Three studies in humans (1 clinical trial and two comparisons of ecstasy users and non-users), one study of ecstasy user demographics, 3 reviews and 4 studies in non-human animals were located in this time period.

Human Pharmacology and Metabolism
Urinary concentrations for two enantiomers of the major MDMA metabolite HMMA were measured in male volunteers given 100 mg MDMA (Pizarro et al. 2002). While the amount of one enantiomer (R-(-)-MDMA) was found to be greater in urine over time than the other enantiomer, there was little difference in the amount of either enantiomer of HMMA. Study findings suggest that enzymes other than CYP2D6 are involved in the metabolism of MDMA, and that these enzymes may be equally or more important than CYP2D6 in the formation of MDMA metabolites.

Neuroendocrine study
A study examining prolactin response to the serotonin releaser d-fenfluramine found that cannabis use, but not ecstasy use, was strongly associated both with blunted prolactin response, particularly when men who used cannabis only were compared with men reporting use of ecstasy (Gouzoulis-Mayfrank et al. 2002). However, the authors were unable to match groups for gender due to the discontinuation of human studies with d-fenfluramine, so that cannabis users were all men and non-drug users were all women. This leaves open the question of possible interactions between gender and either of the two drugs studied. Nevertheless, study findings suggest that differences between ecstasy users and non-ecstasy using controls may be equally or more strongly related to use of other drugs.

Acute and Sub-Acute Effects-Retrospective Study
The acute and sub-acute effects of ecstasy were examined via retrospective study design comparing people who used ecstasy on the first study day (Day 0) with people who did not use ecstasy that day (Verheyden et al. 2002). Ecstasy users reported being less depressed and less aggressive on Day 0, but reported greater aggression on Day 4. Women, but not men, reported greater depression 4 days after ecstasy use as compared with women who had not used ecstasy on Day 0, and women reported experiencing more sub-acute, but not more acute, side-effects.

Demographics
"Most" of a sample of male sex workers in 3 large Australian cities reported using ecstasy, along with alcohol and marijuana, but very few reported using heroin (Minichiello et al. 2002).

Reviews
All three of the reviews located during this time period contain many inaccuracies and are poorly written or uneven (Hess and deBoer 2002; Hurley et al. 2002; Koesters et al. 2002). One review mentions and criticizes MAPS for its support of research into the therapeutic uses of MDMA, apparently because this might foster the perceived "safety" of ecstasy (Koesters et al. 2002).

Acute Effects in Rats
n a rare examination of the acute effects of MDMA in rats (Braida et al. 2002), performance on an 8-arm radial maze, a measure of working memory, is studied after 1, 2 and 3 mg/kg MDMA. It is hard to extrapolate from these findings to study findings with humans (Cami et al. 2000; Vollenweider et al. 1998), but the doses employed in this study are similar to doses used by humans, making the findings more comparable than findings from studies employing doses that produce hyperactivity.

Serotonin Ligand Binding in Baboons
A study comparing the ligand profiles of two radioligands used to image the serotonin transporter reuptake site (SERT) in baboons (Szabo et al. 2002). Results indicate that while McN5652 and C-DASB both detected lower SERT after neurotoxic MDMA regimen, C-DASB provided a better measure than does the more frequently used McN5652. Ligand binding was lower after MDMA than after paroxetine pretreatment, suggesting that the decrease in SERT binding sites may be due to processes other than MDMA-induced neurotoxicity.

Mice: Hepatic (liver) and Cardiac Effects
A study in mice found that MDMA at doses of 5, 10 and 20 mg/kg, dose-dependently produced hepatocyte vacuolization and blood clots, with vacuolation first appearing after 5 mg/kg and clots appearing after 10 mg/kg. High ambient temperature aggravated MDMA-induced liver damage (Carvalho et al. 2002). These findings suggest that people taking ecstasy in warm environments may be at increased risk for hepatotoxicity or liver problems associated with ecstasy use, with risk increasing with higher doses of ecstasy. An in vitro study examined the effects of MDMA, loud noise, and a combination of both on mouse heart tissue (Gesi et al. 2002). Examination of heart tissue found that loud noise and MDMA independently produced subtle changes in right atria at the mitochondrial level not visible with light microscopy, but that the combination of MDMA and loud white noise produced significant alterations in mitochondrial structure. These findings may have some import on potential cardiac effects in ecstasy users attending dance events. However, since loud noise is a stressor in mice, it is possible that the cardiac effects seen in mice resulted either partly or wholly from the stressful experience. In contrast, dance event attendees are liable to find loud music pleasurable, and are familiar with the experience of loud noise.