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 .
Pharmacology of MDMA in humans.
MDMA given at recreational doses ( range tested 50 to 150 mg ) to healthy volunteers , produced mydriasis and marked increases in systolic and diastolic blood pressure , heart rate , and pupillary diameter .  MDMA induced changes on oral temperature . The time course of this observation was biphasic , as a slight decrease at 1 h and a slight increase at 2 and 4 h were observed . MDMA induced a slight dose-dependent impairment on psychomotor performance .  MDMA produced a marked rise in plasma cortisol and prolactin concentrations . The elimination half-life of MDMA was about 8 - 9 h. Drug concentrations increased , and a parallel increase in physiologic and hormonal measures was observed . Both peak concentrations and peak effects were obtained between 1 and 2 h and decreased to baseline values 4 - 6 h after drug administration
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 .