Abstract
Introduction
This study sought to test the association between 3,4-methylenedioxymethamphetamine use, serotonergic function and sleep.
Materials and methods
Ambulatory polysomnography was used to measure three nights sleep in 12 ecstasy users and 12 controls after screening (no intervention), a tryptophan-free amino acid mixture (acute tryptophan depletion (ATD)) and a tryptophan-supplemented control mixture.
Results
ATD significantly decreased rapid eye movement (REM) sleep onset latency, increased the amount of REM sleep and increased the amount of stage 2 sleep in the first 3 h of sleep. There was no difference between ecstasy users’ and controls’ sleep on the screening night or after ATD.
Discussion
These findings imply that the ecstasy users had not suffered significant serotonergic damage as indexed by sleep.
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References
Ali SF, Newport GD, Scallet AC, Binienda Z, Ferguson SA, Bailey JR, Paule MG, Slikker W Jr (1993) Oral administration of 3,4-methylenedioxymethamphetamine (MDMA) produces selective serotonergic depletion in the nonhuman primate. Neurotoxicol Teratol 15(2):91–96
Allen RP, McCann UD, Ricaurte GA (1993) Persistent effects of (+/−)3,4-methylenedioxymethamphetamine (MDMA, “ecstasy”) on human sleep. Sleep 16(6):560–564
Allott K, Canny BJ, Broadbear JH, Stepto NK, Murphy B, Redman J (2008) Neuroendocrine and subjective responses to pharmacological challenge with citalopram: a controlled study in male and female ecstasy/MDMA users. J Psychopharmacol (in press)
Bedi G, Redman J (2008) Ecstasy use and higher-level cognitive functions: weak effects of ecstasy after control for potential confounds. Psychol Med 38(9):1319–1330
Bedi G, Van Dam N, Redman J. (2008) Ecstasy (MDMA) and high prevalence psychiatric symptomatology: somatic anxiety symptoms are associated with polydrug, not ecstasy, use. J Psychopharmacol (in press)
Bhatti T, Gillin JC, Seifritz E, Moore P, Clark C, Golshan S, Stahl S, Rapaport M, Kelsoe J (1998) Effects of a tryptophan-free amino acid drink challenge on normal human sleep electroencephalogram and mood. Biol Psychiatry 43(1):52–59
Bjorvatn B, Fagerland S, Eid T, Ursin R (1997) Sleep/waking effects of a selective 5-HT1A receptor agonist given systemically as well as perfused in the dorsal raphe nucleus in rats. Brain Res 770(1–2):81–88
Booij L, Van der Does W, Benkelfat C, Bremner JD, Cowen PJ, Fava M, Gillin C, Leyton M, Moore P, Smith KA, Van der Kloot WA (2002) Predictors of mood response to acute tryptophan depletion. A reanalysis. Neuropsychopharmacology 27(5):852–861
Braun AR, Balkin TJ, Wesensten NJ, Gwadry F, Carson RE, Varga M, Baldwin P, Belenky G, Herscovitch P (1998) Dissociated pattern of activity in visual cortices and their projections during human rapid eye movement sleep. Science 279(5347):91–95
Buchert R, Thomasius R, Wilke F, Petersen K, Nebeling B et al (2004) A voxel-based PET investigation of the long-term effects of “ecstasy” consumption on brain serotonin transporters. Am J Psychiatry 161(7):1181–1189
Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28(2):193–213
Cano G, Mochizuki T, Saper CB (2008) Neural circuitry of stress-induced insomnia in rats. J Neurosci 28(40):10167–10184
