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 .
Effects of (±) 3,4-methylene–dioxymethamphetamine (ecstasy) on dopamine system function in humans
Twelve ( + /- ) 3,4-methylenedioxymethamphetamine ( MDMA ) users , who did not show other drug dependencies or prolonged alcohol abuse ( group A ) , and 12 control subjects ( group B ) were included in the study . Prolactin ( PRL ) and growth hormone ( GH ) responses to the dopaminergic agonist bromocriptine ( BROM ) and psychometric measures were evaluated 3 weeks after MDMA discontinuation . PRL decreased both in A and B subjects after BROM suppression , without any significant difference between the two groups . PRL responses to BROM in MDMA users were in the normal range . In contrast , GH responses to BROM stimulation were found significantly reduced in ecstasy users , in comparison with control subjects ( P < 0.001 ; F = 6.26 ) .  MDMA users showed higher scores on the Novelty Seeking ( NS ) scale at the Three dimensional Personality Question naire ( TPQ ) , on direct aggressiveness subscale at Buss Durkee Hostility Inventory ( BDHI ) , on subscale D ( depression ) at Minnesota Multiphasic Personality Inventory ( MMPI 2 ) and on Hamilton Depression Rating Scale ( HDRS ) than control subjects . PRL areas under the curves ( AUCs ) showed a significant inverse correlation with NS scores both in A and B subjects . GH AUCs directly correlated with NS scores in healthy subjects , but not in MDMA users . No other psychometric measure correlated with hormonal responses . GH AUCs were inversely correlated with the measures of MDMA exposure ( r = -0.48 ; P < 0.01 ) . Lower GH response to BROM in A subjects ( MDMA users ) could reflect reduced D2 receptor sensitivity in the hypothalamus , possibly due to increased intrasynaptic dopamine concentration . Although the hypothesis of dopaminergic changes associated with a premorbid condition can not be completely excluded , the inverse correlation between DA receptors sensitivity and the extent of ecstasy exposure may suggest a direct pharmacological action of MDMA on brain dopamine function in humans
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 .