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Cognitive impairments from long-term MDMA use

Since I know this is going to come up again, I figure I might as well just address it now. As noted in my recent edit summary, this review[1] (the full text can be accessed in this link) is examining the neural correlates of cognitive impairments in MDMA users. In other words, using fMRI, it's examining the functional differences in specific brain regions between healthy individuals and chronic MDMA users that correlate with specific cognitive impairments. The ref states that these cognitive impairments - in particular, those related to learning and memory - have been consistently documented in humans. It also states that fMRI studies which examine the neural correlates of these cognitive impairments have produced inconsistent results. In plain English, this means that the research which has attempted to identify the neurotoxic/neurodegenerative effects of MDMA that correlate with specific cognitive function deficits is not consistent.

Inconsistency in findings that link MDMA-induced neurotoxicity to MDMA-induced cognitive impairments is not the same thing as inconsistency in findings of MDMA-induced neurotoxicity or inconsistency in findings of MDMA-induced cognitive impairments. Consequently, the source is not contradicting itself and the current article content on deficits in cognitive function that is cited by this source does not contradict this source; rather, that content is directly supported by the quote in the citation. Seppi333 (Insert 2¢) 22:44, 11 January 2017 (UTC)[reply]

References

  1. ^ Garg A, Kapoor S, Goel M, Chopra S, Chopra M, Kapoor A, McCann UD, Behera C (2015). "Functional Magnetic Resonance Imaging in Abstinent MDMA Users: A Review". Curr. Drug Abuse Rev. 8 (1): 15–25. doi:10.2174/1874473708666150303115833. PMID 25731754.
    • Chronic MDMA use results in serotonergic toxicity, thereby altering the regional cerebral blood flow that can be studied using fMRI.
    • The effects of chronic MDMA use have been analysed in various neurocognitive domains such as working memory, episodic memory, semantic memory, visual stimulation, motor function and impulsivity. ...
    Structural neuroimaging in MDMA users has shown reduction in brain 5-HT transporter (5-HTT) [18-21] and 5-HT2a receptor levels [22-24] using positron emission tomography (PET) or single photon emission computed tomography (SPECT) and reduced grey matter density in various brain regions using voxel based morphometry method (VBM) [25]. Chemical Neuroimaging, assaying the levels of myoinositol (MI) and N-acetylaspartate (NAA) in the brains of MDMA users using proton magnetic resonance spectroscopy (MRS), has not revealed any consistent results [17, 26-29]. Functional magnetic resonance imaging (fMRI) studies have shown task evoked differences in regional brain activation, measured as blood oxygen level dependent (BOLD) signal intensity and/or spatial extent of activation, in MDMA users and controls [30-33]. ... Neurocognitive studies, in MDMA users, have consistently revealed dose related memory and learning problems [35-38] ... Serotonergic innervation is known to regulate the cerebral microvasculature. Chronic MDMA use results in serotonin toxicity, therefore MDMA users are expected to have altered regional blood flow detectable in fMRI [17]. ... Animal data has suggested that MDMA is selectively more toxic to the axons more distal to the brainstem cell bodies, that is, those present mainly in the occipital cortex [54, 55]. Also, human PET and SPECT studies have revealed significant reductions in serotonin transporter binding, most evident in the occipital cortex [18, 20] ... The effects of poly-drug exposure may result in additive neurotoxicity or mutual neuro-protection. MDMA is known to induce hyperthermia which is a prooxidant neurotoxic condition [65]. Hyperthermia is known to accentuate the neurotoxic potential of MDMA as well as methamphetamine [66, 67]. On the other hand, lowering of the core body temperature has been shown to have a neuroprotective effect.

Semi-protected edit request on 16 March 2017

Replace citation [21] in the following sentence "Researchers are investigating whether a few low doses of MDMA may assist in treating severe, treatment-resistant posttraumatic stress disorder (PTSD).[12][21]" with this citation: Amoroso, T., & Workman, M. (2016). Treating posttraumatic stress disorder with MDMA-assisted psychotherapy: A preliminary meta-analysis and comparison to prolonged exposure therapy. Journal of Psychopharmacology, 30(7), 595-600. 2601:18B:8200:61D8:7CB6:AB0F:5BE5:4F54 (talk) 00:12, 17 March 2017 (UTC)[reply]

 Done Sizeofint (talk) 00:31, 17 March 2017 (UTC)[reply]

Paste

The following has some useful references but I think it is redundant with current content and too loose on efficacy. Sizeofint (talk) 20:37, 18 May 2017 (UTC)[reply]

MDMA is known to improve sociability, friendliness, extroversion, to increase empathy and feelings of closeness with others, and to reduce interpersonal defensiveness.[1][2][3][4][5] These effects are relevant to people with social anxiety and a group of researchers find that MDMA has therapeutic benefits for alleviating social anxiety.[6][7][8]

