MDMA

Question 1

What is phenethylamine? and what other drug falls under this class?

Answer 1

Methylated amphetamine

• exhibits both stimulant and psychedelic properties

structural (mescaline)

functional (amphetamine)

evidence for the serotonin connection of stimulants

Ridilen

Question 2

what is it extracted from?

Answer 2

Sassafras tree

Question 3

Process of intake

Answer 3

Ingestion

30/60 min onset

Question 4

Characteristics of MDMA

Answer 4

Highly Lipid soluble

Question 5

What is the metabolite and does it have effects?

Answer 5

MDA
also psychoactive
-contributes to longer high

Question 6

metabolite require what?

Answer 6

Enzyme to break them down

10% of caucasian and asian dont have the enzyme

Question 7

what do SSRI’s do?

Answer 7

Inhibit enzyme responsible for decomposing MDMA

Can be potentially toxic complication

Question 8

What is step 1a in the process of taking MDMA?

Answer 8

Competitive reuptake inhibitor

enters the neuron in place of the transmitter leaving more in the synapse

Question 9

What is step 2a in the process of taking MDMA?

Low level

High level

Answer 9

Leaky vesicles
Reverse transport: dose dependent effects

Low levels: serotonin

High levels : Serotonin and dopamine

effects on dopamine weaker than those on serotonin
effects of Norepinephrine release is still in question/unclear

Question 10

What is step 3a in the process of taking MDMA?

Answer 10

Agonist at 5-HT and 5-HT2 receptor

Facilitates release of oxytocin
-limbic system

Question 11

What is step B in the process of taking MDMA?

Answer 11

MAO-A inhibitor

Question 12

What are the ACUTE effects of MDMA

Answer 12

Physiological: Sympathomimetic
-Amphetamine-like
stimulates discrimination between amphetamine and LSD
Bruxism: Teeth grinding

Sudden and extreme onset:

loss on consciousness, brain hemorrhaging, tachycardia
in conjunction with “Club” condition

Question 13

Psychological effects of MDMA

Answer 13

Empathogenic
increase emotional warmth/empath, lowered defensiveness, increase in verbal behaviour

• mild euphoria due to oxytocin
  females more susceptible to effect
  -sudden and extreme onset
  paranoia, panic, delirium, hallucinations

Overdose is typified by impulsive irrational behaviour

Question 14

What are the Negative Sub-acute effects of MDMA

Answer 14

Suicide Tuesday (occurs within 24 hr and can last for a week)
depression and lethargy
symptomatically similar to MDD
sleep disturbance

Question 15

What are the Negative Chronic / withdrawal phase effects of MDMA

Answer 15

Substance-induced paranoid psychosis

temporary state of ‘False yet feasible beliefs” of threat or danger to the individual

Question 16

What are the Negative Selective serotonergic neurotoxin effects of MDMA

Answer 16

Relapse of pre-existing illness
-schizophrenia, bi-polar
lower seizure threshold
with chronic use (small) elevated risk for triggering psychotic disorders
confound of multiple drug usage, no good conrol

Question 17

MDMA Tolerance

Answer 17

Diminished effects after first 7 uses
-serotonin receptor down regulation and less serotonin release
-effects wear off after 1 year abstinence
sporadic intake decreases in-between times
-some subjective report of MDMA tables getting weaker

Question 18

MDMA dependence

Answer 18

Uncertain
-tolerance occurs due to physiological factors
-no withdrawal behaviours
psychological dependance has not been well documented
-confounded with poly-drug use, reports of dysthymia/depression pre-use

Question 19

Large problem with MDMA

Answer 19

It might not be MDMA

Question 20

Synthetic analogues of MDA

Answer 20

Love drug
more stimulating, similar effects
twice as neurotoxic
speculation: flooding vs protracted activation

Question 21

Synthetic analogues

MDE

Answer 21

Eve

introspective experience

Question 22

Synthetic analogues

MMDA

Answer 22

Brain movies

closed eye hallucinations

Question 23

Synthetic analogues

MBDB

Answer 23

Similar to MDA