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Ecstasy

Neue pharmakologische und epidemiologische Erkenntnisse und deren praktische Bedeutung
  • Christina Poethko-Müller
Chapter

Zusammenfassung

Ecstasy ist ein Sammelbegriff für verschiedene Methylendioxyamphetamine mit antriebssteigernder und halluzinogener Wirkung, die darüber hinaus eine sogenannte „entaktogene“ Wirkung aufweisen. Der Begriff „entaktogen“ wird als „im Inneren ein Gefühl erzeugen“oder „Herstellen einer inneren Ber“hrung“ übersetzt und charakterisiert die Wirkung psychoaktiver Stoffe, die unbewußte Gefühle und Erfahrungen wieder zugänglich machen und die Selbstreflexion fördern. Bei 3,4 Methylendioxymethamphetamin (MDMA) als Hauptvertreter dieser Gruppe steht diese entaktogene Wirkung im Vordergrund des erstrebten Rausches. Darüber hinaus erzeugt MDMA neben den auch vorhandenen antriebssteigernden und euphorisierenden Wirkungen ein Gefühl der großen Nähe zu anderen Menschen. Negative psychotrope Wirkungen können den akuten Rausch überdauern und werden vor allem in Form von depressiver Verstimmung und Angst erlebt.

Ecstasy ist keine neue Substanz. Neu ist jedoch das Ausmaß und die Geschwindigkeit, mit der sich Ecstasy — gekoppelt an die Verbreitung der Techno-Party-Szene — weltweit durchgesetzt hat.

Epidemiologische Untersuchungen der letzten zwei Jahre vermitteln Einblicke, die über die eindrücklichen Steigerungsraten der Bundeskriminalstatistiken (Sicherstellungsmengen; Anteil an den erstauffälligen Konsumenten) hinausgehen. Die aus Repräsentativerhebungen und Erhebungen in der Technoszene ermittelte Lebenszeitprävalenz für Ecstasy bestätigen den intensiven Gebrauch vor allem in dieser Szene als sog.

„Freizeitdroge“. Darüber hinaus zeichnet sich jedoch die Existenz einer Konsumentengruppe mit exzessiven Gebrauchsmustern und psychischer Abhängigkeit ab. Für diese Gruppe wird ein erhebliches Risiko hinsichtlich medizinischer oder psychiatrischer Komplikationen angenommen. Diese Komplikationen lassen sich auf zentrale und periphere serotonerge Wirkungen von Ecstasy zurückführen bzw.durch die neurotoxischen Wirkungen von Ecstasy erklären. Die Quote psychisch abhängiger Ecstasy-Konsumenten ist überraschend hoch. Die möglichen neurotoxischen Wirkungen sind eventuell irreversibel. Die Risiken und die Ausbreitungsgeschwindigkeit von Ecstasy zeigen die Notwendigkeit geeigneter primär- und sekundärpräventiver Maßnahmen, die durch das herkömmliche Drogenhelfersystem bislang nur unzureichend geleistet werden konnten.

Pharmacology and Epidemiology of Ecstasy

Summary

The term „Ecstasy“ includes a group of different methylenedioxyamphetamines which produce hallucinogenic activity, stimulation and the so-called ëentactogenic’effects.—„ntactogen“ is usually translated as „produ-cing a touching within“ or „creating an internal contact“ and refers to the special psychotropic effect of this substances. Entactogens have been reported to make users aware of previously unconscious feelings and experiences. The „entactogenic“ effect is the most typical of the psychedelic effects n 3,4-methylenedioxyamphetamine (MDMA). MDMA induces euphoria and acts stimulating, but the most common effect of MDMA is a heightened sense of „closeness“ with other people. The negative effects, especially depression and a general sense of anxiety, may endure after the acute phase of ecstasy. Ecstasy is not a novel substance. However, the rapid spread connected with the arising technoscene and the increasing prevalence of ecstasy-use world-wide is unprecedented.

