Increased visual cortical excitability in ecstasy users: a transcranial magnetic stimulation study.

OBJECTIVES To test the presence of abnormalities of visual cortical excitability in people using ecstasy as a recreational drug. METHODS Ecstasy users and control subjects underwent single pulse transcranial magnetic stimulation (TMS) of the occipital cortex. The phosphene threshold was analysed and compared in the two groups. RESULTS Phosphene thresholds were significantly lower in ecstasy users compared with control subjects, and were correlated negatively with frequency of ecstasy use. Frequency of use was positively correlated with the presence of visual hallucinations. The phosphene threshold of subjects with hallucinations was significantly lower than that of subjects without hallucinations. CONCLUSIONS The use of ecstasy as a recreational drug is associated with an increased excitability of the visual cortex, possibly linked with massive serotonin release, followed by serotonin depletion, in this cortical area.