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MDMA

Pharmacogenetics of ecstasy: CYP1A2, CYP2C19, and CYP2B6 polymorphisms moderate pharmacokinetics of MDMA in healthy subjects

January 20, 2017 / MDMA, Papers, Publications / By / , , , ,

Abstract

In vitro studies showed that CYP2C19, CYP2B6, and CYP1A2 contribute to the metabolism of 3,4-methylenedioxymethamphetamine (MDMA, ecstasy) to 3,4-methylenedioxyamphetamine (MDA). However, the role of genetic polymorphisms in CYP2C19, CYP2B6, and CYP1A2 in the metabolism of MDMA in humans is unknown. The effects of genetic variants in these CYP enzymes on the pharmacokinetics and pharmacodynamics of MDMA were characterized in 139 healthy subjects (69 male, 70 female) in a pooled analysis of eight double-blind, placebo-controlled studies. MDMA-MDA conversion was positively associated with genotypes known to convey higher CYP2C19 or CYP2B6 activities. Additionally, CYP2C19 poor metabolizers showed greater cardiovascular responses to MDMA compared with other CYP2C19 genotypes. Furthermore, the maximum concentration of MDA was higher in tobacco smokers that harbored the inducible CYP1A2 rs762551 A/A genotype compared with the non-inducible C-allele carriers. The findings indicate that CYP2C19, CYP2B6, and CYP1A2 contribute to the metabolism of MDMA to MDA in humans. Additionally, genetic polymorphisms in CYP2C19 may moderate the cardiovascular toxicity of MDMA.

Vizeli, P., Schmid, Y., Prestin, K., zu Schwabedissen, H. E. M., & Liechti, M. E. (2017). Pharmacogenetics of ecstasy: CYP1A2, CYP2C19, and CYP2B6 polymorphisms moderate pharmacokinetics of MDMA in healthy subjects. European Neuropsychopharmacology, 27(3), 232-238. 10.1016/j.euroneuro.2017.01.008
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Hyperthermia Severely Affects the Vascular Effects of MDMA and Metabolites in the Human Internal Mammary Artery In Vitro

January 13, 2017 / MDMA, Neuroscience, Papers, Publications / By / , , , , , ,

Abstract

3,4-Methylenedioxymethamphetamine (MDMA or “ecstasy”) is a recreational drug used worldwide for its distinctive psychotropic effects. Although important cardiovascular effects, such as increased blood pressure and heart rate, have also been described, the vascular effects of MDMA and metabolites and their correlation with hyperthermia (major side effect of MDMA) are not yet fully understood and have not been previously reported. This study aimed at evaluating the effects of MDMA and its main catechol metabolites, alpha-methyldopamine (α-MeDA), N-methyl-alpha-methyldopamine (N-Me-α-MeDA), 5-(glutathion-S-yl)-alpha-methyldopamine [fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][5-(GSH)-α-MeDA] and 5-(glutathion-S-yl)-N-methyl-alpha-methyldopamine [5-(GSH)-N-Me-α-MeDA], on the 5-HT-dependent vasoactivity in normothermia (37 °C) and hyperthermia (40 °C) of the human internal mammary artery (IMA) in vitro. The results showed the ability of MDMA, α-MeDA and N-Me-α-MeDA to exert vasoconstriction of the IMA which was considerably higher in hyperthermic conditions (about fourfold for MDMA and α-MeDA and twofold for N-Me-α-MeDA). The results also showed that all the compounds may influence the 5-HT-mediated concentration-dependent response of IMA, as MDMA, α-MeDA and N-Me-α-MeDA behaved as partial agonists and 5-(GSH)-α-MeDA and 5-(GSH)-N-Me-α-MeDA as antagonists. In conclusion, MDMA abuse may imply a higher cardiovascular risk associated both to MDMA and its metabolites that might be relevant in patients with underlying cardiovascular diseases, particularly in hyperthermia.

Fonseca, D. A., Guerra, A. F., Carvalho, F., Fernandes, E., Ferreira, L. M., Branco, P. S., … & Cotrim, M. D. (2017). Hyperthermia Severely Affects the Vascular Effects of MDMA and Metabolites in the Human Internal Mammary Artery In Vitro. Cardiovascular Toxicology, 1-12. 10.1007/s12012-017-9398-y
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Can 3,4,-methylenedioxymethamphetamine therapy be used to treat alcohol use disorder?

