The confounding problem of polydrug use in recreational ecstasy/MDMA users: a brief overview
by
Gouzoulis-Mayfrank E, Daumann J.
Department of Psychiatry and Psychotherapy,
University of Cologne, Cologne, Germany.
J Psychopharmacol. 2006 Mar;20(2):188-93.

ABSTRACT

The popular dance drug ecstasy (3,4-methylenedioxymethamphetamine -- MDMA) is neurotoxic upon central serotonergic neurons in laboratory animals and possibly also in humans. In recent years, several studies reported alterations of serotonergic transmission and neuropsychiatric abnormalities in ecstasy users which might be related to MDMA-induced neurotoxic brain damage. To date, the most consistent findings associate subtle cognitive, particularly memory, deficits with heavy ecstasy use. However, most studies have important inherent methodological problems. One of the most serious confounds is the widespread pattern of polydrug use which makes it difficult to relate the findings in user populations to one specific drug. The present paper represents a brief overview on this issue. The most commonly co-used substances are alcohol, cannabis and stimulants (amphetamines and cocaine). Stimulants are also neurotoxic upon both serotonergic and dopaminergic neurons. Hence, they may act synergistically with MDMA and enhance its long-term adverse effects. The interactions between MDMA and cannabis use may be more complex: cannabis use is a wellrecognized risk factor for neuropsychiatric disorders and it was shown to contribute to psychological problems and cognitive failures in ecstasy users. However, at the cellular level, cannabinoids have neuroprotective actions and they were shown to (partially) block MDMA-induced neurotoxicity in laboratory animals. In future, longitudinal and prospective research designs should hopefully lead to a better understanding of the relation between drug use and subclinical psychological symptoms or neurocognitive failures and, also, of questions around interactions between the various substances of abuse.

THC
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MDMA/MDE
Controversies
Protect and survive
Cannabis, Ecstasy and memory
Ecstasy and serotonin synthesis
MDMA (Ecstasy) plus methamphetamine
Polydrug use among MDMA/Ecstasy users
Cannabinoids: neuroprotective or neutotoxic?
Cannabinoids protect against MDMA-induced hyperthermia

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