MDMA Dependence and Discontinuation Syndrome

描述(由申请人提供)：MDMA是青少年和年轻人滥用最广泛的药物之一。最近的研究表明，对MDMA的依赖很普遍，高达48%的使用者被诊断为依赖。这些研究表明，与滥用和依赖MDMA有关的日常问题可能比之前认为的更加严重和普遍。然而，对MDMA的依赖还没有得到充分的描述，症状、体征、风险和保护因素，对MDMA的依赖的自然历史在很大程度上仍然不为人知。回顾报告记录了MDMA使用者出现明显戒断症状的高比率。症状在多大程度上是由于其他药物、在MDMA影响下进行的活动的后遗症、先前存在的疾病的重新出现，或者代表真正的MDMA停用综合症，仍有待确定。我们提出了一系列对照住院试验来表征MDMA依赖和MDMA特异性的停药综合征。在第一个实验中，MDMA使用者(80名依赖者和80名非依赖者)将被住院，并给予安慰剂或单次无毒剂量的MDMA，以引发停用综合征。在第二个实验中，40名住院依赖MDMA的使用者将被给予安慰剂或单一无毒剂量的MDMA，以缓解非法使用MDMA后的戒断。将进行即时报告、观察者评级、生理、神经认知、荷尔蒙和行为测量。对MDMA的上瘾似乎是一种严重的使用风险；我们的研究将仔细定义这种新出现的疾病的重要临床特征。

DESCRIPTION (provided by applicant): MDMA is one of the most widely abused drugs by adolescents and young adults. Recent studies suggest widespread MDMA dependence, with up to 48% of users diagnosed as dependent. These studies suggest that day-to-day problems relating to MDMA abuse and dependence may be more severe and prevalent than previously believed. Yet MDMA dependence has not been fully characterized, with signs, symptoms, risk and protective factors, and the natural history of MDMA dependence remaining largely unknown. Retrospective reports document high rates of appaxent withdrawal symptoms in MDMA users. It remains to be determined the extent to which symptoms are due to other drugs, sequelae of activities undertaken while under the influence of MDMA, reemergence of preexisting conditions, or represent a true MDMA discontinuation syndrome. We propose a series of controlled inpatient trials to characterize MDMA dependence and the MDMA-specific discontinuation syndrome. In the first experiment, MDMA users (80 dependent and 80 nondependent) will be hospitnlized and given placebo or a single nontoxic dose of MDMA in order to elicit a discontinuation syndrome. In the second experiment, 40 hospitalized dependent MDMA users will be given placebo or a single nontoxic dose of MDMA to relieve withdrawal following illicit use of MDMA. Stir-report, observer-rated, physiological, neurocognitive, hormonal, and behavioral measures will be made. Addiction to MDMA appears to be a serious risk of use; our studies will carefttlly define important clinical features of this emerging disorder.