December 30, 2016 / MDMA, Papers, Psychology, Publications, Substance Use Disorder / By /

Abstract

Treating people with alcohol use disorder has been an important target area for psychedelic research – both in the first studies of the 1950s and during the Psychedelic Renaissance of the last 10 years. To date, most studies have looked at the classical psychedelic drugs as adjuncts to psychotherapy; with attention paid to the psychospiritual aspect of the experience as a central therapeutic process in effecting abstinence from drinking. Psychotherapy assisted with 3,4,-methylenedioxymethamphetamine (MDMA) has never been explored for treating alcohol use disorder. However, MDMA has some unique pharmacological characteristics – particularly its capacity for reducing the fear response and facilitating engagement in therapy around past psychological trauma – that could make it a useful candidate for tackling the core features of alcohol use disorder. This paper briefly describes the burden of alcohol use disorders and the history of psychedelic-assisted psychotherapy in the field of addictions. It gives the theoretical and experimental justification for MDMA-assisted psychotherapy for treating people with alcohol use disorder and introduces a forthcoming study from Bristol and London, UK, exploring the role for MDMA in treating a person with this challenging condition.

Sessa, B. (2016). Can 3, 4,-methylenedioxymethamphetamine therapy be used to treat alcohol use disorder?. Journal of Psychedelic Studies, (0), 1-9. 10.1556/2054.01.2016.003
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Predicting the Abuse Liability of Entactogen-Class, New and Emerging Psychoactive Substances via Preclinical Models of Drug Self-administration

December 2, 2016 / MDMA, Papers, Psychology, Publications, Substance Use Disorder / By / ,

Abstract

Animal models of drug self-administration are currently the gold standard for making predictions regarding the relative likelihood that a recreational drug substance will lead to continued use and addiction. Such models have been found to have high predictive accuracy and discriminative validity for a number of drug classes including ethanol, nicotine, opioids, and psychostimulants such as cocaine and methamphetamine. Members of the entactogen class of psychostimulants (drugs that produce an “open mind state” including feelings of interpersonal closeness, intimacy and empathy) have been less frequently studied in self-administration models. The prototypical entactogen 3,4-methylenedioxymethamphetamine (MDMA; “Ecstasy”) supports self-administration but not with the same consistency nor with the same efficacy as structurally related drugs amphetamine or methamphetamine. Consistent with these observations, MDMA use is more episodic in the majority of those who use it frequently. Nevertheless, substantial numbers of MDMA users will meet the criteria for substance dependence at some point in their use history. This review examines the currently available evidence from rodent self-administration studies of MDMA and two of the new and emerging psychoactive substances (NPS) that produce entactogen type neuropharmacological responses – mephedrone (4-methylmethcathinone; 4MMC; “meow meow”) and methylone (3,4-methylenedioxymethcathinone). Overall, the current evidence predicts that these NPS entactogens have enhanced abuse liability compared with MDMA.

Aarde, S. M., & Taffe, M. A. (2016). Predicting the Abuse Liability of Entactogen-Class, New and Emerging Psychoactive Substances via Preclinical Models of Drug Self-administration. 10.1007/7854_2016_54
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Discriminative Stimulus Properties of MDMA: The Role of Serotonin and Dopamine

December 1, 2016 / MDMA, Neuroscience, Papers, Publications / By /

Abstract

Rationale: ±3,4-methylenedioxymethamphetamine (MDMA, “ecstasy”) produces unique and complex subjective effects which distinguish it from other recreationally used drugs. An understanding of the neurochemical mechanisms that underlie these effects is important in order to assess the potential for MDMA abuse and to inform researchers exploring of the drug’s therapeutic potential. The present thesis investigated the neurochemical mechanisms underlying the subjective effects of MDMA using drug discrimination procedures in laboratory animals. Despite evidence that training dose can markedly impact the results of drug discrimination studies, the impact of training dose on the discriminative stimulus properties of MDMA has been largely overlooked. The broad aims of these experiments were 1) to test the ability of two different doses of MDMA to support drug discrimination learning, and 2) to determine the role of serotonin (5-HT) and dopamine (DA) neurotransmitter systems in producing the discriminative stimulus effects of each MDMA training dose. 

