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Specific effects of ecstasy and other illicit drugs on cognition in poly-substance users

Published online by Cambridge University Press:  08 November 2007

T. Schilt ,
M. M. L. de Win ,
G. Jager ,
M. W. Koeter ,
N. F. Ramsey ,
B. Schmand  and
W. van den Brink
T. Schilt*
Affiliation:
Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands Amsterdam Institute for Addiction Research, The Netherlands
M. M. L. de Win
Affiliation:
Department of Radiology, Academic Medical Center, University of Amsterdam, The Netherlands
G. Jager
Affiliation:
Department of Neurosurgery, University Medical Center Utrecht, The Netherlands
M. W. Koeter
Affiliation:
Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands Amsterdam Institute for Addiction Research, The Netherlands
N. F. Ramsey
Affiliation:
Department of Neurosurgery, University Medical Center Utrecht, The Netherlands
B. Schmand
Affiliation:
Department of Neurology, Academic Medical Center, University of Amsterdam, The Netherlands Department of Psychology, University of Amsterdam, The Netherlands
W. van den Brink
Affiliation:
Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands Amsterdam Institute for Addiction Research, The Netherlands
*
*Address for correspondence: T. Schilt, M.Sc., Department of Psychiatry, PBO 429, Academic Medical Center – University of Amsterdam, PO Box 75867, 1070 AW Amsterdam, The Netherlands. (Email: t.schilt@amc.uva.nl)
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Abstract

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.

Method

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.

Keywords

cannabiscognitionecstasyMDMAmemoryneuropsychologyneurotoxicitypolydrug use
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 9 , September 2008 , pp. 1309 - 1317
Copyright
Copyright © 2007 Cambridge University Press

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