Why do you think this content which is humanizing straight research is redundant?--TMCk (talk) 02:35, 19 May 2017 (UTC)[reply]
We already have a section on effects. I don't think it is necessary to repeat them in the research section. "A group of researchers find that MDMA has therapeutic benefits for alleviating social anxiety" has some weasel wording issues (which group?). Additionally, at least one of the sources was a bit more nuanced (I haven't closely examined the others yet) with the authors saying it "may" have therapeutic benefit, not that they believe it certainly does as this wording implies. Sizeofint (talk) 06:33, 19 May 2017 (UTC)[reply]
With respect to the sentence – "MDMA is known to improve sociability, friendliness, extroversion, to increase empathy and feelings of closeness with others, and to reduce interpersonal defensiveness.[1][2][3][4][5]" – WP:MEDRS sources are required since these are clinical claims of drug effects. Among the cited refs, only this ref[3] is a MEDRS-compliant source (i.e., a medical review). In any event, if others think that this is worth covering, I don't think that it should be too difficult to find other reviews that cover the effects that aren't supported by the cited review. There's plenty of medical sources which state that amphetamine increases sociability and self-expression, so MDMA is not unique in that regard. The non-empathogenic effects of MDMA on social behavior are likely derived from its amphetamine-like dopaminergic effects. Seppi333 (Insert 2¢) 09:01, 19 May 2017 (UTC)[reply]


Section references

References

  1. ^ a b Scahill, Lawrence; Anderson, George M. (15 December 2010). "Is ecstasy an empathogen?". Biological psychiatry. 68 (12): 1082–1083. doi:10.1016/j.biopsych.2010.10.020. ISSN 0006-3223. Retrieved 18 May 2017.
  2. ^ a b Bedi, Gillinder; Hyman, David; de Wit, Harriet (15 December 2010). "Is ecstasy an 'empathogen'? Effects of MDMA on prosocial feelings and identification of emotional states in others". Biological psychiatry. 68 (12): 1134–1140. doi:10.1016/j.biopsych.2010.08.003. ISSN 0006-3223. Retrieved 18 May 2017.
  3. ^ a b c Kamilar-Britt, Philip; Bedi, Gillinder (18 May 2017). "The Prosocial Effects of 3,4-methylenedioxymethamphetamine (MDMA): Controlled Studies in Humans and Laboratory Animals". Neuroscience and biobehavioral reviews. 57: 433–446. doi:10.1016/j.neubiorev.2015.08.016. ISSN 0149-7634. Retrieved 18 May 2017.
  4. ^ a b Bedi, Gillinder; Phan, K. Luan; Angstadt, Mike; de Wit, Harriet (18 May 2017). "Effects of MDMA on sociability and neural response to social threat and social reward". Psychopharmacology. 207 (1): 73–83. doi:10.1007/s00213-009-1635-z. ISSN 0033-3158. Retrieved 18 May 2017.
  5. ^ a b "Ecstasy ingredient touted as treatment for anxiety in autism | Spectrum | Autism Research News". Spectrum | Autism Research News. 16 November 2016. Retrieved 18 May 2017.
  6. ^ Syder, Alexander. MDMA Case Study. A Case for Decriminalization or Prohibition?. GRIN Verlag. ISBN 9783668046870. Retrieved 18 May 2017.
  7. ^ Ingersoll, R. Elliott; Rak, Carl F. Psychopharmacology for Mental Health Professionals: An Integrative Approach. Cengage Learning. ISBN 9781305537231. Retrieved 18 May 2017.
  8. ^ Ph.D Vera Sonja, Maass. Understanding Social Anxiety: A Recovery Guide for Sufferers, Family, and Friends. ABC-CLIO. ISBN 9781440841965. Retrieved 18 May 2017.

"As of 2017, MDMA has no accepted medical indications."

Neither of the two provided sources actually support this weird statement. The first suggests that MDMA should be removed from its "no medical use" status and the other says that its use for therapeutic use is rare these days. --86.50.81.67 (talk) 02:41, 23 May 2017 (UTC)[reply]

If the authors are arguing its status should be changed then it currently must have no accepted medical use. Sizeofint (talk) 04:14, 23 May 2017 (UTC)[reply]
I agree with Sizeofint. The lack of medical indications logically follows from the fact that it has "no medical uses"; in any event, the source that was recently added to that sentence explicitly states this. Seppi333 (Insert 2¢) 18:55, 23 May 2017 (UTC)[reply]

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Oddly phrased sentance.

"There are numerous methods available in the literature to synthesize MDMA via different intermediates.[98][99][100][101]" seems this sentence is worded very poorly. It's redundant, essentially stating "There are many ways to make MDA" twice. I also don't think it needs the qualifier "in literature". I think a better sentence might be "There are numerous methods available to synthesize MDMA.[98][99][100][101]"

--173.66.69.186 (talk) 01:56, 26 August 2017 (UTC)[reply]

source: https://en.wikipedia.org/w/index.php?title=Talk:MDMA&oldid=797281960

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