Efectos cognitivos y conductuales secundarios al consumo de metanfetaminas.

Autores/as

  • Imara Chaverra-Torres Pontificia Universidad Javeriana Cali (Colombia)
  • Juan Camilo Bedoya-Salazar Pontificia Universidad Javeriana Cali (Colombia)
  • Carolina Melo-Bravo Pontificia Universidad Javeriana Cali (Colombia)
  • Lina Becerra-Hernández Pontificia Universidad Javeriana Cali (Colombia) https://orcid.org/0000-0002-4468-6716

Palabras clave:

MDMA, Metanfetaminas, Abuso de sustancias, Cognición, Cerebro adicto

Resumen

El éxtasis o 3,4-metilenedioxmetanfetamina (MDMA), es una droga simpaticomimética de metabolismo hepático, popular entre los jóvenes por sus efectos de euforia, extroversión, experiencias sensoriales aumentadas, desrealización moderada, empatía y facilitación de las relaciones interpersonales. El presente artículo revisa a profundidad el tema de los efectos cognitivos y conductuales agudos, subagudos y crónicos generados por el consumo de MDMA de acuerdo a literatura publicada entre 2000-2020. Se describen cambios a nivel social agudos, como el reforzamiento de conductas prosociales, y crónicos, como la disminución en las tareas empáticas y la aparición de conductas agresivas. En cuanto a las funciones mentales superiores, se encontró que en consumidores crónicos hay una disminución del procesamiento y almacenamiento de la información, alteraciones en la memoria operativa, verbal y visual, pobreza en el lenguaje verbal y dificultad en la toma de decisiones asociada a mayor impulsividad. En el afecto, se evidenció que las personas presentaban síntomas asociados con depresión y ansiedad, y aumento de la prevalencia de episodios psicóticos, tanto aguda como crónicamente. Según estos hallazgos, el MDMA es una sustancia con efectos nocivos en el procesamiento de tareas de cognición social, funciones ejecutivas, modulación afectiva, percepción de la realidad y, finalmente, deterioro de la calidad de vida del consumidor crónico.

Biografía del autor/a

Imara Chaverra-Torres, Pontificia Universidad Javeriana Cali (Colombia)

Estudiante de Medicina, Semillero de Innovadores en Salud ISSEM.

Juan Camilo Bedoya-Salazar, Pontificia Universidad Javeriana Cali (Colombia)

Estudiante de Medicina, Semillero de Innovadores en Salud ISSEM.

Carolina Melo-Bravo, Pontificia Universidad Javeriana Cali (Colombia)

Estudiante de Medicina, Semillero de Innovadores en Salud ISSEM.

Lina Becerra-Hernández, Pontificia Universidad Javeriana Cali (Colombia)

Médica, Magíster en Ciencias Biomédicas, Doctora en Ciencias Biomédicas, Profesora Departamento de Ciencias Básicas de la Salud.

Citas

Hoffman R. MDMA (ecstasy) intoxication. Uptodate. 2020. Disponible en: https://www.uptodate.com/contents/mdma-ecstasy-intoxication?search=mdma&source=search_result&selectedTitle=1~109&usage_type=default&display_rank=1#H9

White M. How MDMA’s pharmacology and pharmacokinetics drive desired effects and harms. 2014. American College of Clinical Pharmacology. 54(3):245-251. DOI: 10.1002/jcph.266

Lyttle T, Montagne M. Drugs, music and ideology: a social pharmacological interpretation of the acid house movement. Int J Addictions, 27 (10):1159-77. DOI: 10.3109/10826089209047341

Oesterheld J., et al. Ecstasy: Pharmacodynamic and Pharmacokinetic Interactions. Psychosomatics. 2004. 45(1):84-87. DOI: 10.1176/appi.psy.45.1.84

Loftis MJ, Janowsky A. Neuroimmune Basis of Methamphetamine Toxicity. International Review of Neurobiology. 2014; 118:165-197. DOI: 10.1016/B978-0-12-801284-0.00007-5

Robledo P. Las anfetaminas. Trastornos Adictivos. 2008; 10(3): 166-173. DOI: 10.1016/S1575-0973(08)76363-3

Glasner-Edwards S, Marinelli-Casey P, Hillhouse M, Ang A, Mooney L, Rawson R. Depression Among Methamphetamine Users. J Nerv Ment Dis. 2009; 197(4):225-231.

