A reconsideration and response to Parrott AC (2013) “Human psychobiology of MDMA or ‘Ecstasy’: an overview of 25 years of empirical research”

Parrott recently published a review of literature on MDMA/ecstasy. This commentary is a response to the content and tenor of his review, which mischaracterizes the literature through misstatement and omission of contrary findings, and fails to address the central controversies in the literature. The review makes several erroneous statements concerning MDMA‐assisted psychotherapy, such as incorrect statements about research design and other statements that are baseless or contradicted by the literature. Though it critiques an attempt by other authors to characterize the risks of MDMA, the review fails to produce a competing model of risk assessment, and does not discuss potential benefits. Parrott does not represent an even‐handed review of the literature, but instead recites dated misconceptions about neurotoxicity concerns involving the recreational drug ecstasy, which do not relate directly to the use of pure MDMA in a therapeutic setting. Unchallenged, Parrott's report may deter researchers from further investigating an innovative treatment that in early clinical trials has demonstrated lasting benefits for people with chronic, treatment‐resistant post‐traumatic stress disorder. Copyright © 2014 John Wiley & Sons, Ltd.

[1]  A. Parrott Human psychobiology of MDMA or ‘Ecstasy’: an overview of 25 years of empirical research , 2013, Human psychopharmacology.

[2]  T. Brewerton,et al.  Durability of improvement in post-traumatic stress disorder symptoms and absence of harmful effects or drug dependency after 3,4-methylenedioxymethamphetamine-assisted psychotherapy: a prospective long-term follow-up study , 2013, Journal of psychopharmacology.

[3]  U. Schnyder,et al.  A randomized, controlled pilot study of MDMA (±3,4-Methylenedioxymethamphetamine)-assisted psychotherapy for treatment of resistant, chronic Post-Traumatic Stress Disorder (PTSD) , 2013, Journal of psychopharmacology.

[4]  Y. Lin,et al.  Interaction between smoking and obstructive sleep apnea: not just participants. , 2012, Chinese medical journal.

[5]  S. Gruber,et al.  REPLY TO PARROTT (2011), FISK ET AL. (2011) AND RODGERS ET AL. (2011) , 2011 .

[6]  A. Parrott Residual neurocognitive features of ecstasy use: a re-interpretation of Halpern et al. (2011) consistent with serotonergic neurotoxicity. , 2011, Addiction.

[7]  S. Gruber,et al.  Residual neurocognitive features of long-term ecstasy users with minimal exposure to other drugs. , 2011, Addiction.

[8]  L. Jerome,et al.  The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study , 2011, Journal of psychopharmacology.

[9]  T. Veenstra,et al.  Increased oxidative‐modifications of cytosolic proteins in 3,4‐methylenedioxymethamphetamine (MDMA, ecstasy)‐exposed rat liver , 2011, Proteomics.

[10]  J. V. van Amsterdam,et al.  Ranking the Harm of Alcohol, Tobacco and Illicit Drugs for the Individual and the Population , 2010, European Addiction Research.

[11]  H. Sørensen,et al.  Posttraumatic stress disorder and completed suicide. , 2010, American journal of epidemiology.

[12]  U. McCann,et al.  Sleep apnea in young abstinent recreational MDMA (“ecstasy”) consumers , 2009, Neurology.

[13]  M. Tancer,et al.  Effects of acute 3,4-methylenedioxymethamphetamine on sleep and daytime sleepiness in MDMA users: a preliminary study. , 2009, Sleep.

[14]  D. Nutt,et al.  Equivalent effects of acute tryptophan depletion on REM sleep in ecstasy users and controls , 2009, Psychopharmacology.

[15]  J. Cadet,et al.  Neurotoxicity of substituted amphetamines: Molecular and cellular mechanisms , 2007, Neurotoxicity Research.

[16]  R Garside,et al.  The harmful health effects of recreational ecstasy: a systematic review of observational evidence. , 2009, Health technology assessment.

[17]  Sanjay R. Patel,et al.  Epidemiology, risk factors, and consequences of obstructive sleep apnea and short sleep duration. , 2009, Progress in cardiovascular diseases.

[18]  M. Cloitre Effective psychotherapies for posttraumatic stress disorder: a review and critique. , 2009, CNS spectrums.

[19]  M. Farré,et al.  MDMA-Assisted Psychotherapy Using Low Doses in a Small Sample of Women with Chronic Posttraumatic Stress Disorder , 2008, Journal of psychoactive drugs.

[20]  C. Blakemore,et al.  Development of a rational scale to assess the harm of drugs of potential misuse , 2007, The Lancet.

[21]  U. Dirnagl,et al.  Ecstasy-induced cell death in cortical neuronal cultures is serotonin 2A-receptor-dependent and potentiated under hyperthermia , 2006, Neuroscience.

[22]  Michael H. Baumann,et al.  3,4-Methylenedioxymethamphetamine (MDMA) neurotoxicity in rats: a reappraisal of past and present findings , 2006, Psychopharmacology.

[23]  E. Gouzoulis-Mayfrank,et al.  The confounding problem of polydrug use in recreational ecstasy/MDMA users: a brief overview , 2006, Journal of psychopharmacology.

[24]  M. Pallàs,et al.  Neurotoxicity of amphetamine derivatives is mediated by caspase pathway activation in rat cerebellar granule cells. , 2004, Toxicology and applied pharmacology.

[25]  E. Ansorena,et al.  Role of reactive oxygen species, glutathione and NF-κB in apoptosis induced by 3,4-methylenedioxymethamphetamine (“Ecstasy”) on hepatic stellate cells , 2004 .

[26]  E. Ansorena,et al.  Role of reactive oxygen species, glutathione and NF-kappaB in apoptosis induced by 3,4-methylenedioxymethamphetamine ("Ecstasy") on hepatic stellate cells. , 2004, Biochemical pharmacology.

[27]  H. Sumnall,et al.  Altered states: the clinical effects of Ecstasy. , 2003, Pharmacology & therapeutics.

[28]  H. Wittchen,et al.  Traumatic events and post‐traumatic stress disorder in the community: prevalence,risk factors and comorbidity , 2000, Acta psychiatrica Scandinavica.

[29]  G. Greer,et al.  Subjective reports of the effects of MDMA in a clinical setting. , 1986, Journal of psychoactive drugs.