Use of amphetamine by recreational users of ecstasy (MDMA) is associated with reduced striatal dopamine transporter densities: a [123I] b -CIT SPECT study - preliminary report (2002)

RATIONALE. Tablets sold as ecstasy often contain not only 3,4-methylenedioxymethamphetamine (MDMA) but other compounds well known to cause doparninergic neurotoxicity, such as (meth)amphetamine. Furthermore, the use of ecstasy in the Netherlands is often combined with the use of amphétamine. However, little is known about the effects of ecstasy use or the combination of ecstasy and amphétamine use on dopamine (DA) neurones in the hurnan brain. OBJECTIVES. This study was designed to investigate the effects of ecstasy as well as the combined use of ecstasy and amphétamine on the density of nigrostriatal DA neurones. METHODS. [123I]b-CIT SPECT was used to quantify striatal DA transporters. Striatal [123I]b-CIT binding ratios of control subjects (n=15) were compared with binding ratios of ecstasy users (n=29) and individuels with a history of combined ecstasy and amphétamine use (n=9) after adjustment for age. RESULTS. Striatal [123I]b-CIT binding ratios were significantly lower in combined ecstasy and amphétamine users compared to sole ecstasy users (6.75 versus 8.46, respectively: -20.2%, P=0.007). Binding ratios were significantly higher in ecstasy users when compared to controls (8.46 versus 7.47, respectively: +13.2%, P=0.045). CONCLUSIONS. These initial observations suggest that the sole use of ecstasy is not related to dopaminergic neurotoxicity in humans. In contraste the reported use of amphetamine by regular users of ecstasy seems to be associated with a réduction in nigrostriatal DA neurones. (Author' s abstract)