Schmid Y, Hysek CM, Simmler LD, Crockett MJ, Quednow BB, Liechti ME. Differential effects of MDMA and methylphenidate on social cognition. Journal of Psychopharmacology. 2014; 28(9):847-856. DOI: 10.1177/0269881114542454

Hysek CM, Schmid Y, Simmler LD, Domes G, Heinrichs M, Eisenegger C, Preller, KH, Quednow BB. MDMA enhances emotional empathy and prosocial behavior. Social cognitive and affective neuroscience. 2014; 11:1645-1652. DOI: 10.1093/scan/nst161

Morley KC, McGregor IS. (±)-3,4-Methylenedioxymethamphetamine (MDMA, “Ecstasy”) increases social interaction in rats. European Journal of Pharmacology. 2000; 408(1):41-49. DOI: 10.1016/s0014-2999(00)00749-4

Fone KC, Becket S. et al. Long-term changes in social interaction and reward following repeated MDMA administration to adolescent rats without accompanying serotonergic neurotoxicity. Psychopharmacology. 2002; 159:437-444. DOI: 10.1007/s00213-001-0931-z

Ando RD, Benko A, Ferrington L, Kirilly E, Kelly PAT, Bagdy G. Partial lesion of the serotonergic system by a single dose of MDMA results in behavioural disinhibition and enhances acute MDMA-induced social behaviour on the social interaction test. Neuropharmacology. 2006; 50(7):884-896. DOI: 10.1016/j.neuropharm.2005.12.010

McGregor I, Clemens K, Van der Plasse G, Li K, Hunt G, Chen F, Lawrence A. Increased Anxiety 3 Months after Brief Exposure to MDMA (‘Ecstasy’) in Rats: Association with Altered 5-HT Transporter and Receptor Density. Neuropsychopharmacology. 2003; 28:1472-1484.

Karimi S, Jahanshahi M, Golalipour MJ. The Effect of MDMA-Induced Anxiety on Neuronal Apoptosis in Adult Male Rats’ Hippocampus. Folia Biologica (Praha). 2014; 60:187-191.

Wunderli MD, Vonmoos M, Treichler L, Zeller C, Dziobek I, Kraemer T, Baumgartner M, Seifritz E, Quednow B. Social Cognition and Interaction in Chronic Users of 3,4-Methylenedioxymethamphetamine (MDMA, “Ecstasy”), International Journal of Neuropsychopharmacology. 2018; 21(4) 333-344. DOI: 10.1093/ijnp/pyx098

Kirkpatrick M, Delton AW, Robertson TE, de Wit H. Prosocial effects of MDMA: A measure of generosity. Journal of Psychopharmacology. 2015; 29(6):661-668. DOI: 10.1177/0269881115573806

Verheyden SL, Hadfield J, Calin T. Sub-acute effects of MDMA (±3,4-methylenedioxymethamphetamine, “ecstasy”) on mood: evidence of gender differences. Psychopharmacology. 2002; 161: 23-31. DOI: 10.1007/s00213-001-0995-9

Curren H, Rees H, Hoare T, Hoshi R, Bond A. Empathy and aggression: two faces of ecstasy? A study of interpretative cognitive bias and mood change in ecstasy users. Psicofarmacología, 2004; 173:425-433.

Hawkey A., April B., Galizio M., Effects of MDMA on olfactory memory and reversal learning in rats. Neurobiology of learning and Memory. 2014; 114:209-216. DOI: 10.1016/j.nlm.2014.06.012

Ricaurte GA, McCann UD. Experimental studies on 3,4-methylenedioxymethamphetamine (MDA, ‘ecstasy’) and its potential to damage brain serotonin neurons. Neurotox Res. 2001. 3(85). DOI: 10.1007/bf03033232

Nulsen C, Fox A, Hammond G. Differential Effects of Ecstasy on Short-Term and Working Memory: A Meta-Analysis. Neuropsychol. 2010; 20:21-32. DOI 10.1007/s11065-009-9124-z

Becker B, Wagner D, Koester P, Bender K. Kabbasch C, Daumann J. Memory-related hippocampal functioning in ecstasy and amphetamine users. Psycopharmacology. 2013; 225:923-934. DOI: 10.1007/s00213-012-2873-z

Hallander B, Schouw M, Groot P, Hiosman H, Caan M, Barkhof F, Reneman L. Preliminary evidence of hippocampal damage in chronic users of ecstasy. Neurol Neurosurg Psychiatry. 2012;83:83-85. Doi:10.1136/jnnp.2010.228387

