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Reneman L, Lavalaye J, Schmand B, de Wolff FA, van den Brink W, den Heeten GJ, Booij J. 
“Cortical Serotonin Transporter Density and Verbal Memory in Individuals Who Stopped Using 3,4-Methylenedioxymethamphetamine (MDMA or 'Ecstasy'): Preliminary Findings”. 
Archives of General Psychiatry. 2001;58(10):901-906.
Background Although the popular drug 3,4-methylenedioxymethamphetamine (MDMA or 'ecstasy') has been shown to damage brain serotonin (5-HT) neurons in animals, the fate and functional consequences of 5-HT neurons after MDMA injury are not known in humans. We investigated the long-term effects of MDMA use on cortical 5-HT neurons in humans and memory function, because brain 5-HT has been implicated in memory function. Methods Twenty-two recent MDMA users, 16 ex-MDMA users who had stopped using MDMA for more than 1 year, and 13 control subjects. The effects of MDMA use on cortical 5-HT neurons was studied by means of single-photon emission computed tomography with iodine 123–labeled 2-carbomethoxy-3-(4-iodophenyl) tropane ([123I]-CIT) by quantification of brain 5-HT transporter densities. Verbal memory performance was assessed with the Rey Auditory Verbal Learning Test. Results Mean cortical [123I]-CIT-labeled 5-HT transporter density was significantly lower in recent MDMA users than in controls (1.17 vs 1.28 [–9%]) but not in ex-MDMA users (1.24 vs 1.28 [-3%]). Recent and ex-MDMA users recalled significantly fewer words than did controls on the immediate recall (47.0 and 48.0 vs 60.0, respectively; P = .001) as well as the delayed recall (9.8 and 10.1 vs 13.1, respectively; P = .003). Greater use of MDMA was associated with greater impairment in immediate verbal memory. However, memory performance was not associated with [123I]-CIT binding to cortical 5-HT transporters or duration of abstinence from MDMA. Conclusion The present study suggests that, while the neurotoxic effects of MDMA on 5-HT neurons in the human cortex may be reversible, the effects of MDMA on memory function may be long-lasting.
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