Specific effects of ecstasy and other illicit drugs on cognition in poly-substance users.
BACKGROUND
A large number of studies, reviews and meta-analyses have reported cognitive deficits in ecstasy users. However most ecstasy users are polydrug users, and therefore it cannot be excluded that these deficits are (partly) the result of drugs other than ecstasy. The current study, part of the Netherlands XTC Toxicity (NeXT) study, investigates the specific sustained effects of ecstasy relative to amphetamine, cocaine and cannabis on the brain using neuropsychological examination.


METHODS
A stratified sample of 67 subjects with such a variation in type and amount of drug use was included that correlations between the consumption of the various drugs were relatively low allowing stepwise linear multiple regression analyses to differentiate between the effects of ecstasy and those of other substances. Subjects were assessed with neuropsychological tests measuring attention, working memory, verbal and visuospatial memory, and visuospatial ability.


RESULTS
Ecstasy use [mean 327 (S.D.=364) tablets in lifetime] had a specific significant dose-related negative effect on verbal delayed recall after adjusting for the use of other drugs.


CONCLUSIONS
These findings strongly suggest a specific sustained negative effect of ecstasy use on verbal memory. The clinical relevance is not immediately clear, because test performance generally remained within the normal range. However the magnitude of the effect is substantial (d>0.5) and long-term consequences cannot be excluded.
Schilt
T
T
Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands. t.schilt@amc.uva.nl
de Win
M M L
MM
Jager
G
G
Koeter
M W
MW
Ramsey
N F
NF
Schmand
B
B
van den Brink
W
W
D000293:Adolescent; D000328:Adult; D000661:Amphetamine / Q000009:adverse effects; D001288:Attention / Q000187:drug effects; D002188:Cannabis / Q000009:adverse effects; D000697:Central Nervous System Stimulants / Q000009:adverse effects; D003042:Cocaine / Q000009:adverse effects; D003071:Cognition / Q000187:drug effects; D003072:Cognition Disorders / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006213:Hallucinogens / Q000009:adverse effects; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D008297:Male; D008570:Memory, Short-Term / Q000187:drug effects; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects*; D009426:Netherlands / Q000453:epidemiology; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D013028:Space Perception / Q000187:drug effects; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology*; D014705:Verbal Behavior / Q000187:drug effects; D014796:Visual Perception / Q000187:drug effects
D000697:Central Nervous System Stimulants; D006213:Hallucinogens; D013287:Illicit Drugs; D000661:Amphetamine; D003042:Cocaine; D018817:N-Methyl-3,4-methylenedioxyamphetamine