Anxiety-related Symptoms following the Sporadic Use of Ecstasy – A Case Study
Tomislav Majić, Lasse Brandt, Christiane Montag
Journal of Psychoactive Drugs November 25, 2021 DOI: 10.1080/02791072.2021.2006372 via OpenAlex
Summary
AI-generated from the abstractA 24-year-old high-functioning student with a history of obsessive-compulsive disorder and sporadic recreational ecstasy use developed a complex depersonalization/derealization syndrome, including intermittent time distortions and brief episodes of misidentifying people, after using ecstasy during a stressful period. Obsessive thoughts returned and he experienced his first panic attack. Symptoms fully remitted after 14 months of combined pharmacological treatment and psychotherapy. Months after discontinuing escitalopram, panic attacks recurred and became regular. While MDMA shows promise for treating anxiety disorders in controlled therapy, recreational or self-medicated use may be harmful for individuals with a history of anxiety or dissociative symptoms.
Study at a glance
| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | High-functioning 24-year-old student with a history of obsessive-compulsive disorder and sporadic recreational ecstasy use |
| Intervention | pharmacological treatment and psychotherapy |
| Duration | 14-month treatment and follow-up, with additional follow-up after escitalopram discontinuation |
| Topics | Anxiety MDMA |
| Keywords | Depersonalization Psychiatry Panic |
| Citations | 3 |
| Key finding | A patient with a history of OCD developed depersonalization/derealization syndrome, panic attacks, and recurrent obsessive thoughts after recreational ecstasy use during a stressful period, with symptoms remitting after 14 months of treatment but panic attacks recurring after escitalopram discontinuation. |
Abstract
3,4-methylenedioxymethamphetamine (MDMA/"ecstasy") is widespread in the electronic club scene, but MDMA has also been suggested for the treatment of anxiety spectrum disorders like posttraumatic stress disorder (PTSD) and social anxiety in autistic adults. Here, we report a case of a high functioning 24-old student with a sporadic recreational use of ecstasy, and a history of a single episode of obsessive-compulsive disorder (OCD). A few days after using ecstasy during a period of stressful life events, he developed a complex depersonalization/derealization syndrome (DDS) including intermittent distortions of time and very short intermittent episodes of misidentification of persons. Furthermore, obsessive thoughts reappeared and he suffered a panic attack for the first time in his life. Under combined pharmacological treatment and psychotherapy, symptoms gradually subsided until full remission after 14 months. Some months after discontinuation of escitalopram, however, panic attacks recurred, evolving into a regular pattern. Even if MDMA is a promising tool for the treatment of some anxiety spectrum disorders in the framework of substance-assisted psychotherapy, the use of ecstasy might be also harmful for some patients with a history of anxiety or dissociative symptoms, when used recreationally or as a self-medication outside of a controlled clinical setting.