Sub-acute effects of MDMA (±3,4-methylenedioxymethamphetamine, "ecstasy") on mood: evidence of gender differences

Recreational users of MDMA ('ecstasy') show sex-dependent mood changes days after taking the drug. Women who used MDMA reported higher depression scores four days later compared to male users and non-using controls, and their mid-week depression correlated with the amount of MDMA taken. Both men and women reported lower aggression on the night of use but significantly higher aggression mid-week; in men, the increase in aggression correlated with the weekend dose. No association was found between mood and long-term use patterns. The findings suggest that central serotonin function may be temporarily reduced after acute MDMA use, with women more susceptible to mid-week low mood and both sexes showing increased aggression.

Study at a glance

Abstract

RationaleResearch with animals suggests that central 5-hydroxytryptamine (5-HT) function may be attenuated for a period following a single dose of +/-3,4-methylenedioxymethamphetamine (MDMA, 'ecstasy'). If the same is true in humans, then functions thought to be modulated by 5-HT may differ in MDMA users compared with non-users a few days after the drug is taken.AimsThe present study therefore investigated both acute and sub-acute effects of MDMA on mood of recreational users. A second aim was to determine whether these effects differ for females and males.DesignA parallel group design was used to compare 40 participants who reported taking MDMA with 40 participants who reported using illicit substances excluding MDMA (polydrug controls). Participants were assessed on the night of drug use (day 0) and again 4 days later.ResultsFemale MDMA users showed higher depression scores mid-week than male users or male or female controls. Mid-week depression in female users was correlated with the amount of MDMA taken on day 0. MDMA users rated lower levels of aggression than controls on the night of drug use but significantly higher levels of aggression mid-week, and in males change in aggression correlated with the amount of MDMA taken on the weekend. There was no association between mood and measures of long-term use of MDMA (e.g. years of use).ConclusionWomen are more susceptible than men to mid-week low mood following weekend use of MDMA; however, both men and women show increased self-rated aggression. These results are interpreted in terms of an attenuation of 5-HT function for a period following acute use of MDMA.