Letter to the Editor: Mirtazepine for MDMA-induced Depression
Abstract
The American Journal on Addictions, 14:300â301, 2005 Copyright # American Academy of Addiction Psychiatry ISSN: 1055-0496 print / 1521-0391 online DOI: 10.1080/10550490590966137 LETTERS TO THE EDITOR Mirtazepine for MDMA-induced Depression Jeffrey C. Fetter, M.D. DMA (Ecstasy) is a popular club drug with stimulant and hallucinogenic properties which has growing evidence of long-term neuropsychiatric effects. Animal studies have demonstrated immediate damage to serotonergic axons projecting from the dorsal raphe to the forebrain.1 Up to 7 years after treatment with MDMA in primates, the neocortex retains evidence of serotonergic denervation.2 Data on long term affective consequences of MDMA use in humans are sparse and there are no studies describing their treatment. Mirtazepine may have efficacy for MDMA-induced depression via either direct augmentation of serotonin tone, or by causing norepinephrine release which in turn promotes serotonergic axon regrowth.3 CASE M A 28-year-old female hairdresser presented for depression and anxiety which she dates to six years ago when she used MDMA nearly weekly for a year. She has not used any illicit drugs before or since that time. She complained of severe dysphoria, anhe- donia and poor appetite as well as profound sense of worthlessness and poor self esteem, feeling that she