• Thelma Schilt, Anneke E Goudriaan, Maarten W Koeter, Wim van den Brink, and Ben Schmand.
• Department of Psychiatry-PB 0.429, Amsterdam Institute for Addiction Research Academic Medical Center, University of Amsterdam, PO Box 75867, 1070 AW Amsterdam, The Netherlands. t.schilt@amc.uva.nl
• Psychopharmacology (Berl.). 2009 Apr 1; 203 (3): 519-27.

RationaleEcstasy (+/-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.ObjectiveThis study tested the hypothesis that a neuropsychological indicator of impulsivity predicts initiation of ecstasy use.Materials And MethodsDecision-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.ResultsSignificant 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.ConclusionDecision-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.

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