Epidemiological research of the last two years provides insights going further than just showing increasing numbers in the criminal statistics (e.g. ecstasy seizures; number of ecstasy users who became conspicuous the first time). According to surveys the lifetime prevalence of ecstasy is highest in the context of the techno culture, where ecstasy is mainly taken as a recreational drug. However, there seems to be a consumer group who exhibit extreme patterns of use and a high degree of psychic dependency. These consumers may be jeopardised by medical and psychiatric complications. The complications are due to the central and peripheral serotonergic effects of ecstasy. There are also neurotoxic side effects of ecstasy clearly proven in animal models and recently, for the first time, also shown in humans.

The rate of psychic dependency is surprisingly high. Possible neurotoxic effects may be irreversible. In the face of the risks and the rapid spread of ecstasy suitable primary and secondary prevention is needed. Until now this has not been accomplished by the established structures.

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Literatur

  1. 1.
    Eisner B (1989) Extasy: The MDMA Story. Ronin Publishing Inc., Berkley.Google Scholar
  2. 2.
    Schmidt-Semisch H (1996) Ecstasy und Designer-Drogen. Wiener Zeitschrift für Suchtforschung 19:3–16.Google Scholar
  3. 3.
    Shulgin AT, Sargent T, Naranjo C (1967) The chemistry and psychopharmacology of nutmeg and of several related phenyliso-propylamines. In: Efron D (ed) Ethnological Search for Psychoactive Drugs, US Government Printing Office, Washington DC, pp 202–214.Google Scholar
  4. 4.
    Fromberg E (1992) Designer-Drogen und ihre Herausforderung für Beratung und Therapie. In: Designer Drogen (Tagungsbericht) Forum Sucht. Landschaftsverband Westfalen Lippe, S 25-35.Google Scholar
  5. 5.
    Patentschrift des kaiserlichen Patentamtes Nr, 274350 Klasse 12p. Gruppe 32/10 (patentiert ab 24.12.1912, ausgegeben 16.5.1914).Google Scholar
  6. 6.
    Seymour RB (1986) MDMA. Haight Asbury Publications, San Francisco.Google Scholar
  7. 7.
    Sahihi A (1998) Designer-Drogen. Die neue Gefahr. Beltz Verlag, Weinheim.Google Scholar
  8. 8.
    Hess P (1992) Zur Pharmakologie von MDMA. In: Weigle C, Rippchen W (Hrsg) Piepers Medienexperimente. Löhrbach Verlag.Google Scholar
  9. 9.
    Marks J (1979) The search for the îManchu-rian candidate”: Dell, New York.Google Scholar
  10. 10.
    Lee MA, Shlain B (1985) Acid dreams: the CIA, LSD and the sixties rebellion. Grove Weidenfld, New York.Google Scholar
  11. 11.
    Saunders N (1994) Ecstasy. Verlag Ricco Bilder, Zürich.Google Scholar
  12. 12.
    Shulgin AT, Nichols DE (1978) Characterization of three new psychotomimetics. In: Stillman R, Willete R (eds) The Psychopharmacology of Halluzinogens. Pergamon Press, New York, pp 74–83.Google Scholar
  13. 13.
    Downing J (1986) The psychological and physiological effects of MDMA on normal volunteers. Journal of Psychoactive Drugs 18: 335–340.PubMedCrossRefGoogle Scholar
  14. 14.
    Greer G, Strassman RJ (1985) Information on Ecstasy. American Journal of Psychiatry 142: 1391.PubMedGoogle Scholar
