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McCann UD, Szabao Z, Scheffel U, Dannals RF, Ricaurte GA. 
“Positron emission tomography findings in heavy users of MDMA”. 
Lancet. 1999 Feb 13;353(9152):592-3.
Sir--We thank Julie Holland for her comments, since they afford us an opportunity to address some of the misconceptions about MDMA-induced serotonin (5-HT) neurotoxicity and its detection by PET. Holland posits that compulsive behaviour rather than MDMA use might be responsible for the reductions in serotin (5-HT) transporter density. To our knowledge, there is no evidence that obsessive compulsive disorder is associated with reductions in 5-HT transporter density. Moreover, we excluded participants with this disorder and other psychiatric disorders linked to 5-HT to avoid the type of potential confound that Holland postulates.
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