title: The effects of ecstasy on neurotransmitter systems: a review on the findings of molecular imaging studies.
abstract: Ecstasy is a commonly used psychoactive drug with 3,4-methylenedioxymethamphetamine (MDMA) as the main content. Importantly, it has been suggested that use of MDMA may be neurotoxic particularly for serotonergic (5-hydroxytryptamine (5-HT)) neurons. In the past decades, several molecular imaging studies examined directly in vivo the effects of ecstasy/MDMA on neurotransmitter systems.
  
  
  
  The objective of the present study is to review the effects of ecstasy/MDMA on neurotransmitter systems as assessed by molecular imaging studies in small animals, non-human primates and humans.
  
  
  
  A search in PubMed was performed. Eighty-eight articles were found on which inclusion and exclusion criteria were applied.
  
  
  
  Thirty-three studies met the inclusion criteria; all were focused on the 5-HT or dopamine (DA) system. Importantly, 9 out of 11 of the animal studies that examined the effects of MDMA on 5-HT transporter (SERT) availability showed a significant loss of binding potential. In human studies, this was the case for 14 out of 16 studies, particularly in heavy users. In abstinent users, significant recovery of SERT binding was found over time. Most imaging studies in humans that focused on the DA system did not find any significant effect of ecstasy/MDMA use.
  
  
  
  Preclinical and clinical molecular imaging studies on the effects of ecstasy/MDMA use/administration on neurotransmitter systems show quite consistent alterations of the 5-HT system. Particularly, in human studies, loss of SERT binding was observed in heavy ecstasy users, which might reflect 5-HT neurotoxicity, although alternative explanations (e.g. down-regulation of the SERT) cannot be excluded.
authors: Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, 1105, AZ, Amsterdam, The Netherlands. y.vegting@amc.uva.nl.
authors: Yosta
authors: Y
authors: Vegting
authors: Department of Radiology, Academic Medical Center, University of Amsterdam, 1105, AZ, Amsterdam, The Netherlands.|Brain Imaging Center, Academic Medical Center, University of Amsterdam, 1105, AZ, Amsterdam, The Netherlands.
authors: Liesbeth
authors: L
authors: Reneman
authors: Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, 1105, AZ, Amsterdam, The Netherlands.|Brain Imaging Center, Academic Medical Center, University of Amsterdam, 1105, AZ, Amsterdam, The Netherlands.
authors: Jan
authors: J
authors: Booij
mesh_terms: D000818:Animals; D001921:Brain / Q000000981:diagnostic imaging / Q000187:drug effects*; D004298:Dopamine / Q000378:metabolism; D059907:Functional Neuroimaging; D006213:Hallucinogens / Q000494:pharmacology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D057054:Molecular Imaging; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000494:pharmacology*; D009474:Neurons / Q000187:drug effects* / Q000378:metabolism; D020258:Neurotoxicity Syndromes / Q000378:metabolism; D018377:Neurotransmitter Agents / Q000378:metabolism; D049268:Positron-Emission Tomography; D011954:Receptors, Dopamine / Q000187:drug effects* / Q000378:metabolism; D012701:Serotonin / Q000378:metabolism; D050486:Serotonin Plasma Membrane Transport Proteins / Q000187:drug effects* / Q000378:metabolism; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D006213:Hallucinogens; D018377:Neurotransmitter Agents; D011954:Receptors, Dopamine; D050486:Serotonin Plasma Membrane Transport Proteins; D012701:Serotonin; D018817:N-Methyl-3,4-methylenedioxyamphetamine; D004298:Dopamine
keywords: 3,4-Methylenedioxymethamphetamine; Dopamine; Ecstasy; MDMA; Neuroimaging; Neurotoxicity; PET; SPECT; Serotonin; fMRI