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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 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.