5: Long-term ecstasy use may impair memory
It is not possible to look directly at damaged serotonin terminals in living humans. The best evidence for damage to serotonin neurons after long-term or repeated Ecstasy use in humans is the association between the neurochemical and behavioral changes. Although many behavioral measures have been assessed in Ecstasy users (the list is extensive), the most consistent findings are that some chronic Ecstasy users have verbal and visual memory impairments. Research is ongoing to determine if thinking ability is disrupted as well. However, it is important to keep in mind that many users of Ecstasy may unknowingly be taking other drugs that are sold as Ecstasy, and/or they may intentionally use other drugs, such as marijuana, which may contribute to the observed deficits in memory. Additionally, most studies in people do not have measures of memory ability in Ecstasy users before they began taking drugs. Therefore, it is difficult to rule out pre-existing memory deficits in Ecstasy users compared to nonusers. Nevertheless, in some studies Ecstasy users who had memory impairments also had less serotonin metabolites or changes in other markers of serotonin function. In fact, several studies have shown that the degree of impairment or the changes in markers of serotonin function were related to the extent of Ecstasy use over the lifetime. On the image, point to the brain areas that are involved in the memory impairment - the neocortex (yellow) and the hippocampus (blue). [As an aside, you can tell students an interesting link between low serotonin and memory impairment: normal people who are fed a diet that causes them to synthesize less serotonin also have memory impairment.]
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NIDA (2007). The Neurobiology of Ecstasy (MDMA). Retrieved , from https://www.drugabuse.gov/publications/teaching-packets/neurobiology-ecstasy-mdma
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