  15. 15.
    Greer G, Tolbert P (1986) Subjective reports of the effects of MDMA in a clinical setting. Journal of Psychoactive Drugs 18: 319–327.PubMedCrossRefGoogle Scholar
  16. 16.
    Meyers F, Rose A, Smith D (1967–1968) Incidents involving the Haight-Ashbury population and some uncommonly used drugs. Journal of Psychedelic Drugs 1:140–146.Google Scholar
  17. 17.
    Peroutka SJ (1987) Incidence of recreational use of 3,4-methylenedioxymethamphet-amine (MDMA,îEcstasy“) on an undergraduate campus. New England Journal of Medicine 317:1542–1543.PubMedGoogle Scholar
  18. 18.
    Lawn JC (1986) Schedules of controlled substance; scheduling of 3,4-methylenedi-oxymethamphetamine (MDMA) into Schedule I of the Controlled Substance Act. Federal Register 51:36552–36560.Google Scholar
  19. 19.
    Henry JA, Jeffreys S, Dawlling S (1992) Toxicity and deaths from 3,4-methylenedioxym-ethamphetamine (îecstasy”). Lancet 340: 384–387.PubMedCrossRefGoogle Scholar
  20. 20.
    Hermle LE, Gouzoulis M, Undtzer M (1994) Rauschdrogen in der psychiatrischen Forschung. Ectracta Psychiatrica 7/8:16–20.Google Scholar
  21. 21.
    Kuhlmann T (1996) Ecstasy, eine Designerdroge der Technoszene. Psychiatrische Praxis 23:266–269.PubMedGoogle Scholar
  22. 22.
    Nichols DE (1986) Differences between the mechanism of Action of MDMA, MDMB and the Classic Hallucinogens. Identification of a New Class: Entactogens. Journal of Psychoactive Drugs 18:305–313.PubMedCrossRefGoogle Scholar
  23. 23.
    Thomasius R (1997a) îEcstasy’-Rauschwirkungen, Komplikationen, Risikoträger. Sucht-Sonderheft, S18-25.Google Scholar
  24. 24.
    Kovar KA, Rösch C, Rupp A, Hermle L (1990) Synthetische Suchtstoffe der 2.Generati-on (sog. Designer Drugs). 1. Mitt.: Amphetamine und andere Arylalkanamine. Pharmazie in unserer Zeit 19:99–107.PubMedCrossRefGoogle Scholar
  25. 25.
    Callaway CW, Geyer MA (1991 b) Stimulant effects of 3,4-methylenedioxymethamphet-amine in the nucleus accumbens of rat. European Journal of Pharmacology 214:45–51.CrossRefGoogle Scholar
  26. 26.
    Gold LH, Hubner CB, Koob GF (1989) A role for the mesolimbic dopamine system in the psychostimulant actions of MDMA. Psycho-pharmacology 99:40–47.CrossRefGoogle Scholar
  27. 27.
    Gray JA (1991) The neuropsychology of temperament. In: Strelau J, Angleitner A (eds) Explorations in temperament. Plenum Press, New York.Google Scholar
  28. 28.
    Beck J, Morgan PA (1986) Designer Drug Confusion: a focus on MDMA. Journal of Drug Education 16:287–302.PubMedCrossRefGoogle Scholar
  29. 29.
    Liester MB, Grob CS, Bravo GL, Walsh RN (1992) Phenomenology and sequelae of 3,4-me-thylenedioxymethamphetamine use. Journal of Nervous and Mental Disease 180: 345–352.PubMedCrossRefGoogle Scholar
  30. 30.
    Peroutka SJ, Newman H, Harris H (1988) Subjective effects of 3,4-methylenedioxym-ethamphetamine in recreational users. Neuropharmacology 1:273–277.Google Scholar
  31. 31.
    Siegel RK (1986) MDMA: Nonmedical use and intoxication. Journal of Psychoactive Drugs 18:349–354.PubMedCrossRefGoogle Scholar
  32. 32.
