MDMA, abuse

Although the problem of MDMA abuse has generated great interest because of MDMA s potential neurotoxicity, it is possible that nonneurotoxic entactogens can be developed. As in most areas of technology, this is a... 

Hemopneumothorax has been reported in association with MDMA abuse (33). 

A healthy 17-year-old boy, who complained of dental sensitivity that occurred only when he consumed fizzy drinks, presented with marked tooth wear. All the teeth were involved, especially the premolars and permanent molars. He ate a poorly balanced diet, with 500 ml carbonated drinks twice daily. He subsequently admitted to frequent MDMA abuse. 

Inman DS, Greene D. The agony and the ecstasy acute urinary retention after MDMA abuse. BJU Int 2003 91 123. 

Zhou, J.F., Zhou, Y.FI., Zhang, L., Chen, FI.FI., Cai, D. (2003). 3,4-Methylenedioxymethamphetamine (MDMA) abuse markedly inhibits acetylcholinesterase activity and induces severe oxidative damage and lippid peroxidative damage. Biomed. Environ. Sci. 16 53-61. 

Hyponatraemia is one of the most serious complications of MDMA abuse as documented in a new case report [29 ]. 

Rawson RA, Gonzales R, Brethen P Treatment of methamphetamine use disorders an update. J Subst Abuse Treat 23 145—150, 2002a Rawson RA, Huber A, Brethen P, et al Status of methamphetamine users 2—5 years after outpatient treatment. J Addict Dis 21 107—119, 2002b Reneman L, Lavalaye J, Schmand B, et al Cortical serotonin transporter density and verbal memory in individuals who stopped using 3,4-methylenedioxymetham-phetamine (MDMA or ecstasy ) preliminary findings (comment). Arch Gen Psychiatry 58 901—906, 2001... 

National Institute on Drug Abuse Research Report Series MDMA (Ecstasy) Abuse. Rockville, MD, National Institute on Drug Abuse, 2004b. Available at http // www.drugabuse.gov/ResearchReports/MDMA/MDMA3. html. Accessed May 9, 2005. 

Ricaurte GA, McCann UD, Szabo Z, et al Toxicodynamics and long-term toxicity of the recreational drug 3,4-methylenedioxy-methamphetamine (MDMA, Ecstasy ). Toxicol Lett 112-113 143-146, 2000 Robinson TN, Killen JD, Taylor CB, et al Perspectives on adolescent substance use a defined population study. JAMA 258 2072-2076, 1987 Rubinstein JS Abuse of antiparkinson drugs feigning of extrapyramidal symptoms to obtain trihexyphenidyl. JAMA 239 2365, 1978 Rumack BH (ed) LSD, in Poisindex, Vol 54. Denver, CO, Micromedex, 1987 Rusyniak DE, Banks ML, Mills EM, et al Dantrolene use in 3,4-methylenedioxymethamphetamine ( ecstasy )-medicated hyperthermia (letter). Anesthesiology 10 263, 2004... 

Schreiber R, Brocco M, Audinot V, et al (l-(2,5-Dimethoxy-4 iodophenyl)-2-amino-propane)-induced head-twitches in the rat are mediated by 5-hydroxytryptamine (5-HT) 2A receptors modulation by novel 5-HT2A/2C antagonists, Dj antagonists and 5-HTagonists. J Pharmacol Exp Ther 273 101—112, 1995 Screaton GR, Singer M, Cairns HS, et al Hyperpyrexia and rhabdomyolysis after MDMA ( ecstasy ) abuse. Lancet 399 667—668, 1992... 

Wills S Drugs of Abuse. London, Pharmaceutical Press, 1997 Winstock AR Chronic paranoid psychosis after misuse of MDMA. BMJ 302 1150-1151, 1991... 

There is virtually no one who is involved in drug abuse research, or who studies the properties of recreationally used drugs, that is not by now familiar with 3,4-methylenedioxymethamphetamine (MDMA) (figure 1). Over the past 4 years this substance, usually referred to in the popular press as Ecstasy, has received widespread media attention. This chapter will relate recent findings with respect to the potential dangers attendant on the use of MDMA and explore its pharmacological properties. 

My own bias is toward the therapeutic potential. I do not care whether anything we develop produces euphoria or dependence potential. I think from the point of view of a drug abuse problem or a dependence liability that the alpha-ethyl probably does not have the reinforcing qualities and is not as pleasurable as MDMA. 

Recent controversy about the recreational abuse and potential therapeutic use of designer drugs has focused attention on MDA (methylenedioxyampheta-mine HCl) and structurally related phenylisopropylamine compounds, including MDMA istructural analogs of the psychomotor stimulant amphetamine and the hallucinogen mescaline, and produce stimulant and/or hallucinogenic effects (Shulgin 1978). 

Recreational abuse of designer drugs poses a major problem. Evidence concerning the safety of these drugs has shown that MDA and MDMA are toxic to serotonergic neurons in rodent (Ricaurte et al. 1985 Stone et al. 1987 O Heam et al. 1988) and primate brains (Ricaurte et al. 1988). 

The stimulation of locomotor activity by MDMA and the importance of mesolimbic dopamine in this response reflect similarities with the prototype phenylethylamine stimulant, amphetamine. It is important to note that these parameters are frequently associated with rewarding aspects of drugs and drug abuse. Additionally, the behavioral profiles of MDMA and I E share certain characteristics with hallucinogen-Iike agents. This unique mixture of stimulus properties and neurochemical actions may contribute to a dangerous behavioral toxicity and neurotoxic potential for drugs like MDMA. 

This work was supported by U.S. Public Health Service grants DA 00869 and DA 04222. The National Institute of Drug Abuse contributed the methamphetamine hydrochloride. MDMA, and MDA, NOVO Industrials is acknowledged for contributing GBR 12909. 

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