Vasopressin and oxytocin secretion in response to the consumption of ecstasy in a clubbing population.
Despite the common use of MDMA (ecstasy) in the UK, the mechanism underlying associated potentially fatal cerebral oedema is unclear. We used a new experimental approach working directly with clubbers to perform a study on 30 (17 male) experienced clubbers (mean 6.6 years of clubbing). Pre- and post-clubbing measurements were performed to compare plasma levels of pituitary hormones (vasopressin, oxytocin), plasma and urine osmolality, urinary pH, and plasma sodium and urea. Ecstasy consumption was confirmed by using urinary drug screening pre- and post-clubbing. MDMA was detected in the urine samples of 17 subjects, three of which tested positive during pre-clubbing tests. Mean plasma vasopressin concentration increased in the MDMA group (1.28 +/- 0.29 to 1.43 +/- 0.41 pmol/l), but fell in other participants (1.23 +/- 0.42 to 1.16 +/- 0.0.34 pmol/l). Similarly, mean plasma oxytocin concentrations increased after ingestion of MDMA (2.02 +/- 0.29 to 2.43 +/- 0.24 pmol/l), but fell in the group that did not use MDMA (2.17 +/- 0.36 pmol/l to 1.89 +/- 0.37 pmol/l). There was a significant group by time interaction for plasma osmolality and plasma sodium (p = 0.001 and p = 0.003, respectively) and between change in urinary osmolality (p < 0.001) and MDMA use, with the pattern of change being consistent with the induction of inappropriate vasopressin secretion (also known as SIADH) by MDMA. This report demonstrates SIADH in ecstasy-using "clubbers", which has important clinical implications.
National Addiction Centre, Institute of Psychiatry, King's College London, 4 Windsor Walk, London SE5 8AF, UK. k.wolff@iop.kcl.ac.uk
Kim
K
Wolff
E M
EM
Tsapakis
A R
AR
Winstock
D
D
Hartley
D
D
Holt
M L
ML
Forsling
Katherine J
KJ
Aitchison
D000293:Adolescent; D000328:Adult; D001127:Arginine Vasopressin / Q000097:blood*; D001143:Arousal / Q000187:drug effects; D005260:Female; D006706:Homeostasis / Q000187:drug effects; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D007177:Inappropriate ADH Syndrome / Q000097:blood / Q000139:chemically induced; D008297:Male; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects*; D010121:Oxytocin / Q000097:blood*; D011863:Radioimmunoassay; D012931:Social Environment; D012932:Social Facilitation; D019966:Substance-Related Disorders / Q000097:blood* / Q000523:psychology; D014882:Water-Electrolyte Balance / Q000187:drug effects
D013287:Illicit Drugs; D001127:Arginine Vasopressin; D010121:Oxytocin; D018817:N-Methyl-3,4-methylenedioxyamphetamine