    Solowij N, Hall W, Lee N (1992) Recreational MDMA use in Sydney: A profile of îEcstasy“ users and their experiences with the drug. British Journal of Addiction 87:1161–1172.PubMedCrossRefGoogle Scholar
  33. 33.
    Thomasius R, Schmolke M, Kraus D (1997c) MDMA (îEcstasy“)-Konsum-ein Überblick zu psychiatrischen und medizinischen Folgen. Fortschritte der Neurologie-Psychiatrie 65:49–61.PubMedCrossRefGoogle Scholar
  34. 34.
    Currant HV, Travill RA (1997) Mood and cognitive effects of 3,4-methylenedioxyam-phetamine (MDMA, îecstasy“): week-end îhigh“ followed by mid-week low. Addiction 92:821–831.Google Scholar
  35. 35.
    Gerra G, Zaimovic A, Giucastro G, Maestri D, et al (1998) Serotonergic function after (±)3,4-methylene-dioxymethamphetami-ne (éEcstasy’) in humans. International Clinical Pharmacology 13:1–9.Google Scholar
  36. 36.
    Cadier MA, Clarke JA (1993) Ecstasy and Whizz at a rave resulting in a major burn plus complications. Burns 19:239–240.PubMedCrossRefGoogle Scholar
  37. 37.
    Fahal IH, Sallomi DF, Yaqoob M, Bell GM (1992) Acute renal failure after ecstasy. British Medical Journal 305:29.PubMedCrossRefGoogle Scholar
  38. 38.
    Gledhill JA, Moore DF, Bell D, Henry JA (1993) Subarachnoidal haemorrhage associated with MDMA abuse. Journal of Neurology, Neurosurgery and Psychiatry 56:1036–1037.PubMedCrossRefGoogle Scholar
  39. 39.
    Gorard DA, Davies SE, Clark ML (1992) Misuse of ecstasy. British Medical Journal 305:309.PubMedCrossRefGoogle Scholar
  40. 40.
    Hughes JC, McCabe M, Evans RJ (1993) Intra-cranial haemorrhage associated with ingestion of îEcstasy“. Archives of Emergency Medicine 10:372–374.PubMedCentralPubMedCrossRefGoogle Scholar
  41. 41.
    Oranje WA, Pol Pv, Wurff Avd, Zeijen RNM, etal. (1994) XTC-induced hepatitis. Netherlands Journal of Medicine 44:56–59.PubMedGoogle Scholar
  42. 42.
    Shearman JD, Capman RW, Satsangi J, Ryley NG (1992) Misuse of ecstasy. British Medical Journal 305:309.PubMedCrossRefGoogle Scholar
  43. 43.
    Suarez RV, Riemersma R (1988) îEcstasy„ and sudden cardiac death. American Journal of Forensic Medicine and Pathology 9:339–341.PubMedCrossRefGoogle Scholar
  44. 44.
    Campkin NTA, Davies UM (1992) Another death from Ecstasy. Journal of the Royal Society of Medicine 8:561.Google Scholar
  45. 45.
    Chadwick IS, Linsley A, Freemont A, Doran B, et al. (1991) Ecstasy 3,4-methylenedioxyam-phetamine (MDMA), a fatality associated with coagulopathy and hyperthermia. Journal of the Royal Society of Medicine 84: 371.PubMedCentralPubMedGoogle Scholar
  46. 46.
    Dowling GP, McDonough ET, Bost RO (1987) „Eve“ and „Ecstasy“ a report of five deaths associated with the use of MDEA and MDMA. JAMA 257:1615–1617.PubMedCrossRefGoogle Scholar
  47. 47.
    Dinse H (1997) Ecstasy (MDMA)-lntoxikati-on. Ein Überblick. Anaesthesist 46:697–703.PubMedCrossRefGoogle Scholar
  48. 48.
    Freye E (1997) Abusus von Ecstasy und verwandten Designer-Drogen. Anästhesiologie & Intensivmedizin 9:517–530.Google Scholar
  49. 49.
    Sauer O, Weilemann LS (1997) Psychogene Amphetamine (îEcstasy“). Intensivmedizin und Notfallmedizin 34:5–13.CrossRefGoogle Scholar
  50. 50.
    Heinz TW (1996) Auswirkungen des Konsums von îDesignerdrogen“. Deutsches Ärzteblatt 93:358–360.Google Scholar
