MDMA

From PsychonautWiki
(Redirected from Mdma)
Jump to: navigation, search
Summary sheet: MDMA
MDMA
Molecular structure of MDMA
MDMA.svg
Chemical Nomenclature
Common names MDMA, Molly, Mandy, MD, Ecstasy, E, X, XTC, Rolls
Substitutive name 3,4-Methylenedioxy-N-methylamphetamine
Systematic name (RS)-1-(Benzo[d][1,3]dioxol-5-yl)-N-methylpropan-2-amine
Class Membership
Psychoactive class Stimulant / Entactogen
Chemical class Amphetamine
Routes of Administration

WARNING: Always start with lower doses due to differences between individual body weight, tolerance, metabolism, and personal sensitivity. See responsible use section.



Oral
Dosage
Threshold 20 - 40 mg
Light 40 - 70 mg
Common 70 - 140 mg
Strong 140 - 180 mg
Heavy 180 mg +
Duration
Total 3 - 5 hours
Onset 20 - 60 minutes
Come up 20 - 60 minutes
Peak 1.5 - 2.5 hours
Offset 1 - 1.5 hours
After effects 12 - 48 hours









DISCLAIMER: PW's dosage information is gathered from users and resources for educational purposes only. It is not a recommendation and should be verified with other sources for accuracy.

3,4-Methylenedioxymethamphetamine (also known as Ecstasy, XTC, MDMA, MD, Molly, and Mandy, among others) is a widely-used synthetic entactogenic substance of the amphetamine and phenethylamine chemical classes. It produces prototypical entactogenic effects such as anxiety relief, disinhibition, enhanced feelings of empathy, affection, and sociability, muscle relaxation, stimulation, and euphoria when administered.

MDMA was originally synthesized in 1912 for its potential anti-bleeding properties but was largely forgotten about for the following 65 years. The first reports of its recreational usage did not appear until 1970.[1] Psychedelic chemist and researcher Alexander Shulgin is credited with introducing and popularizing the use of MDMA in underground psychotherapeutic circles in the late 1970s.[2] It became a controlled substance in 1985 when its use began to propagate out into the mainstream night-life and rave culture.[3]

Since the 1980s, MDMA has become widely known as "Ecstasy" (shortened to "E", "X", or "XTC"), usually referring to its street forms as illicitly pressed pills or tablets.[4] The American term "Molly" and the British equivalent term "Mandy" originally referred to crystal or powder MDMA that was purported to be of high purity and free of adulteration.[5] However, it has since evolved into a generic street term for any number of euphoric stimulants that are sold in powder or crystal form.[citation needed]

Despite MDMA being illegal in most, if not all countries, its use remains widespread. In 2014, MDMA was estimated to be one of the most popular recreational drugs used in the world, alongside cocaine and cannabis.[6] It has become associated with a number of contemporary youth and alternative subcultures.[citation needed]

Today, researchers are investigating whether controlled doses of MDMA may be useful in psychotherapy as an aid in treating a number of psychiatric conditions such as severe, treatment-resistant posttraumatic stress disorder (PTSD), social anxiety in autistic adults,[7] and anxiety in those with life-threatening illness.[8][9][10] More research is needed, however, to determine if its potential benefits outweighs the risk of its possible harms.[9][10]

History and culture

History icon.svg

This History and Culture section is a stub.

As such, it may contain incomplete or wrong information. You can help by expanding it.

MDMA was originally synthesized by Anton Köllisch, a chemist then employed by the Merck company. Köllisch was interested in developing substances that would help manage excess bleeding and was interested in the activity of MDMA, an intermediary in the production of hydrastinine, a hemostatic agent used at the time. In 1965, Alexander Shulgin synthesized MDMA while conducting experiments with methylenedioxy-substituted compounds but did not test the psychoactivity of the compound.[citation needed]

Around 1975, Shulgin heard about the effects of MDMA from a student. After hearing several more stories about the self-administration of MDMA, he decided to experiment with it. Shulgin was impressed with the effects of the substance and thought it could have useful therapeutic applications. Shulgin advertised the substance to therapists and psychiatrists for medical use, and it eventually became quite popular in the medical world for the treatment of various psychiatric disorders.[citation needed]

During this time the Californian psychotherapist Dr. Leo Zeff, who had worked with LSD psychotherapy in the 1960s, came out of retirement and subsequently introduced the then-legal MDMA to over 4,000 patients. Then known as "Adam", from the mid-1970s to the mid-1980s there was a growth of clinicians using MDMA around California.[11]

