'Is MDMA a human neurotoxin?': diverse views from the discussants.

UNLABELLED Every discussant at the Novartis symposium was invited to submit a 250-word abstract, giving their views upon the question: 'Is MDMA a human neurotoxin?'. These abstracts are presented here. They illustrate a wide range of viewpoints and opinions, as might be expected from experts in such diverse fields: animal neuroscience, human cognitive testing, police pathology laboratory, psychotherapeutic institute and psychiatric hospital. Some abstracts emphasized the methodological weaknesses of the human empirical data: the uncertain nature of 'Ecstasy' tablets, the reliance on self-report data, and the contributory factors of heat, dancing/exertion, poor diet and other illicit drugs. These factors may lead to psychobiological changes, which could be misinterpreted as neural damage. The absence of gliosis in animal models was also noted, which led to suggestions that there might be alternative interpretations for the neural changes which have been observed in rats and monkeys. Others noted the absence of neural/behavioural change following a single Ecstasy tablet, or commented upon the therapeutic benefits of MDMA in a quiet supportive environment. Nevertheless, novel studies from England, Germany, Italy, the Netherlands, Scotland and Wales confirmed and extended the range of cognitive, behavioural, EEG and neurological deficits, displayed by drug-free Ecstasy users. Moreover, these deficits often remained when other illicit drug use was statistically controlled. IN CONCLUSION If MDMA neurotoxicity in humans is a myth, then it is a myth with a heavy serotonergic component.