Obsessive-compulsive disorder followed by psychotic episode in long-term ecstasy misuse.

Abstract

AIM:

We report the case of two young subjects who developed an obsessive-compulsive disorder (OCD) during a heavy use of ecstasy. After several months of discontinuation of the drug, major depression with psychotic features developed in one subject and a psychotic disorder in the other individual. No mental disorder preceded the use of ecstasy in any subject.

FINDINGS:

A familial and personality vulnerability for mental disorder was revealed in one subject, but not in the other, and all physical, laboratory and cerebral NMR evaluations showed normal results in both patients. Remission of OCD and depressive episode or psychotic disorder was achieved after treatment with a serotoninergic medication associated with an antipsychotic.

CONCLUSIONS:

The heavy long-term use of ecstasy may induce an alteration in the brain balance between serotonin and dopamine, which might constitute a pathophysiological mechanism underlying the onset of obsessive-compulsive, depressive and psychotic symptoms. The heavy use of ecstasy probably interacted with a vulnerability to psychiatric disorder in one subject, whereas we cannot exclude that an "ecstasy disorder" ex novo affected the other individual.

• Authors: Carlo Marchesi, Matteo Tonna, Carlo Maggini
• Journal: The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry (World J Biol Psychiatry) Vol. 10 Issue 4 Pt 2 Pg. 599-602 ( 2009) ISSN: 1814-1412 [Electronic] England
• PMID: 17853269 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antidepressive Agents, Tricyclic
• Antipsychotic Agents
• Hallucinogens
• Benzodiazepines
• Serotonin
• N-Methyl-3,4-methylenedioxyamphetamine
• Risperidone
• Olanzapine
• Clomipramine
• Dopamine

Topics

• Adolescent
• Amphetamine-Related Disorders (diagnosis, psychology)
• Antidepressive Agents, Tricyclic (therapeutic use)
• Antipsychotic Agents (therapeutic use)
• Benzodiazepines (therapeutic use)
• Borderline Personality Disorder (diagnosis, psychology)
• Brain (drug effects)
• Clomipramine (therapeutic use)
• Comorbidity
• Depressive Disorder, Major (chemically induced, diagnosis, drug therapy, genetics, psychology)
• Dopamine (metabolism)
• Female
• Genetic Predisposition to Disease (genetics)
• Hallucinogens (toxicity)
• Humans
• Male
• N-Methyl-3,4-methylenedioxyamphetamine (toxicity)
• Obsessive-Compulsive Disorder (chemically induced, diagnosis, drug therapy, genetics, psychology)
• Olanzapine
• Psychoses, Substance-Induced (diagnosis, drug therapy, genetics, psychology)
• Risk Factors
• Risperidone (therapeutic use)
• Serotonin (metabolism)
• Substance Withdrawal Syndrome (diagnosis, drug therapy, psychology)
• Young Adult