Background: MDMA (ecstasy) has been a popular recreational drug among young people. MDMA modulates serotonergic activity in the brain and has been shown to be toxic to serotonergic neurons in animals. Disturbances in this neurotransmitter system lead to neuropsychiatric symptoms, hence it has been a concern that use of ecstasy in humans would lead to a higher frequency of psychiatric disease and cognitive impairment. We wanted to review human studies to find evidence for these side effects of ecstasy.
Materials and methods: We investigated 10 studies regarding the connection between use of ecstasy and mental health, as well as 20 studies regarding the connection between use of ecstasy and cognitive impairment. Three of these studies were longitudinal, the others were cross-sectional.
Results and interpretation: There is a higher frequency of both psychiatric illness and cognitive impairment among ecstasy users. On the other hand, many methodological factors must be considered before causality is assumed.