Gouzoulis-Mayfrank E, Daumann J
Department of Psychiatry and Psychotherapy, University of Cologne, Germany.
Addiction. 2006 Mar;101(3):348-61. doi: 10.1111/j.1360-0443.2006.01314.x.
The popular dance drug ecstasy (3,4-methylenedioxymethamphetamine: MDMA and some analogues) causes selective and persistent neurotoxic damage of central serotonergic neurones in laboratory animals. Serotonin plays a role in numerous functional systems in the central nervous system (CNS). Consequently, various abnormalities including psychiatric, vegetative, neuroendocrine and cognitive disorders could be expected in humans following MDMA-induced neurotoxic brain damage.
In recent years, the question of ecstasy-induced neurotoxicity and possible functional sequelae has been addressed in several studies with drug users. The aim of this paper was to review this literature and weigh the strength of the evidence for persistent brain damage in ecstasy users.
We used Medline to view all available publications on 'ecstasy' or 'MDMA'. All available studies dealing with ecstasy users entered this analysis.
Despite large methodological problems the bulk of evidence suggests residual alterations of serotonergic transmission in MDMA users, although at least partial restitution may occur after long-term abstinence. However, functional sequelae may persist even after longer periods of abstinence. To date, the most consistent findings associate subtle cognitive, particularly memory, impairments with heavy ecstasy use. However, the evidence cannot be considered definite and the issues of possible pre-existing traits or the effects of polydrug use are not resolved.
Questions about the neurotoxic effects of ecstasy on the brain remain highly topical in light of its popularity among young people. More longitudinal and prospective studies are clearly needed in order to obtain a better understanding of the possible long-term sequelae of ecstasy use in humans.
流行的摇头丸（3,4 - 亚甲基二氧甲基苯丙胺：MDMA及一些类似物）在实验动物中会导致中枢5-羟色胺能神经元发生选择性和持续性神经毒性损伤。5-羟色胺在中枢神经系统（CNS）的众多功能系统中发挥作用。因此，预计在人类中，MDMA诱导的神经毒性脑损伤后会出现包括精神、植物神经、神经内分泌和认知障碍在内的各种异常情况。
近年来，一些针对吸毒者的研究探讨了摇头丸诱导的神经毒性及可能的功能后遗症问题。本文的目的是回顾该文献，并权衡支持摇头丸使用者存在持续性脑损伤的证据力度。
我们使用Medline检索所有关于“摇头丸”或“MDMA”的可用出版物。所有涉及摇头丸使用者的可用研究都纳入了本分析。
尽管存在大量方法学问题，但大量证据表明摇头丸使用者的5-羟色胺能传递存在残留改变，不过长期戒断后可能至少会部分恢复。然而，即使在更长时间的戒断后，功能后遗症可能仍然存在。迄今为止，最一致的发现是，大量使用摇头丸与轻微的认知障碍，尤其是记忆障碍有关。然而，证据尚不能被视为确凿无疑，可能存在的先前特质或多药使用的影响等问题也尚未解决。
鉴于摇头丸在年轻人中的流行，其对大脑的神经毒性作用问题仍然备受关注。显然需要更多的纵向和前瞻性研究，以便更好地了解人类使用摇头丸可能产生的长期后遗症。