  51. 51.
    Sternbach GL, Varon JV (1992) Designer drugs. Recognizing and managing their toxic effects. Postgraduate Medicine 91: 169–176.PubMedGoogle Scholar
  52. 52.
    Singarajah C, Lavies NG (1992) An overdose of ecstasy. A role for dantrolene. Anaesthesia 47:686–687.PubMedCrossRefGoogle Scholar
  53. 53.
    Campkin NTA, Davies UM (1993) Treatment of îecstasy“ overdose with dantrolene (letter). Anaesthesia 48:82–83.PubMedCrossRefGoogle Scholar
  54. 54.
    Lamer AJ (1992) Complications of îecstasy“ misuse (letter). Lancet 340:726.CrossRefGoogle Scholar
  55. 55.
    Padkin A (1994) Treating MDMA (îEcstasy“) toxicity. Anaesthesia 49:259.PubMedCrossRefGoogle Scholar
  56. 56.
    Webb C, Williams V (1993) Ecstasy intoxication: appreciation of complications and the role of dantrolene. Anaesthesia 48: 1057–1060.CrossRefGoogle Scholar
  57. 57.
    Gu XF, Azmitia EC (1993) Integrative transport-mediated release from cytoplasmatic and vesicular 5-hydroxytryptamine stores in cultured neurons. European Journal of Pharmacology 235:51–75.PubMedCrossRefGoogle Scholar
  58. 58.
    Berger UV, Gu XF, Azmitia EC (1992) The substituted amphetamines 3,4-methylen-edi-oxymethamphetamine, methamphet-amine, para-chloroamphetamine and fen-fluramine induce 5-hydroxytryptamine release via a common mechanism blocked by fluoxetine and cocaine. European Journal of Pharmacology 215:153–160.PubMedCrossRefGoogle Scholar
  59. 59.
    Gehlert DR, Schmidt CJ, Wu L, Lovenberg W (1985) Evidence for specific methylenedi-oxymethamphetamine (ecstasy) binding sites in the rat brain. European Journal of Pharmacology 119:135–136.PubMedCrossRefGoogle Scholar
  60. 60.
    Rudnik G, Wall SC (1992) The molecular mechanisms of ecstasy [3,4-methylen-edi-oxyamphetamine (MDMA)]. Serotonin transporters are targets for MDMA-induced serotonin release. Proceedings of the National Academy of Sciences of the United States of America 89:1817–1821.CrossRefGoogle Scholar
  61. 61.
    Schechter MD (1989) Serotonergic-dop-aminergic mediation of 3,4-methylene-di-oxymethamphetamine (MDMA, îEcstasy“). Pharmacology, Biochemistry and Behaviour 31: 817–824.CrossRefGoogle Scholar
  62. 62.
    Leonardi ETK, Azmitia EC (1994) MDMA (Ecstasy) inhibition of MAO Type A and Type B: comparisons with fenfluramine and fluoxetine (Prozac). Neuropsychopharmacology 10:231–238.PubMedCrossRefGoogle Scholar
  63. 63.
    Pierce PA, Peroutka SJ (1989) Hallucinogenic drug interactions with neurotransmitter receptor binding sites in human cortex. Psychopharmacology 97:118–122.PubMedCrossRefGoogle Scholar
  64. 64.
    Wing LL, Tapson GS, Geyer MA (1995) 5-HT-2 mediation of acute behavioral-effects of hallucinogens in rats. Psychpharmacology 100:417–425.CrossRefGoogle Scholar
  65. 65.
    Habert E, Graham D, Tahraoui L, Claustre Y et al. (1985) Characterization of [3H]-paroxetine binding to rat cortical membranes. European Journal of Pharmacology 118:107–114.PubMedCrossRefGoogle Scholar
  66. 66.
    Zhou D, Schreinert M, Pilz J, Huether G (1996) Rat strain differences in the vulnerability of serotonergic nerve endings to neuroto-xic damage by p-chloroamphetamine. Journal of Neural Transmission 103: 1381–1395.PubMedCrossRefGoogle Scholar
