What are long-term neuropsychiatric effects of MDMA toxicity?

Updated: May 30, 2020
  • Author: In-Hei Hahn, MD, FACEP, FACMT; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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The literature suggests the possibility of long-term psychiatric complications involving regular use of MDMA. The long-term effects may be related to the decrease in serotonin reuptake transporter (SERT) function and numbers. Recovery of SERT may take weeks and months; ultimately, persistent use may lead to permanent serotonergic damage of the axons and terminals sparing the cell bodies. Patients have reported symptoms of depression, anxiety, panic attacks, and insomnia after ending MDMA use. Further studies report that patients using MDMA have difficulty concentrating and short-term memory impairment. [15] Although much of the focus in the ED involves managing the acute toxic effects of MDMA, educate patients that long-term neurologic and psychiatric complications may occur.

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