Methods: Groups of rats were trained to discriminate MDMA (1.5 or 3.0 mg/kg) from saline or to discriminate MDMA (1.5 or 3.0 mg/kg) from amphetamine (0.5 mg/kg) and saline, using two- or three-lever, food-reinforced drug discrimination procedures. The first experiments determined the impact of training dose on the acquisition of the MDMA discrimination. Reliability of the discrimination was assessed by measuring the impact of changes in acquisition criteria. Once the discrimination had been acquired, generalisation tests were carried out in two-lever experiments with the SSRIs, fluoxetine and clomipramine, the 5-HT2 agonists, mCPP and DOI, and the 5-HT1 agonists, 8-OH-DPAT and RU-24969, to investigate the role of 5-HT in the discriminative stimulus effects of 1.5 mg/kg vs 3.0 mg/kg MDMA. Next, the role of DA was investigated in further generalisation test sessions with the DA releasing stimulant, AMPH, the non-selective D1/D2 agonist, apomorphine, the D1 agonist, SKF38393, and the D2 agonist, quinpirole. Finally, experiments were carried out in which the ability of the 5-HT2A antagonist, ketanserin, the 5-HT1B/1D antagonist, GR-127935, the 5-HT1A antagonist, WAY100635, the D1 antagonist, SCH23390, and the D2 antagonist, eticlopride, to attenuate the discriminative stimulus effects of 1.5 mg/kg vs 3.0 mg/kg MDMA was assessed.

Results: A higher training dose of MDMA was associated with a more rapid acquisition of drug discrimination in both the two- and three-lever tasks, and significant differences were observed with respect to the ability of each dose of MDMA to maintain consistently accurate discrimination across both tasks. All of the serotonin agonists that were tested generalised to the discriminative stimulus effects of 1.5 mg/kg MDMA in a two-lever discrimination task. In contrast, only agonists for 5-HT1A or 5-HT2A receptors generalised to the discriminative stimulus effects of 3.0 mg/kg MDMA. Non-selective dopamine agonists generalised to the discriminative stimulus effects of 3.0 mg/kg but not 1.5 mg/kg MDMA, whereas selective D1 and D2 agonists failed to generalise to the discriminative stimulus effects of either training dose. None of the DA or 5-HT antagonists tested had a marked impact of the discrimination of 1.5 mg/kg MDMA whereas administration of a D2 antagonist produced a small but significant attenuation on the discriminative stimulus effects of 3.0 mg/kg MDMA.

Conclusions: The results of the present thesis suggest that the discriminative stimulus effects of MDMA may change both quantitatively and qualitatively as a function of dose. The subjective effects produced by lower doses appear to be mediated primarily via serotonergic mechanisms, whereas higher doses may involve the additional recruitment of dopaminergic mechanisms. These findings have implications for our understanding of MDMA in terms of the drug’s potential for dependence and abuse.

Webster, J. (2016). Discriminative Stimulus Properties of MDMA: The Role of Serotonin and Dopamine. 10063/5622

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Effects of dextromethorphan on MDMA-induced serotonergic aberration in the brains of non-human primates using [123I]-ADAM/SPECT

December 1, 2016 / MDMA, Neuroscience, Papers, Publications / By / , , , , , ,

Abstract

3,4-Methylenedioxymethamphetamine (MDMA), a common recreational drug, is known to cause serotonergic neurotoxicity in the brain. Dextromethorphan (DM) is a widely used antitussive reported to exert anti-inflammatory effect in vivo. In this study, we examined the long-term effect of MDMA on the primate serotonergic system and the protective property of DM against MDMA-induced serotonergic abnormality using single photon emission computed tomography (SPECT). Nine monkeys (Macaca cyclopis) were divided into three groups, namely control, MDMA and co-treatment (MDMA/DM). [123I]-ADAM was used as the radioligand for serotonin transporters (SERT) in SPECT scans. SERT levels of the brain were evaluated and presented as the uptake ratios (URs) of [123I]-ADAM in several regions of interest of the brain including midbrain, thalamus and striatum. We found that the URs of [123I]-ADAM were significantly lower in the brains of MDMA than control group, indicating lower brain SERT levels in the MDMA-treated monkeys. This MDMA-induced decrease in brain SERT levels could persist for over four years. However, the loss of brain SERT levels was not observed in co-treatment group. These results suggest that DM may exert a protective effect against MDMA-induced serotonergic toxicity in the brains of the non-human primate.

Ma, K. H., Liu, T. T., Weng, S. J., Chen, C. F. F., Huang, Y. S., Chueh, S. H., … & Huang, W. S. (2016). Effects of dextromethorphan on MDMA-induced serotonergic aberration in the brains of non-human primates using [123I]-ADAM/SPECT. Scientific Reports, 6. 10.1038/srep38695
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Ecstasy research: will increasing observational data aid our understanding of MDMA?

