MDMA Flashcards
Historic synthesis and potential uses
synthesised in 1912 and patented in 1914. toxicology reported in the 1950s by US military.
Use in psychotherapy explored in 1980s. was declared a schedule 1 drug in 1985 by the DEA
Clinical trials started in 2011 for PTSD. granted breakthrough therapy status by the FDA in 2017
Consumption prevalence
One of the major class A drugs consumed. less frequent drug use than cocaine.
More commonly used by younger individuals, most prevalent in netherlands, ireland and czechia
subjective effects
20-60 min onset, 1-1:30 hour peak, lasts 3-5 hours
effects more profound in females.
Causes interoceptivity, relaxation, euphoria, emotional openness, empathy, tactile sensation enhancement, reduced negative thoughts and disinhibition. mildly hallucinogenic, with increased sound and colour intensity.
Context dependent effects. more stimulatory in party/club environments, but interoceptivity in quiet contexts. in lab environments often see childishness and reflections on childhood.
higher doses see increased hedonic and arousal behaviours.
Molecular mechanism
SERT > NET > DAT blocking.
Also inhibits VMAT1 and VMAT2. reverses the flow of monoamines, leading to direct release of 5HT.
Some mild affinity for 5-HT2B and partial agonism for trace amine receptor 1 (TAAR1) - MAOIs increase levels of trace amines the most - potential role of TAAR1 agonism in MDMA effects (likely mild due to lower affinity).
Adverse effects
Tachycardia, palpitations, dry mouth, bruxism (grinding teeth), diaphoresis (excessive sweating), insomnia.
Can cause rhabdomyolysis in high doses.
Can also lead to severe hyperthermia - renal, liver, and cardiovascular damage, can cause death. exacerbated by exercise and high temp environments such as raves. Rates of deaths are quite low compared to other recreational drugs - approx 50 per year
Acute worsening of learning and memory.
Tolerance and withdrawal
Tolerance occurs instantly after use, with a long (several days) “come down” period of recovery following use
Pleasurable effects decrease and side effects increase following repeated use.
Withdrawal causes fatigue, loss of appetite, depression, and trouble concentrating