Carhart-Harris RL, Nutt DJ, Munafo M, Wilson SJ (2009) Current and former ecstasy users report different sleep to matched controls: a web-based questionnaire study. J Psychopharmacol 23(3):249–257
Carpenter LL, Anderson GM, Pelton GH, Gudin JA, Kirwin PD, Price LH, Heninger GR, McDougle CJ (1998) Tryptophan depletion during continuous CSF sampling in healthy human subjects. Neuropsychopharmacology 19(1):26–35
Cornwall J, Cooper JD, Phillipson OT (1990) Afferent and efferent connections of the laterodorsal tegmental nucleus in the rat. Brain Res Bull 25(2):271–284
Curran HV, Verheyden SL (2003) Altered response to tryptophan supplementation after long-term abstention from MDMA (ecstasy) is highly correlated with human memory function. Psychopharmacology (Berl) 169(1):91–103
Daumann J Jr, Fischermann T, Heekeren K, Thron A, Gouzoulis-Mayfrank E (2004) Neural mechanisms of working memory in ecstasy (MDMA) users who continue or discontinue ecstasy and amphetamine use: evidence from an 18-month longitudinal functional magnetic resonance imaging study. Biol Psychiatry 56(5):349–355
Delgado PL (2006) Monoamine depletion studies: implications for antidepressant discontinuation syndrome. J Clin Psychiatry 67(Suppl 4):22–26 (review)
Dughiero G, Schifano F, Forza G (2001) Personality dimensions and psychopathological profiles of ecstasy users. Hum Psychopharmacol 16(8):635–639
Durdle H, Lundahl LH, Johanson CE, Tancer M (2008) Major depression: the relative contribution of gender, MDMA, and cannabis use. Depress Anxiety 25(3):241–247
Ellenbogen MA, Young SN, Dean P, Palmour RM, Benkelfat C (1996) Mood response to acute tryptophan depletion in healthy volunteers: sex differences and temporal stability. Neuropsychopharmacology 15(5):465–474
Evans L, Golshan S, Kelsoe J, Rapaport M, Resovsky K, Sutton L, Gillin JC (2002) Effects of rapid tryptophan depletion on sleep electroencephalogram and mood in subjects with partially remitted depression on bupropion. Neuropsychopharmacology 27(6):1016–1026
Farré M, Abanades S, Roset PN, Peiró AM, Torrens M, O’Mathúna B, Segura M, de la Torre R (2007) Pharmacological interaction between 3,4-methylenedioxymethamphetamine (ecstasy) and paroxetine: pharmacological effects and pharmacokinetics. J Pharmacol Exp Ther 323(3):954–962
Fischer C, Hatzidimitriou G, Wlos J, Katz J, Ricaurte G (1995) Reorganization of ascending 5-HT axon projections in animals previously exposed to the recreational drug (+/−)3,4-methylenedioxymethamphetamine (MDMA, “ecstasy”). J Neurosci 15(8):5476–5485
Hatzidimitriou G, McCann UD, Ricaurte GA (1999) Altered serotonin innervation patterns in the forebrain of monkeys treated with (+/−)3,4-methylenedioxymethamphetamine seven years previously: factors influencing abnormal recovery. J Neurosci 19(12):5096–5107
Haynes PL, McQuaid JR, Kelsoe J, Rapaport M, Gillin JC (2004) Affective state and EEG sleep profile in response to rapid tryptophan depletion in recently recovered nonmedicated depressed individuals. J Affect Disord 83(2–3):253–262
Hobson JA (1992) Sleep and dreaming: induction and mediation of REM sleep by cholinergic mechanisms. Curr Opin Neurobiol 2(6):759–763 (review)
Hood SD, Bell CJ, Nutt DJ (2005) Acute tryptophan depletion. Part I: rationale and methodology. Aust NZ J Psychiatry 39(7):558–564 Review