  67. 67.
    Huether G, Zhou D, Rüther E (1997) Causes and consequences of the loss of serotonergic presynapses elicited by the consumption of 3,4-methylenedioxymethamphet-amine (MDMA, îecstasy“) and its congeners. Journal of Neural Transmission 104: 771–794.PubMedCrossRefGoogle Scholar
  68. 68.
    Callaway CW, Johnson MP, Gold LH, Nichols DE et al. (1991 a) Amphetamine dérivâtes induce locomotor hyperactivity by acting as indirect serotonin agonists. Psychopharmacology 214:293–301.CrossRefGoogle Scholar
  69. 69.
    Gudelsky GA, Yamamoto BK, Nash JF (1994) Potentiation of 3,4-methylenedioxymeth-amphetamine-induced dopamine release and serotonin neurotoxicity by 5-HT2 agonists. European Journal of Pharmacology 264: 325–330.PubMedCrossRefGoogle Scholar
  70. 70.
    Johnson MP, Conarty PF, Nichols DE (1993) [3H]-Monoamine releasing and uptake inhibition properties of 3,4-methylenedi-oxymethamphetamine and p-chloroamphetamine analogues. European Journal of Pharmacology 200:9–16.CrossRefGoogle Scholar
  71. 71.
    Seiden LS, Sabol KE, Ricaurte G (1993) Amphetamine effects on catecholamine systems and behavior. Annual Review of Pharmacology 32:639–677.CrossRefGoogle Scholar
  72. 72.
    Odell SJ, Weihmuller FB, Marshall JF (1991) Multiple methamphetamine injections induce marked increases in extracellular striatal dopamine which correlate with subsequent neurotoxicity. Brain Research 564:256–260.CrossRefGoogle Scholar
  73. 73.
    Schmidt CJ, Ritter JK, Sonsalla PK, Hanson GR et al. (1985) Role of dopamine in the neuroto-xic effects of methamphetamine. Journal of Pharmacology and Experimental Therapeutics 233:539–544.PubMedGoogle Scholar
  74. 74.
    Stone DM, Johnson M, Hanson GR, Gibb JW (1988) Role of endogenous dopamine in the central serotonergic deficits induced by3,4-methylenedioxymethamphetami-ne. Journal of Pharmacology and Experimental Therapeutics 247:79–87.PubMedGoogle Scholar
  75. 75.
    Sprague J, Nichols DE (1995) The monoamine oxidase B inhibitor L-deprenyl protects against 3,4-methylenedioxymethamphet-amine induced lipid peroxidation and long term serotonergic deficits. Journal of Pharmacology and Experimental Therapeutics 273:667–673.PubMedGoogle Scholar
  76. 76.
    Stone DM, Hanson GR, Gibb JW (1989) In vitro reactivation of rat cortical tryptophan hy-droxylase following in vivo inactivation by MDMA. Journal of Neurochemistry 53: 572–581.PubMedCrossRefGoogle Scholar
  77. 77.
    Berger UV, Grzanna R, Molliver ME (1990) Unlike systematic administration of PCA, direct intracerebral injection does not cause neurotoxicity on 5-HT axons. Experimental Neurology 109:257–268.PubMedCrossRefGoogle Scholar
  78. 78.
    Paris JM, Cunningham KA (1992) Lack of serotonin neurotoxicity after intraraphe microinjection of (+)-3,4-methylenedi-oxymethamphetamine. Brain Research Bulletin 28:115–119.PubMedCrossRefGoogle Scholar
  79. 79.
    Battaglia G, Yeh SY, O’Hearn E, Molliver ME, Kuhar MJ., De Souza EB (1987) 3,4-Methylene-dioxymethamphetamine and 3,4-Methy-lenedioxyamphetamine destroy serotonin termins in rat brain: quantification of neu-rodegeneration by measurements of [3H]-paroxetine-labelled serotonin uptake sites. Journal of Pharmacology and Experimental Therapeutics 242: 911–916.PubMedGoogle Scholar