Gardner H, Lawn N, Fatovich D, et al. Acute Hippocampal Sclerosis Following Ecstasy Ingestion. Neurology. 2009; 73:567-569. DOI 10.1212/WNL.0b013e3181b2a684

Meneses A, Perez-García G, Ponce-Lopez T, Castillo C. Serotonin transporter and memory. Neuropharmacology. 2011; 61:355-363. DOI: 10.1016/j.neuropharm.2011.01.018

Bhide N, Lipto J., Cunningham J., Yamamoto B., Gudelsky G., Repeated exporsure to MDMA provides neuroprotection against subsequent MDMA-induced serotonin depletion in brain. Brain Res. 2009; 1286:32-41. DOI: 10.1016/j.brainres.2009.06.042

Reneman L, Booij J, Majoie C, Brink W, Heeten G. Investigation the potential neurotoxicity of Ecstasy (MDMA): an imaging approach. Human Psychopharmacology: Clinical and Experimental. 2001. 16 (8). DOI: 10.1002/hup.347

De Win MM, Jager G, Booij J, et al. Neurotoxic effects of ecstasy on the thalamus. Br J Psychiatry. 2008; 193(4):289-296. DOI: 10.1192/bjp.bp.106.035089.

McCann U, Wilson M, Sgambati F, et al., Sleep Deprivation Differentially Impairs Cognitive Performance in Abstinent Methylenedioxymethamphetamine (Ecstasy) Users. J Neurosci. 2009; 29(44):14050-15056. DOI: 10.1523/JNEUROSCI.4654-09.2009

Thomasius R, Zapletalova P, Petersen K, et al. Mood, cognition and serotonin transporter availability in current and former ecstasy (MDMA) users: the longitudinal perspective. J Psychopharmacology. 2006; 20(2):211-225. DOI: 10.1177/0269881106059486

Kuypers K, Theunissen E, Van Wel J, de Sousa Fernandes E. Verbal Memory Impairment in Polydrug Ecstasy Users: A Clinical Perspective. Plos One. 2016; 11(2). DOI: 10.1371/journal.pone.0149438

Wagner D, Tkotz S, Koester P, Becker B, et al. Learning, Memory, and Executive Function in New MDMA Users: A 2- year Follow-Up Study. Frontiers in neuroscience. 2015; 9 (445). DOI: 10.3389/fnins.2015.00445

Volkow N. Years of Animal Research Proves MDMA (“Ecstasy”) Can Damage Neurons; MDMA’s Effects on the Human Brain Are Being Studied. National Institute on Drug Abuse. 2014. Disponible en: https://archives.drugabuse.gov/about-nida/directors-page/messages-director/2004/04/years-animal-research-proves-mdma-ecstasy-can-damage-neurons-mdmas-effects-human-brain-are-being

Alting von Geusau N, Stalenhoef P, Huizinga M. Snel J, Ridderinkhof KR. Impaired executive function in male MDMA (“ecstacy”) users. Psychopharmacology. 2004; 175(3):331-341. DOI: 10.1007/s00213-004-1832-8

Quednow BB, Kühn K, Hoppe C, et al. Elevated impulsivity and impaired decision-making cognition in heavy users of MDMA (“Ecstasy”). Psychopharmacology. 2007; 189:517-530. DOI: 10.1007/s00213-005-0256-4

Morgan M, Impallomeni L, Pirona A, et al. Elevated Impulsivity and Impaired Decision-Making in Abstinent Ecstasy (MDMA) Users Compared to Polydrug and Drug-Naïve Controls. Neuropsychopharmacol. 2006. 31:1562-1573. DOI: 10.1038/sj.npp.1300953

Fox H, McLean A, Turner J, Parrott A, Rogers R., Sahakian B. Neuropsychological evidence of a relatively selective profile of temporal dysfunction in drug-free MDMA (“ecstasy”) polydrug users. Psychopharmacology. 2002; 162(2):203-214. DOI: 10.1007/s00213-002-1071-9

Fagundo AB, Cuyàs E, Verdejo-Garcia A, Khymenets O, Langohr K, Martín-Santos R, Farre M, De la Torre R. The influence of 5-HTT and COMT genotypes on verbal fluency in ecstasy users. Journal of Psychopharmacology. 2010; 24(9):1381-1393. DOI: 10.1177/0269881109354926

Baggott MJ, Kirkpatrick MG, Bedi G, de Wit H. Visión íntima: MDMA cambia la forma en que las personas hablan de otras personas importantes. Revista de Psicofarmacología. 2015; 29(6): 669-677. DOI: 10.1177/0269881115581962

