Recreational 3,4-methylenedioxymethamphetamine or 'ecstasy': current perspective and future research prospects

Aims: The purpose of this article is to debate current understandings about the psychobiological effects of recreational 3,4-methylenedioxymethamphetamine(MDMA or ‘ecstasy’), and recommend theoretically-driven topics for future research.Methods: Recent empirical findings, especially those from novel topic areas were reviewed. Potential causes for the high variance often found in groupfindings were also examined.Results and conclusions: The first empirical reports into psychobiological and psychiatric aspects from the early 1990s concluded that regularusers demonstrated some selective psychobiological deficits, for instance worse declarative memory, or heightened depression. More recent researchhas covered a far wider range of psychobiological functions, and deficits have emerged in aspects of vision, higher cognitive skill, neurohormonalfunctioning, and foetal developmental outcomes. However, variance levels are often high, indicating that while some recreational users developproblems, others are less affected. Potential reasons for this high variance are debated. An explanatory model based on multi-factorial causation isthen proposed.Future directions: A number of theoretically driven research topics are suggested, in order to empirically investigate the potential causes for thesediverse psychobiological deficits. Future neuroimaging studies should study the practical implications of any serotonergic and/or neurohormonalchanges, using a wide range of functional measures