Hoshi R, Cohen L, Lemanski L, Piccini P, Bond A, Curran HV (2007) Ecstasy (MDMA) does not have long-term effects on aggressive interpretative bias: a study comparing current and ex-ecstasy users with polydrug and drug-naive controls. Exp Clin Psychopharmacol 15(4):351–358
Iber C, Redline S, Kaplan Gilpin AM, Quan SF, Zhang L, Gottlieb DJ, Rapoport D, Resnick HE, Sanders M, Smith P (2004) Polysomnography performed in the unattended home versus the attended laboratory setting—sleep heart health study methodology. Sleep 27:536–540
Insel TR, Battaglia G, Johannessen JN, Marra S, De Souza EB (1989) 3,4-Methylenedioxymethamphetamine (“ecstasy”) selectively destroys brain serotonin terminals in rhesus monkeys. J Pharmacol Exp Ther 249(3):713–720
Jager G, de Win MM, van der Tweel I, Schilt T, Kahn RS, van den Brink W, van Ree JM, Ramsey NF (2008) Assessment of cognitive brain function in ecstasy users and contributions of other drugs of abuse: results from an FMRI study. Neuropsychopharmacology 33(2):247–258
Jans LA, Lieben CK, Blokland A (2007) Influence of sex and estrous cycle on the effects of acute tryptophan depletion induced by a gelatin-based mixture in adult Wistar rats. Neuroscience 147(2):304–317
Jouvet M (1999) Sleep and serotonin: an unfinished story. Neuropsychopharmacology 21(2):24S–27S
Kalechstein AD, De La Garza R II, Mahoney JJ III, Fantegrossi WE, Newton TF (2007) MDMA use and neurocognition: a meta-analytic review. Psychopharmacology (Berl) 189(4):531–537 (review)
Kirilly E, Molnar E, Balogh B, Kantor S, Hansson SR, Palkovits M, Bagdy G (2008) Decrease in REM latency and changes in sleep quality parallel serotonergic damage and recovery after MDMA: a longitudinal study over 180 days. Int J Neuropsychopharmacol 11(6):795–809
Landolt HP, Kelsoe JR, Rapaport MH, Gillin JC (2003) Rapid tryptophan depletion reverses phenelzine-induced suppression of REM sleep. J Sleep Res 12(1):13–18
Liechti ME, Baumann C, Gamma A, Vollenweider FX (2000a) Acute psychological effects of 3,4-methylenedioxymethamphetamine (MDMA, “ecstasy”) are attenuated by the serotonin uptake inhibitor citalopram. Neuropsychopharmacology 22(5):513–521
Liechti ME, Saur MR, Gamma A, Hell D, Vollenweider FX (2000b) Psychological and physiological effects of MDMA (“ecstasy”) after pretreatment with the 5-HT(2) antagonist ketanserin in healthy humans. Neuropsychopharmacology 23(4):396–404 P
Lu J, Sherman D, Devor M, Saper CB (2006) A putative flip-flop switch for control of REM sleep. Nature 441(7093):589–594
Luebke JI, Greene RW, Semba K, Kamondi A, McCarley RW, Reiner PB (1992) Serotonin hyperpolarizes cholinergic low-threshold burst neurons in the rat laterodorsal tegmental nucleus in vitro. Proc Natl Acad Sci U S A 89(2):743–747
Maquet P, Péters J, Aerts J, Delfiore G, Degueldre C, Luxen A, Franck G (1996) Functional neuroanatomy of human rapid-eye-movement sleep and dreaming. Nature 383(6596):163–166
McCann UD, Ricaurte GA (2007) Effects of (+/−) 3,4-methylenedioxymethamphetamine (MDMA) on sleep and circadian rhythms. Sci World J 2(7):231–238 (review)
McCann UD, Szabo Z, Scheffel U, Dannals RF, Ricaurte GA (1998) Positron emission tomographic evidence of toxic effect of MDMA (“ecstasy”) on brain serotonin neurons in human beings. Lancet 352(9138):1433–1437
McCann UD, Szabo Z, Seckin E, Rosenblatt P, Mathews WB, Ravert HT, Dannals RF, Ricaurte GA (2005) Quantitative PET studies of the serotonin transporter in MDMA users and controls using [11C]McN5652 and [11C]DASB. Neuropsychopharmacology 30(9):1741–1750
