title: How MDMA's pharmacology and pharmacokinetics drive desired effects and harms.
abstract: 3,4-Methylenedioxymethamphetamine (MDMA) is an agent of abuse that has been used by over 16 million Americans. Increased energy, elevated mood, bonding with others, and psychedelic effects are desired effects while liver damage, extended depressed mood, sexual assault, rhabdomyolysis, serotonin syndrome, multiorgan failure, cardiovascular events, arrhythmias, and death are possible adverse effects. These desirable and adverse effects of MDMA are extensions of its fascinating pharmacologic and pharmacokinetic profile. In addition to methamphatemine like effects, MDMA also has mescaline like effects and increases the release of cortisol, oxytocin, and antidiuretic hormone. The desirable effects of MDMA are accentuated by the rave or electronic dance music scene where warm temperatures, vigorous dancing, loud music, and light shows accentuate some of the responses. However, the same environment increases the risk of certain harms. Knowledge of the constellation of these factors is needed for education, prevention of harm, and treatment.
authors.affiliation: University of Connecticut and Hartford Hospital, Hartford, CT, USA.
authors.forename: C
authors.initials: C
authors.lastname: Michael White
mesh_terms: D004347:Drug Interactions; D005060:Europe / Q000453:epidemiology; D006213:Hallucinogens / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology*; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology*; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology*; D015995:Prevalence; D018490:Serotonin Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology*; D019966:Substance-Related Disorders / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
chemical_list: D006213:Hallucinogens; D013287:Illicit Drugs; D018490:Serotonin Agents; D018817:N-Methyl-3,4-methylenedioxyamphetamine
keywords: MDMA; ecstasy; hyperpyrexia; hyponatremia; molly; rhabdomyolysis