  80. 80.
    Johnson M, Elayan I, Hanson GR, Foltz L, Gibb JW, Lim HK (1992) Effects of 4,4-dihydro-xymethamphetamine and 2,4,5-trihydro-xymethamphetamine, two metabolites of 3,4-methylenedioxymethamphetamine, on central serotonergic and dopaminergic systems. Journal of Pharmacology and Experimental Therapeutics 261:447–453.PubMedGoogle Scholar
  81. 81.
    Schmidt CJ (1987) Neurotoxicity of the psyc-hodelic amphetamine, methylenedioxy-methyl-amphetamine. Journal of Pharmacology and Experimental Therapeutics 240:1–7.PubMedGoogle Scholar
  82. 82.
    Colado MI, Murray TK, Green AR (1993) 5-HT loss in rat brain following 3,4-methylene-dioxymethamphetamine (MDMA), p-chlo-roamphetamine and fenfluramine administration and effects of chlormethiazole and dizoclipine. British Journal of Pharmacology 108:583–589.PubMedCrossRefGoogle Scholar
  83. 83.
    Finnegan KT, Calder L, Clikeman J, Wei S et al. (1993) Effects of l-type calcium channel antagonists on the serotonin-depleting actions of MDMA in rats. Brain Research 603: 134–138.PubMedCrossRefGoogle Scholar
  84. 84.
    Stone DM, Stahl DC, Hanson GR, Gibb JW (1986) The effects of 3,4-methylenedi-oxymethamphetamine (MDMA) and of 3,4-methylenedioxyamphetamine(MDA) on monoaminergic systems in the rat brain. European Journal of Pharmacology 128: 41–48.PubMedCrossRefGoogle Scholar
  85. 85.
    Insel TR, Battaglia G, Johannessen JN, Marra S etal (1989) 3,4-methylenedioxymetham-phetamine (»Ecstasy«) destroys brain serotonin terminals in rhesus monkeys. Journal of Pharmacology and Experimental Therapeutics 249:713–720.PubMedGoogle Scholar
  86. 86.
    Ricaurte GA, Forno LS, Wilson MA, de Lanney LE, Irwin I, Molliver ME, Langston JW (1988b) MDMA selectively damages central serotonergic neurons in the primate. JAMA 260: 51–55.PubMedCrossRefGoogle Scholar
  87. 87.
    Wilson MA, Ricaurte GA, Molliver ME (1989) Distinct morphologic classes of serotonergic axons in primates exhibit differential vulnerability to the psychotropic drug 3,4-methylenedioxymethamphetamine. Neuroscience 28:121–137.PubMedCrossRefGoogle Scholar
  88. 88.
    Ricaurte GA, McCann UD (1992) Neurotoxic amphetamine analogues: effects in monkeys and implications for humans. Annals of the New York Academy of Science 684: 371–382.CrossRefGoogle Scholar
  89. 89.
    Ricaurte GA, Delanney LE, Irwin I, Langston JW (1988a) Toxic effects of MDMA on central serotonergic neurons in the primate: importance of route and frequency of drug administration. Brain Research 446:165–168.PubMedCrossRefGoogle Scholar
  90. 90.
    Creighton FJ, Black DL, Hyde CE (1991) Ecstasy psychosis and flashbacks. British Journal of Psychiatry 159:713–715.PubMedCrossRefGoogle Scholar
  91. 91.
    McCann UD, Ricaurte GA (1991) Lasting neuropsychiatric sequelae of ±-methylenedi-oxymethamphetamine (îEcstasy”) in recreational users. Journal of Clinical Psychopharmacology 11: 302–305.PubMedCrossRefGoogle Scholar
  92. 92.
