Victoria University of Wellington, School of Psychology, Kelburn Pde, Easterfield Bldg Rm 702, Wellington, New Zealand.
Neurosci Biobehav Rev. 2011 Apr;35(5):1203-18. doi: 10.1016/j.neubiorev.2010.12.010. Epub 2010 Dec 22.
A number of reviews have focused on the short- and long-term effects of MDMA and, in particular, on the persistent deficits in serotonin neurotransmission that accompany some exposure regimens. The mechanisms underlying the serotonin deficits and their relevance to various behavioral and cognitive consequences of MDMA use are still being debated. It has become clear, however, that some individuals develop compulsive and uncontrolled drug-taking that is consistent with abuse. For other drugs of abuse, this transition has been attributed to neuroadaptations in central dopamine mechanisms that occur as a function of repeated drug exposure. A question remains as to whether similar neuroadaptations occur as a function of exposure to MDMA and the impact of serotonin neurotoxicity in the transition from use to abuse. This review focuses specifically on this issue by first providing an overview of human studies and then reviewing the animal literature with specific emphasis on paradigms that measure subjective effects of drugs and self-administration as indices of abuse liability. It is suggested that serotonin deficits resulting from repeated exposure to MDMA self-administration lead to a sensitized dopaminergic response to the drug and that this sensitized response renders MDMA comparable to other drugs of abuse.
一些综述集中探讨了 MDMA 的短期和长期影响，特别是伴随某些暴露方案的持续血清素神经传递缺陷。血清素缺陷的机制及其与 MDMA 使用的各种行为和认知后果的相关性仍在争论中。然而，很明显，一些人会出现强迫性和无法控制的药物滥用行为。对于其他滥用药物，这种转变归因于中枢多巴胺机制的神经适应性改变，这种改变是反复药物暴露的结果。一个问题仍然存在，即是否会由于暴露于 MDMA 以及血清素神经毒性在从使用到滥用的转变中发生类似的神经适应性改变。这篇综述专门关注了这个问题，首先提供了对人类研究的概述，然后回顾了动物文献，特别强调了测量药物主观效应和自我给药作为滥用倾向指标的范式。有观点认为，重复暴露于 MDMA 自我给药导致对药物的多巴胺反应敏感化，这种敏感化反应使 MDMA 与其他滥用药物相当。