McCann UD, Peterson SC, Ricaurte GA (2007) The effect of catecholamine depletion by alpha-methyl-para-tyrosine on measures of cognitive performance and sleep in abstinent MDMA users. Neuropsychopharmacology 32(8):1695–1706
McCann UD, Szabo Z, Vranesic M, Palermo M, Mathews WB, Ravert HT, Dannals RF, Ricaurte GA (2008) Positron emission tomographic studies of brain dopamine and serotonin transporters in abstinent (+/−)3,4-methylenedioxymethamphetamine (“ecstasy”) users: relationship to cognitive performance. Psychopharmacology (Berl) 200(3):439–450
McGinty DJ, Harper RM (1976) Dorsal raphe neurons: depression of firing during sleep in cats. Brain Res 101(3):569–575
Mechan A, Yuan J, Hatzidimitriou G, Irvine RJ, McCann UD, Ricaurte GA (2006) Pharmacokinetic profile of single and repeated oral doses of MDMA in squirrel monkeys: relationship to lasting effects on brain serotonin neurons. Neuropsychopharmacology 31(2):339–350
Medina KL, Shear PK (2007) Anxiety, depression, and behavioral symptoms of executive dysfunction in ecstasy users: contributions of polydrug use. Drug Alcohol Depend 87(2–3):303–311
Menkes DB, Coates DC, Fawcett JP (1994) Acute tryptophan depletion aggravates premenstrual syndrome. J Affect Disord 32(1):37–44
Merens W, Willem Van der Does AJ, Spinhoven P (2007) The effects of serotonin manipulations on emotional information processing and mood. J Affect Disord 103(1–3):43–62
Meyer JS, Piper BJ, Vancollie VE (2008) Development and characterization of a novel animal model of intermittent MDMA (“ecstasy”) exposure during adolescence. Ann N Y Acad Sci 1139:151–163
Moja EA, Cipolla P, Castoldi D, Tofanetti O (1989) Dose-response decrease in plasma tryptophan and in brain tryptophan and serotonin after tryptophan-free amino acid mixtures in rats. Life Sci 44(14):971–976
Moore P, Gillin C, Bhatti T, DeModena A, Seifritz E, Clark C, Stahl S, Rapaport M, Kelsoe J (1998) Rapid tryptophan depletion, sleep electroencephalogram, and mood in men with remitted depression on serotonin reuptake inhibitors. Arch Gen Psychiatry 55(6):534–539
Moore P, Seifritz E, Schlosser A, Greenfield D, Stahl S, Rapaport M, Kelsoe J (2001) Rapid tryptophan depletion plus a serotonin 1A agonist: competing effects on sleep in healthy men. Neuropsychopharmacology 25(5 Suppl):S40–S44
Morgan MJ, McFie L, Fleetwood H, Robinson JA (2002) Ecstasy (MDMA): are the psychological problems associated with its use reversed by prolonged abstinence? Psychopharmacology (Berl) 159(3):294–303
Neckers LM, Biggio G, Moja E, Meek JL (1997) Modulation of brain tryptophan hydroxylase activity by brain tryptophan content. J Pharmacol Exp Ther 201(1):110–116
Neumeister A (2003) Tryptophan depletion, serotonin, and depression: where do we stand? Psychopharmacol Bull 37(4):99–115 (review)
Neumeister A, Hu XZ, Luckenbaugh DA, Schwarz M, Nugent AC, Bonne O, Herscovitch P, Goldman D, Drevets WC, Charney DS (2006) Differential effects of 5-HTTLPR genotypes on the behavioral and neural responses to tryptophan depletion in patients with major depression and controls. Arch Gen Psychiatry 63(9):978–986
Nishizawa S, Benkelfat C, Young SN, Leyton M, Mzengeza S, de Montigny C, Blier P, Diksic M (1997) Differences between males and females in rates of serotonin synthesis in human brain. Proc Natl Acad Sci U S A 94(10):5308–5313
