title: Pharmacological aspects of the combined use of 3,4-methylenedioxymethamphetamine (MDMA, ecstasy) and gamma-hydroxybutyric acid (GHB): a review of the literature.
abstract: Epidemiological studies show that the use of club drugs is on the rise. Furthermore, the last few decades have seen a rise in patterns of polydrug use. One of the combinations frequently used is ecstasy (MDMA) with gammahydroxybutyrate (GHB). For effective prevention it is important to be aware of this phenomenon and of the pharmacology of these drugs. The effects of the combination extend to different neurotransmitter systems, including serotonin, dopamine and noradrenaline. Studies investigating the effects of combinations of psychoactive substances are limited. In this review we describe the subjective effects of the MDMA/GHB combination. Furthermore, we review the individual actions of MDMA on serotonin, dopamine and noradrenaline systems. In addition, actions of GHB on these systems are discussed as a possible pharmacological basis for the interaction of both drugs. It is postulated that GHB attenuates the unpleasant or dysphoric effects of MDMA by its effect on the central dopaminergic system.
authors.affiliation: Drugs Information and Monitoring System, Trimbos-Institute, Netherlands Institute of Mental Health and Addiction, The Netherlands.
authors.forename: Joachim D K
authors.initials: JD
authors.lastname: Uys
authors.forename: Raymond J M
authors.initials: RJ
authors.lastname: Niesink
mesh_terms: D001007:Anxiety / Q000139:chemically induced; D001831:Body Temperature / Q000187:drug effects; D003863:Depression / Q000139:chemically induced; D004298:Dopamine / Q000378:metabolism*; D006213:Hallucinogens / Q000009:adverse effects*; D006801:Humans; D006885:Hydroxybutyrates / Q000494:pharmacology*; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects*; D009638:Norepinephrine / Q000378:metabolism*; D011596:Psychomotor Disorders / Q000139:chemically induced; D012701:Serotonin / Q000378:metabolism*; D019966:Substance-Related Disorders
chemical_list: D006213:Hallucinogens; D006885:Hydroxybutyrates; C111420:4-hydroxybutyric acid; D012701:Serotonin; D018817:N-Methyl-3,4-methylenedioxyamphetamine; D004298:Dopamine; D009638:Norepinephrine