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1.  Decision making as a predictor of first ecstasy use: a prospective study 
Psychopharmacology  2008;203(3):519-527.
Rationale
Ecstasy (±3,4-methylenedioxymethamphetamine) is a widely used recreational drug that may damage the serotonin system and may entail neuropsychological dysfunctions. Few studies investigated predictors for ecstasy use. Self-reported impulsivity does not predict the initiation of ecstasy use; the question is if neuropsychological indicators of impulsivity can predict first ecstasy use.
Objective
This study tested the hypothesis that a neuropsychological indicator of impulsivity predicts initiation of ecstasy use.
Materials and methods
Decision-making strategy and decision-making reaction times were examined with the Iowa Gambling Task in 149 ecstasy-naive subjects. The performance of 59 subjects who initiated ecstasy use during a mean follow-up period of 18 months (range, 11–26) was compared with the performance of 90 subjects that remained ecstasy-naive.
Results
Significant differences in decision-making strategy between female future ecstasy users and female persistent ecstasy-naive subjects were found. In addition, the gap between decision-making reaction time after advantageous choices and reaction time after disadvantageous choices was smaller in future ecstasy users than in persistent ecstasy-naives.
Conclusion
Decision-making strategy on a gambling task was predictive for future use of ecstasy in female subjects. Differences in decision-making time between future ecstasy users and persistent ecstasy-naives may point to lower punishment sensitivity or higher impulsivity in future ecstasy users. Because differences were small, the clinical relevance is questionable.
doi:10.1007/s00213-008-1398-y
PMCID: PMC2761546  PMID: 19020868
Ecstasy; MDMA; Decision-making; Iowa Gambling Task; Neuropsychology

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