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 .
A prospective study of learning, memory, and executive function in new MDMA users.
AIMS It is still unclear if cognitive abnormalities in human 3,4-methylenedioxymeth-amphetamine  ( MDMA ) users existed before the beginning of use or if other confounders could explain the deficits . The present study was conducted in order to assess the relationship between beginning MDMA use and subsequent cognitive performance and to overcome previous method ological shortcomings . DESIGN A prospect i ve cohort study in new MDMA users between 2006 and 2009 with a follow-up duration of 12 months . SETTING AND PARTICIPANTS Of the 149 almost MDMA-naive subjects examined at the initial assessment , 109 subjects participated again after 1 year . During this period , 43 subjects did not use any other illicit substance apart from cannabis ; 23 subjects used more than 10 pills  MDMA ( mean = 33.6 ) . These groups then were compared by means of multivariate analyses of variance . MEASUREMENTS Change scores between the initial examination and follow-up on a neuropsychological test battery including measures of learning , memory , and frontal executive functions [ Auditiv-Verbaler Lerntest ( AVLT ) , Lern- und Gedächtnistest ( LGT ) 3 , digit span test , digit symbol test , Stroop task , Trail-making test ] . In addition , a comprehensive number of possibly relevant confounders including age , general intelligence , cannabis use , alcohol use , cigarette use , medical treatment , participation in sports , nutrition , sleep patterns and subjective wellbeing was assessed . FINDINGS Groups did not differ in any of the potential confounders . However , significant effects of immediate and delayed recall of a visual paired associates learning task between MDMA users and controls were found ( respectively , F ( ( 1,64 ) ) = 11.43 , P = 0.001 , η(2 ) = 0.136 and F ( ( 1,64 ) ) = 11.08 , P = 0.002 , η(2 ) = 0.144 ) . No significant differences on the other neuropsychological tests were found . CONCLUSIONS MDMA appears to impair visual paired associates learning in new users , suggesting serotonergic dysfunction in hippocampal regions as a consequence of MDMA use
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 .