Glasner-Edwards S, Marinelli-Casey P, Hillhouse M, Ang A, Mooney L, Rawson R. Depression Among Methamphetamine Users. J Nerv Ment Dis. 2009; 197(4):225-231. DOI: 10.1097/NMD.0b013e31819db6fe

Newton TF, Kalechstein AD, Duran S, Vansluis N, Ling W. Methamphetamine abstinence syndrome: Preliminary findings. Am J Addict. 2004; 13:248-255. DOI: 10.1080/10550490490459915

Grant BF, Stinson FS, Dawson DA, Chou SP, Dufour MC, Compton W, Pickering RP, Kaplan K. Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry. 2004; 61:807-816. DOI: 10.1001/archpsyc.61.8.807

Copeland AL, Sorensen JL. Differences between methamphetamine users and cocaine users in treatment. Drug Alcohol Depend. 2001; 62:91-95. DOI: 10.1016/s0376-8716(00)00164-2

Zweben JE, Cohen JB, Christian D, Galloway GP, Salinardi M, Parent D, Iguchi M. Psychiatric symptoms in methamphetamine users. Am J Addict. 2004;13:181-190. DOI: 10.1080/10550490490436055

Lisdahl K, Shear P. Anxiety, depression, and behavioral symptoms of executive dysfunction in ecstasy users: Contributions of polydrug use. Drug and Alcohol Dependence. 2007; 87:303-311. DOI: 10.1016/j.drugalcdep.2006.09.003

Milani RM, Parrott AC, Turner JJD, and Fox H. Gender differences in self-reported anxiety, depression, and somatization among ecstasy/MDMA polydrug users, alcohol/tobacco users, and nondrug users. Addict Behav. 2004; 29:965-971. DOI: 10.1016/j.addbeh.2004.02.044

Harris D, Batki SL. Stimulant psychosis: symptom profile and acute clinical course. Am J Addict. 2000; 9: 28-37. DOI: 10.1080/10550490050172209

McKetin R, McLaren J, Lubman DI, Hides L. The prevalence of psychotic symptoms among methamphetamine users. Addiction. 2006; 101:1473-1478. DOI: 10.1111/j.1360-0443.2006.01496.x

Mahoney JJ, Kalechstein AD, De, La, Garza R, Newton TF. Presence and persistence of psychotic symptoms in cocaine- versus methamphetamine-dependent participants. Am J Addict. 2008; 17:83-98. DOI: 10.1080/10550490701861201

Iwanami A, Sugiyama A, Kuroki N, et al. Patients with methamphetamine psychosis admitted to a psychiatric hospital in Japan. A preliminary report. Acta Psychiatr Scand. 1994; 89:428-432. DOI: 10.1111/j.1600-0447.1994.tb01541.x

Bousman CA, McKetin R, Burns R, Woods SP, Morgan EE, Atkinson JH, et al. Typologies of positive psychotic symptoms in methamphetamine dependence. Am J Addict. 2015; 24:94-7. DOI: 10.1111/ajad.12160.

Chen CK, Lin SK, Sham PC, Ball D, Loh EW, Hsiao CC, et al. Pre-morbid characteristics and co-morbidity of methamphetamine users with and without psychosis. Psychol Med. 2003; 33:1407-14. DOI: 10.1017/s0033291703008353

Hong G, Yan Z, Haifeng J, Youwei Z, Tianzhen C, Haoye T, et al. A Research of Methamphetamine Induced Psychosis in 1,430 Individuals With Methamphetamine Use Disorder: Clinical Features and Possible Risk Factors. Front Psychiatry. 2018; 9:551. DOI: 10.3389/fpsyt.2018.00551

Glasner-Edwards S, Mooney LJ, Marinelli-Casey P, Hillhouse M, Ang A, Rawson R, et al. Clinical course and outcomes of methamphetamine-dependent adults with psychosis. J Subst Abuse Treat. (2008) 35:445-50. DOI: 10.1016/j.jsat.2007.12.004

Descargas

Publicado

2022-12-23

Cómo citar

Chaverra-Torres, I., Bedoya-Salazar, J. C., Melo-Bravo, C., & Becerra-Hernández, L. (2022). Efectos cognitivos y conductuales secundarios al consumo de metanfetaminas. Salutem Scientia Spiritus, 8(4), 84–94. Recuperado a partir de https://revistas.javerianacali.edu.co/index.php/salutemscientiaspiritus/article/view/635

Número

Sección

Revisión de la literatura