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MethylenedioxymethamphetamineAka: Ecstasy, MDMA

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  1. See Also
    1. Club Drug
    2. Amphetamine
    3. Methamphetamine
    4. Cocaine
  2. Pathophysiology
    1. Background
      1. Type of Methamphetamine
      2. Illicit Drug used at raves and clubs
    2. Stimulates Serotonin, Dopamine, Norepinephrine release
    3. Inhibits monoamine oxidase
      1. Limits breakdown of neurotransmitters
    4. MDMA is commonly mixed with other unlisted substances
      1. May contain caffeine or pseudophedrine
      2. May contain Hallucinogens (e.g. LSD, MDA, MDEA, 2-CB)
  3. Pharmacokinetics
    1. Onset: 30-60 minutes after oral intake
    2. Duration: 8 hours
  4. Symptoms
    1. Initial
      1. Agitated
      2. Time sense is altered
      3. Decreased hunger and thirst
    2. Later
      1. Euphoria
      2. Sense of intimacy with others
      3. Sense of well-being
  5. Adverse Effects
    1. See Sympathomimetic Toxicity
    2. Trismus or bruxism
      1. Users reduce this by sucking on Pacifier or lollipop
    3. Sympathetic overdrive
      1. Tachycardia
      2. Mydriasis
      3. Diaphoresis
      4. Urinary Retention
    4. Serotonin Syndrome
    5. Hyperthermia
    6. Hyponatremia
    7. NMDA withdrawal related depression
  6. Management: Toxicity
    1. See Sympathomimetic Toxicity
  7. References
    1. Gahlinger (2004) Am Fam Physician 69:2619

Ecstasy - drug (C0115471)

Definition (MSH)An N-substituted amphetamine analog. It is a widely abused drug classified as a hallucinogen and causes marked, long-lasting changes in brain serotonergic systems. It is commonly referred to as MDMA or ecstasy.
Definition (CSP)synthetic adrenergic agonist resembling both amphetamine (a stimulant) and mescaline (a hallucinogen); "designer drug" once touted as potentially psychotherapeutic, but now a controlled substance considered a drug of abuse.
Definition (PDQ)A ring-substituted amphetamine derivative, structurally related to the hallucinogen mescaline, with entactogenic (openess- and empathy-generating), neurotoxic, and motor-stimulatory activities. Although the mechanism by which it causes its unusual entactogenic effects is largely unknown, 3,4-methylenedioxymethamphetamine (MDMA) produces an acute, rapid enhancement in both the release of serotonin from and the inhibition of serotonin reuptake by serotonergic nerve endings in the brain. Once within the cell, MDMA depletes stores of tryptophan hydroxylase (TPH) via acute oxidative inactivation; in turn, depleted stores of TPH leave cell terminals open to damage from oxidative stress, possibly a source of MDMA neurotoxicity. This agent also induces norepinephrine, dopamine, and acetylcholine release and can act directly on a number of receptors, including alpha 2-adrenergic and 5-hydroxytryptamine (5-HT) 2A receptors. MDMA may suppress the dyskinesia associated with long-term use of L-dopamine (L-DOPA) without affecting the efficacy of L-DOPA treatment, perhaps via indirect stimulation of 5-HT 1A receptors. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=475676&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=475676&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C61081" NCI Thesaurus)
Definition (NCI)A ring-substituted amphetamine derivative structurally related to the hallucinogen mescaline, with entactogenic, neurotoxic, and motor-stimulatory activities. Although the mechanism is unknown, 3,4-methylenedioxymethamphetamine (MDMA) produces an acute, rapid enhancement in the release of serotonin from and inhibits serotonin reuptake by serotonergic nerve endings in the brain. Intracellularly MDMA depletes stores of tryptophan hydroxylase (TPH) via acute oxidative inactivation. In turn, depleted stores of TPH leave cell terminals open to damage from oxidative stress, possibly a source of MDMA neurotoxicity. This agent also induces norepinephrine, dopamine, and acetylcholine release and can act directly on a number of receptors, including alpha 2-adrenergic and 5-hydroxytryptamine (5-HT) 2A receptors. MDMA may suppress the dyskinesia associated with long-term use of L-dopamine (L-DOPA) without affecting the efficacy of L-DOPA treatment.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121) , Hazardous or Poisonous Substance (T131)
MSHD018817
EnglishE - Ecstasy, Ecstasy, Ecstasy - agent, Ecstasy - drug, MDM, MDMA, MDMA - Methylenedioxymethamphetamine, methylene dioxymethamphetamine, Methylene-dioxymethamphetamine, Methylenedioxymethamfetamine, Methylenedioxymethamphetamine, METHYLMETHYLENEDIOXYAMPHETAMINE N 03 04, MMDA
Spanishextasis - agente, metilen-dioximetanfetamina, metilendioximetanfetamina
Parent Conceptsprimary stimulants of abuse (C0678472), Amphetamine (C0002658), Hallucinogens (C0018533), Amphetamines (C0002667), Central Nervous System Stimulants (C0002763), Methamphetamine (C0025611), Psychoactive substance of abuse - non-pharmaceutical (C0443078), Duplicate concept (C1274013)
SourcesAOD, CSP, LNC, MEDLINEPLUS, MSH, MTH, NCI, PDQ, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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