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methylenedioxymethamphetamine (MDMA, Ecstasy, Molly)

Street Drug. Major metabolite of methamphetamine. Uses: - stimulant & hallucinogen - may be of benefit as add-on to psychotherapy in patients with PTSD [6] Pathology: - toxic to serotoninergic neurons Adverse effects: 1) tachycardia 2) valvular heart disease [2] 3) hypertension 4) confusion 5) anxiety 6) paranoia 7) depression [3] 8) mydriasis 8) serotonin syndrome [5] Laboratory: - serum sodium: hyponatremia [5] - labs with Loincs - methylenedioxymethamphetamine in specimen - methylenedioxymethamphetamine in hair - methylenedioxymethamphetamine in saliva - methylenedioxymethamphetamine in gastric fluid - methylenedioxymethamphetamine in stool - methylenedioxymethamphetamine in meconium - methylenedioxymethamphetamine in blood - methylenedioxymethamphetamine in serum/plasma - methylenedioxymethamphetamine in vitreous fluid - methylenedioxymethamphetamine in urine Management: overdose - benzodiazepines 1st line for agitation [5]

Interactions

drug interactions drug adverse effects (more general classes)

Related

methamphetamine

General

adrenergic neuron stimulant amine analeptic (CNS stimulant) aromatic compound pharmacologic metabolite

Database Correlations

PUBCHEM correlations

References

  1. Prescriber's Letter 8(2):11 2001
  2. MDMA Use May Increase Risk for Cardiac Valve Disease http://www.drugabuse.gov/NIDA_notes/NNvol18N6/mdma.html
  3. Briere FN et al Prospective associations between meth/amphetamine (speed) and MDMA (ecstasy) use and depressive symptoms in secondary school students J Epidemiol Community Health doi:10.1136/jech-2011-200706 PMID: 22516739 http://jech.bmj.com/content/early/2012/04/12/jech-2011-200706.abstract
  4. Prescriber's Letter 20(12): 2013 Drugs of Abuse Detail-Document#: 291211 (subscription needed) http://www.prescribersletter.com
  5. Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
  6. Monaco K MDMA-Assisted Therapy Offers a Win for PTSD Remission. Trial patients achieved good outcome with addition of psychoactive drug to psychotherapy. MedPage Today May 2, 2021 https://www.medpagetoday.com/meetingcoverage/apa/92379 - Mitchell J, et al Efficacy and safety results from the first phase 3 randomized controlled trial of MDMA-assisted psychotherapy for treatment of severe chronic PTSD. American Psychiatric Association (APA) 2021.