Parrott AC (2000) Human research on MDMA (3,4-methylene-dioxymethamphetamine) neurotoxicity: cognitive and behavioural indices of change. Neuropsychobiology 42(1):17–24 (review)
Parrott AC (2006) MDMA in humans: factors which affect the neuropsychobiological profiles of recreational ecstasy users, the integrative role of bioenergetic stress. J Psychopharmacol 20(2):147–163
Reay JL, Hamilton C, Kennedy DO, Scholey AB (2006) MDMA polydrug users show process-specific central executive impairments coupled with impaired social and emotional judgement processes. J Psychopharmacol 20(3):385–388
Rechtschaffen A, Kales A (1968) A manual of standarized terminology, techniques and scoring system for sleep stages in human subjects. US Government Printing Office
Reneman L, Booij J, de Bruin K, Reitsma JB, de Wolff FA, Gunning WB, den Heeten GJ, van den Brink W (2001) Effects of dose, sex, and long-term abstention from use on toxic effects of MDMA (ecstasy) on brain serotonin neurons. Lancet 358(9296):1864–1869
Ricaurte GA, McCann UD (1992) Neurotoxic amphetamine analogues: effects in monkeys and implications for humans. Ann N Y Acad Sci 648:371–382 Review
Ricaurte G, Bryan G, Strauss L, Seiden L, Schuster C (1985) Hallucinogenic amphetamine selectively destroys brain serotonin nerve terminals. Science 229(4717):986–988
Riedel WJ, Klaassen T, Schmitt JA (2002) Tryptophan, mood, and cognitive function. Brain Behav Immun 16(5):581–589 (review)
Riemann D, Feige B, Hornyak M, Koch S, Hohagen F, Voderholzer U (2002) The tryptophan depletion test: impact on sleep in primary insomnia—a pilot study. Psychiatry Res 109(2):129–135
Roiser JP, Müller U, Clark L, Sahakian BJ (2006) The effects of acute tryptophan depletion and serotonin transporter polymorphism on emotional processing in memory and attention. Int J Neuropsychopharmacol 10(4):449–461
Rubia K, Lee F, Cleare AJ, Tunstall N, Fu CH, Brammer M, McGuire P (2005) Tryptophan depletion reduces right inferior prefrontal activation during response inhibition in fast, event-related fMRI. Psychopharmacology (Berl) 179(4):791–803
Rudnick G, Wall SC (1992) The molecular mechanism of “ecstasy” [3,4-methylenedioxy-methamphetamine (MDMA)]: serotonin transporters are targets for MDMA-induced serotonin release. Proc Natl Acad Sci U S A 89(5):1817–1821
Sabol KE, Lew R, Richards JB, Vosmer GL, Seiden LS (1996) Methylenedioxymethamphetamine-induced serotonin deficits are followed by partial recovery over a 52-week period. Part I: synaptosomal uptake and tissue concentrations. J Pharmacol Exp Ther 276(2):846–854
Saper CB, Chou TC, Scammell TE (2001) The sleep switch: hypothalamic control of sleep and wakefulness. Trends Neurosci 24(12):726–731
Scanzello CR, Hatzidimitriou G, Martello AL, Katz JL, Ricaurte GA (1993) Serotonergic recovery after (+/−)3,4-(methylenedioxy) methamphetamine injury: observations in rats. J Pharmacol Exp Ther 264(3):1484–1491
Scheffel U, Szabo Z, Mathews WB, Finley PA, Dannals RF, Ravert HT, Szabo K, Yuan J, Ricaurte GA (1998) In vivo detection of short- and long-term MDMA neurotoxicity—a positron emission tomography study in the living baboon brain. Synapse 29(2):183–192
