Thus , the current state of research does not allow for the conclusion that long-term use of MDMA affects decision-making behavior in general .
Different cognitive impairments have been reported as a result of long-term MDMA/ecstasy use .
Increased impulsivity and altered decision-making have been shown to be associated with the development and maintenance of addictive disorders pointing toward the necessity to underst and a potential impairment of decision-making due to MDMA use .
Thus , assessing the long-term effects of MDMA is crucial in order to evaluate its controversially discussed therapeutic use .
The aim of this systematic review was to summarize the scientific literature on potential effects of chronic MDMA use on higher order decision-making processes in humans .
Learning, Memory, and Executive Function in New MDMA Users: A 2-Year Follow-Up Study
3,4-Methylenedioxymethamphetamine ( MDMA ) is associated with changes in neurocognitive performance . Recent studies in laboratory animals have provided additional support for the neurodegeneration hypothesis . However , results from animal research need to be applied to humans with caution . Moreover , several of the studies that examine  MDMA users suffer from method ological shortcomings . Therefore , a prospect i ve cohort study was design ed in order to overcome these previous method ological shortcomings and to assess the relationship between the continuing use of MDMA and cognitive performance in incipient MDMA users . It was hypothesized that , depending on the amount of MDMA taken , the continued use of MDMA over a 2-year period would lead to further decreases in cognitive performance , especially in visual paired association learning tasks . Ninety-six subjects were assessed , at the second follow-up assessment : 31 of these were non-users , 55 moderate-users , and 10 heavy-users . Separate repeated measures analyses of variance were conducted for each cognitive domain , including attention and information processing speed , episodic memory , and executive functioning . Furthermore , possible confounders including age , general intelligence , cannabis use , alcohol use , use of other concomitant substances , recent medical treatment , participation in sports , level of nutrition , sleep patterns , and subjective well-being were assessed . The Repeated measures analysis of variance ( rANOVA ) revealed that a marginally significant change in immediate and delayed recall test performances of visual paired associates learning had taken place within the follow-up period of 2 years . No further deterioration in continuing MDMA-users  was observed in the second follow-up period . No significant differences with the other neuropsychological tests were noted . It seems that MDMA use can impair visual paired associates learning in new users . However , the groups differed in their use of concomitant use of illicit drugs . Therefore , performance differences between the groups can not completely ascribed to the use of MDMA
Thus , the current state of research does not allow for the conclusion that long-term use of MDMA affects decision-making behavior in general .
Different cognitive impairments have been reported as a result of long-term MDMA/ecstasy use .
Increased impulsivity and altered decision-making have been shown to be associated with the development and maintenance of addictive disorders pointing toward the necessity to underst and a potential impairment of decision-making due to MDMA use .
Thus , assessing the long-term effects of MDMA is crucial in order to evaluate its controversially discussed therapeutic use .
The aim of this systematic review was to summarize the scientific literature on potential effects of chronic MDMA use on higher order decision-making processes in humans .