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 .
How could MDMA (ecstasy) help anxiety disorders? A neurobiological rationale
Abstract Exposure therapy is known to be an effective treatment for anxiety disorders . Nevertheless , exposure is not used as much as it should be , and instead patients are often given supportive medications such as serotonin reuptake inhibitors ( SSRIs ) and benzodiazepines , which may even interfere with the extinction learning that is the aim of treatment . Given that r and omized controlled trials are now investigating a few doses of ±3,4-methylenedioxymethamphetamine ( MDMA , ‘ ecstasy ’ ) in combination with psychotherapy for treatment-resistant anxiety disorders , we would like to suggest the following three mechanisms for this potentially important new approach : 1 ) MDMA  increases oxytocin levels , which may strengthen the therapeutic alliance ; 2 ) MDMA  increases ventromedial prefrontal activity and decreases amygdala activity , which may improve emotional regulation and decrease avoidance and 3 ) MDMA  increases norepinephrine release and circulating cortisol levels , which may facilitate emotional engagement and enhance extinction of learned fear associations . Thus , MDMA has a combination of pharmacological effects that , in a therapeutic setting , could provide a balance of activating emotions while feeling safe and in control , as described in case reports of MDMA-augmented psychotherapy . Further clinical and pre clinical studies of the therapeutic value of MDMA are indicated
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 .