Selvaraj S, Hoshi R, Bhagwagar Z, Murthy NV, Hinz R, Cowen P, Curran HV, Grasby P (2009) Brain serotonin transporter binding in former users of MDMA (‘ecstasy’). Br J Psychiatry 194(4):355–359
Smith KA, Fairburn CG, Cowen PJ (1997) Relapse of depression after rapid depletion of tryptophan. Lancet 349(9056):915–919
Sumnall HR, Cole JC (2005) Self-reported depressive symptomatology in community samples of polysubstance misusers who report ecstasy use: a meta-analysis. J Psychopharmacol 19(1):84–92
Taffe MA, Huitrón-Resendiz S, Schroeder R, Parsons LH, Henriksen SJ, Gold LH (2003) MDMA exposure alters cognitive and electrophysiological sensitivity to rapid tryptophan depletion in rhesus monkeys. Pharmacol Biochem Behav 76(1):141–152
Tancer M, Johanson CE (2007) The effects of fluoxetine on the subjective and physiological effects of 3,4-methylenedioxymethamphetamine (MDMA) in humans. Psychopharmacology (Berl) 189(4):565–573
Thakkar MM, Strecker RE, McCarley RW (1998) Behavioral state control through differential serotonergic inhibition in the mesopontine cholinergic nuclei: a simultaneous unit recording and microdialysis study. J Neurosci 18(14):5490–5497
Thomasius R, Zapletalova P, Petersen K, Buchert R, Andresen B, Wartberg L, Nebeling B, Schmoldt A (2006) Mood, cognition and serotonin transporter availability in current and former ecstasy (MDMA) users: the longitudinal perspective. J Psychopharmacol 20(2):211–225 (review)
Voderholzer U, Hornyak M, Thiel B, Huwig-Poppe C, Kiemen A, König A, Backhaus J, Riemann D, Berger M, Hohagen F (1998) Impact of experimentally induced serotonin deficiency by tryptophan depletion on sleep EEG in healthy subjects. Neuropsychopharmacology 18(2):112–124
Wehrle R, Kaufmann C, Wetter TC, Holsboer F, Auer DP, Pollmächer T, Czisch M (2007) Functional microstates within human REM sleep: first evidence from fMRI of a thalamocortical network specific for phasic REM periods. Eur J Neurosci 25(3):863–871
Weltzin TE, Fernstrom JD, McConaha C, Kaye WH (1994) Acute tryptophan depletion in bulimia: effects on large neutral amino acids. Biol Psychiatry 35(6):388–397
Williams WA, Shoaf SE, Hommer D, Rawlings R, Linnoila M (1999) Effects of acute tryptophan depletion on plasma and cerebrospinal fluid tryptophan and 5-hydroxyindoleacetic acid in normal volunteers. J Neurochem 72(4):1641–1647
Wilson S, Argyropoulos S (2005) Antidepressants and sleep: a qualitative review of the literature. Drugs 65(7):927–947 (review)
Wilson SJ, Bailey JE, Rich AS, Adrover M, Potokar J, Nutt DJ (2004) Using sleep to evaluate comparative serotonergic effects of paroxetine and citalopram. Eur Neuropsychopharmacol 14(5):367–372
Wilson SJ, Bailey JE, Rich AS, Nash J, Adrover M, Tournoux A, Nutt DJ (2005) The use of sleep measures to compare a new 5HT1A agonist with buspirone in humans. J Psychopharmacol 19(6):609–613
Young SN, Smith SE, Pihl RO, Ervin FR (1985) Tryptophan depletion causes a rapid lowering of mood in normal males. Psychopharmacology (Berl) 87(2):173–177
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Carhart-Harris, R.L., Nutt, D.J., Munafo, M.R. et al. Equivalent effects of acute tryptophan depletion on REM sleep in ecstasy users and controls. Psychopharmacology 206, 187–196 (2009). https://doi.org/10.1007/s00213-009-1595-3
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DOI: https://doi.org/10.1007/s00213-009-1595-3