December 1, 2016 / MDMA, Neuroscience, Papers, Psychology, Publications / By /

Abstract

Over the past three decades, millions of dollars have been spent on thousands of studies attempting to better understand the neurotoxic effects of MDMA. All of the clinical studies have recruited people who use ecstasy—a drug that does often but not always contain MDMA. Although most researchers agree that MDMA is the cause of neurocognitive deficits in ecstasy users, this consensus is based on a large body of literature with many limitations.

Amoroso, T. (2016). Ecstasy research: will increasing observational data aid our understanding of MDMA?. The Lancet Psychiatry, 3(12), 1101-1102. 10.1016/S2215-0366(16)30345-5
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Decision-making in chronic ecstasy users: a systematic review

November 15, 2016 / MDMA, Papers, Psychology, Publications / By / , ,

Abstract

Different cognitive impairments have been reported as a result of long-term MDMA/ecstasy use. Increased impulsivity and altered decision-making have been shown to be associated with the development and maintenance of addictive disorders pointing towards the necessity to understand a potential impairment of decision-making due to MDMA use. Thus, assessing the long-term effects of MDMA is crucial in order to evaluate its controversially discussed therapeutic use. The aim of this systematic review is to summarize the scientific literature on potential effects of chronic MDMA use on higher order decision-making processes in humans. Therefore, a systematic search for controlled trials relevant to the topic has been performed. Only studies using specific tasks on decision-making were included that involved subjects in the drug-free interval with drug-naïve, and/or polydrug control groups. A total of twelve studies could be identified that met the inclusion criteria, all of which were cross-sectional studies. The findings on decision-making disturbances in MDMA users were heterogeneous. Seven studies reported increased risky decisions, whereas five studies did not find MDMA-specific influences on decision-making. Increased impulsivity was observed both in MDMA groups and in (poly)drug control groups in almost all studies. Thus, the current state of research does not allow for the conclusion that long-term use of MDMA affects decision-making behavior in general. More detailed specifications as well as further investigations of the relevant processes are needed. Significant tendencies towards risky decision-making among long-term MDMA use have been observed, but need to be confirmed by studies using a longitudinal design.

Betzler, F., Viohl, L., & Romanczuk‐Seiferth, N. (2016). Decision‐making in chronic ecstasy users: a systematic review. European Journal of Neuroscience. 10.1111/ejn.13480
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Cognitive and behavioural effects induced by social stress plus MDMA administration in mice

November 10, 2016 / Depressive Disorders, MDMA, Papers, Psychology, Publications / By / , , , ,

Abstract

Adverse life experiences such as social stress may make an individual more vulnerable to drug addiction and mental disorders associated with drug consumption. The present work aimed to evaluate the effects of stress induced by acute social defeat combined with the administration of 3,4-methylenedioxymethamphetamine (MDMA) on depression-like behaviour, memory function and motor response to drug in late adolescent male mice. Two groups of mice were exposed to social defeat (SD) during four encounters with an aggressive co-specific, which took place on alternate days. Immediately after defeat, animals were treated with saline or MDMA 10mg/kg (SD+SAL and SD+MDMA). In control groups, mice were placed in a neutral cage without an opponent (Control+SAL, Control+MDMA). Corticosterone levels and temperature were measured on the last day of this phase. During the following days, the behaviour of the animals was evaluated in the tail suspension test (an animal model of depression), memory tasks (passive avoidance and object recognition) and, after administration of 5mg/kg of MDMA, in the open-field test. Exposure of adult mice to acute social defeat plus MDMA increased immobility in the tail suspension test (depression-like behaviour), produced cognitive impairment, and reduced the motor response to MDMA. An increase in corticosterone levels and a decrease of temperature were also observed. As hypothesised, a combination of social stress and consumption of MDMA increases the risk of developing mental and cognitive disorders. Our results support the idea that stress is a common contributing factor to the high rate of comorbidity between substance abuse and mental disease.

García-Pardo, M. P., Roger-Sánchez, C., Rodríguez-Arias, M., Miñarro, J., & Aguilar, M. A. (2017). Cognitive and behavioural effects induced by social stress plus MDMA administration in mice. Behavioural Brain Research, 319, 63-72. 10.1016/j.bbr.2016.11.012
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