Potential human neurotoxicity of MDMA ('Ecstasy'): subjective self-reports, evidence from an Italian drug addiction centre and clinical case studies

The present paper attempts to give an updated overview of the magnitude of the phenomenon of ecstasy abuse in Italy and other European countries. It gives an account of some clinical case studies and of a larger-scale report on polydrug (including MDMA) consumers attending our Public Health Addiction Treatment Unit in recent years, with a view to clarifying the characteristics and psychopathological consequences (mainly depression, psychotic disorders, cognitive disturbances, bulimic episodes, impulse control disorders, panic disorders, social phobia) of MDMA consumption. Longer-term, larger-dose (acute or cumulative) MDMA consumers were found to be at high risk of developing these psychopathological disturbances. A tentative description of certain personological dimensions of ecstasy consumers is also given (the novelty-seeking dimension was characteristic of those who occasionally experimented with the drug) while those who ingested larger quantities revealed low harm avoidance scores). Results are discussed in the light of the complex and different methodological issues arising from this kind of study, in which MDMA is far from being the only drug of abuse.