MDMA Dependence and Discontinuation Syndrome

描述（由申请人提供）：MDMA是青少年和年轻人最广泛滥用的药物之一。最近的研究表明普遍存在MDMA依赖，高达48%的使用者被诊断为依赖。这些研究表明，与MDMA滥用和依赖有关的日常问题可能比以前认为的更为严重和普遍。然而，MDMA依赖尚未完全表征，体征，症状，风险和保护因素，以及MDMA依赖的自然史在很大程度上仍然未知。回顾性报告显示MDMA使用者明显戒断症状的发生率很高。这些症状在多大程度上是由其他药物引起的，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，或代表真正的MDMA停药综合征，仍有待确定。我们提出了一系列的对照住院试验，以表征MDMA依赖和MDMA特异性停药综合征。在第一个实验中，MDMA使用者（80名依赖和80名非依赖）将住院并给予安慰剂或单一无毒剂量的MDMA，以引起停药综合征。在第二个实验中，40名住院的依赖MDMA使用者将被给予安慰剂或单一无毒剂量的MDMA，以减轻非法使用MDMA后的戒断反应。将进行搅拌报告、观察者评价、生理、神经认知、激素和行为测量。对MDMA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.