    McGuire PK, Cope H, Fahy TA (1994) Diversity of psychopathology associated with the use of 3,4-methylenedioxymethamphet-amine (îEcstasy”). British Journal of Psychiatry 165:391–395.PubMedCrossRefGoogle Scholar
  93. 93.
    Pallanti S, Mazzi D (1992) MDMA (ecstasy) precipitation of panic disorder. Biological Psychiatry 32:91–95.PubMedCrossRefGoogle Scholar
  94. 94.
    Schifano F, Magni G (1994) MDMA („Ecstasy”) abuse: psychopathological features and craving for chocolate: a case series. Biological Psychiatry 36: 763–767.PubMedCrossRefGoogle Scholar
  95. 95.
    White SR, Obradovic T, Imel KM, Wheaton MJ (1996) The effects of methylenedioxym-ethamphetamine (MDMA, îEcstasy”) on monoaminergic neurotransmission in the central nervous system. Progress in Neurobiology 49:455–479.PubMedCrossRefGoogle Scholar
  96. 96.
    McCann UD, Ridenour BS, Shaham, Ricaurte GA (1994) Serotonin neurotoxicity after 3,4-methylenedioxymethamphetamine (MDMA): a controlled study in humans. Neuropsychopharmacology 10:129–138.PubMedCrossRefGoogle Scholar
  97. 97.
    Thomasius R Ecstasy: Verwendergruppen und Gefährdungsgrade. Eine empirische Studie auf der Grundlage einer psychiatrisch-psychodynamischen und klinischen apparativen Diagnostik von 100 Ecstasy-Konsumenten. Wiener Zeitschrift für Suchtforschung (im Druck).Google Scholar
  98. 98.
    McCann DU, Szabo Z, Scheffel U, Dannais RF, Ricaurte GA (1998) Positron emission tomo-grafic evidence of toxic effects of MDMA („Ecstasy”) on brain serotonin neurons in human beings. Lancet 352: 1433–1437.PubMedCrossRefGoogle Scholar
  99. 99.
    BKA Rauschgiftjahresbericht 1996, Bundesrepublik Deutschland.Google Scholar
  100. 100.
    Herbst K, Kraus L, Scherer K (1996) Repräsentativerhebung zum Gebrauch psychoaktiver Substanzen bei Erwachsenen in Deutschland. Institut fürTherapieforschung, München.Google Scholar
  101. 101.
    Bundeszentrale für gesundheitliche Aufklärung (1994) Die Drogenaffinität Jugendlicher in der Bundesrepublik Deutschland. Wiederholungsbefragung 1993/94. BZgA, Köln.Google Scholar
  102. 102.
    Rakete G, Flüsmeier U (1997) Der Konsum von Ecstasy. Hamburgische Landesstelle gegen Suchtgefahren e. V. im Auftrag der BZgA.Google Scholar
  103. 103.
    Schuster P, Wittchen HU (1996) Ecstasy-und Halluzinogengebrauch bei Jugendlichen. Gibt es eine Zunahme? Verhaltenstherapie 6:222–232.CrossRefGoogle Scholar
  104. 104.
    Tossmann HP, Heckmann W (1997) Drogenkonsum Jugendlicher in der Techno-Party-Szene, im Auftrag der BZgA.Google Scholar
  105. 105.
    Wilkens W, Thiel G, Friedrich E (1997) Illegal oder (l)egal-rechtlicher Status und Konsum von MBDB und anderen Ecstasy Wirkstoffen. Eine Szenebefragung aus 1996.Google Scholar
  106. 106.
    Thomasius R (1997b) Ecstasy Konsumenten, Risiken, praktische Hilfen. Der Mediziner 9: 44–48.Google Scholar
  107. 107.
    Domes R, Rabes M (1997) Europäisches Modellprojekt erarbeitet Ecstasy-Materialien. Büro für Suchtprävention, Hamburg.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1999

Authors and Affiliations

  • Christina Poethko-Müller
    • 1
  1. 1.Bundesinstitut für Arzneimittel und MedizinprodukteBerlinDeutschland

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