that long-term use of the recreational drug ecstasy, especially among women, can have serious negative effects on specific cells in the brain.

The Dutch study indicates that ecstasy (MDMA) can cause the irreversible loss of serotonin neurons which can result in neuropsychiatric disorders such as depression, anxiety, panic disorder, and disorders of impulse control.

Liesbeth Reneman and colleagues investigated the effects of moderate and heavy ecstasy use, gender differences, and long-term effects of ecstasy use on serotonin neurons in different brain regions. They recruited 15 moderate ecstasy users, 23 heavy users, 16 ex-users who had stopped using ecstasy for more than a year, and 15 controls who claimed never to have used the drug.

How Women Are Affected

The effects of ecstasy were assessed by calculating the ratio of serotonin receptor density in different parts of the brain compared with the cerebellum by using a single-photon-emission computed tomography (SPECT).

Among heavy ecstasy users, substantial decreases in overall binding ratios were seen in women but not men. In female ex-ecstasy users, overall densities of serotonin transporters were significantly higher than in heavy ecstasy users.

Sample May Be Too Small

But the study may not have been large enough to establish a difference in how the drug affects women differently from men, according to a commentary published in The Lancet.

George Ricaurte and Una McCann from Johns Hopkins University School of Medicine wrote: "Although the study is timely and potentially important, the small sample size and methodological questions limit confidence in conclusions about differences between sexes or possibility of reversibility of the effects of MDMA [ecstasy] in human beings. Studies in larger cohorts of both sexes, free of psychiatric illnesses in which serotonin is implicated, are needed."

The effects of moderate ecstasy use on serotonin neurons have not been studied, and gender differences and the long-term effects of ecstasy use on serotonin neurons have not been identified.

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  1. Reneman L, Booij J, de Bruin K, et al. Effects of dose, sex, and long-term abstention from use on toxic effects of MDMA (Ecstasy) on brain serotonin neuronsThe Lancet. 2001;358(9296):1864-1869. doi:10.1016/S0140-6736(01)06888-X

  2. Ricaurte GA, McCann UD. Assessing long-term effects of MDMA (Ecstasy)The Lancet. 2001;358(9296):1831-1832. doi:10.1016/S0140-6736(01)06880-5