The recreational use of MDMA became popular at around the same time, particularly in nightclubs, and eventually caught the attention of the Drug Enforcement Administration. After several hearings, a US Federal Administrative Law Judge recommended that MDMA should be made a Schedule III controlled substance so that it could be used in the medical field. Despite this, the director of the DEA overruled this and classified MDMA as a Schedule I controlled substance.[citation needed]

In the UK, the 1971 Misuse of Drugs Act, which had already been altered in 1977 to include all ring-substituted amphetamines like MDMA, was further amended in 1985 to refer specifically to Ecstasy, placing it in the Class A category.[11]

Chemistry

MDMA, or 3,4-methylenedioxy-N-methylamphetamine, is a synthetic molecule of the substituted amphetamine class. Molecules of the amphetamine class all contain a phenethylamine core comprised of a phenyl ring bound to an amino (NH2) group through an ethyl chain, with an additional methyl substitution at Rα. In addition to this, MDMA contains a methyl substitution on RN, a feature it shares with methamphetamine. Critically, the MDMA molecule also contains substitutions at R3 and R4 of the phenyl ring with oxygen groups -- these oxygen groups are incorporated into a methylenedioxy ring through a methylene bridge. MDMA shares this methylenedioxy ring with other entactogens and stimulants like MDA, MDEA and MDAI.

Generic structure of a phenethylamine molecule

Pharmacology

MDMA is believed to act primarily as a presynaptic releasing agent of the three principal monoamine neurotransmitters serotonin, norepinephrine, and dopamine, which arises from its activity at trace amine-associated receptor 1 (TAAR1) and vesicular monoamine transporter 2 (VMAT2).[12][13][14]

MDMA is a monoamine transporter substrate (i.e. a substrate for the transporters for dopamine (DAT), norepinephrine (NET), and serotonin (SERT), enabling it to enter monoaminergic neurons via these neuronal membrane transport proteins.[13] By acting as a monoamine transporter substrate, MDMA produces competitive reuptake inhibition at the neuronal membrane transporters, competing for endogenous monoamines for reuptake.[13][15]

MDMA inhibits both vesicular monoamine transporters (VMATs), the second of which (VMAT2) is highly expressed within monoamine neurons vesicular membranes.[14] Once inside a monoamine neuron, MDMA acts as a VMAT2 inhibitor and a TAAR1 agonist.[13][16] The inhibition of VMAT2 by MDMA results in increased concentrations of the aforementioned monoamine neurotransmitters in the cytosol of the neuron.[14][17] Activation of TAAR1 by MDMA triggers protein kinase signaling events which then phosphorylates the associated monoamine transporters of the neuron.[13]

Subsequently, these phosphorylated monoamine transporters either reverse transport direction – i.e. move neurotransmitters from inside the cell to the synaptic cleft – or withdraw into the neuron, respectively producing the inflow of neurotransmitters and noncompetitive reuptake inhibition at the neuronal membrane transporters.[13] MDMA has ten times more affinity for uptake at serotonin transporters compared to dopamine and norepinephrine transporters and consequently has mainly serotonergic effects.[18]

To summarize, 1) MDMA first enters monoamine neurons by acting as a monoamine transporter substrate[13] 2) MDMA activity at VMAT2 moves neurotransmitters out from synaptic vesicles and into the cell body[14] and 3) MDMA activity at TAAR1 moves neurotransmitters out of the interior of the cell and into the synaptic cleft, where extra-endogenous concentrations can accumulate.[13]

MDMA also has weak agonist activity at postsynaptic serotonin receptors 5-HT1 and 5-HT2 receptors, and its more efficacious metabolite MDA likely augments this action.[19][20][21][22] Cortisol, prolactin, and oxytocin quantities in serum are increased by MDMA.[23]

A placebo-controlled study in 15 human volunteers found 100 mg MDMA increased blood levels of oxytocin, and the amount of oxytocin increase was correlated with the subjective prosocial effects of MDMA.[24](S)-MDMA is more effective in eliciting 5-HT, NE, and DA release, while (D)-MDMA is overall less effective, and more selective for 5-HT and NE release (displaying only a very faint efficacy on DA release).[25]

Additionally, MDMA is a ligand at both sigma receptor subtypes, though its efficacies at these receptors and the role that they play have yet to be elucidated.[26]

Subjective effects

The effects listed below are based upon the subjective effects index and personal experiences of PsychonautWiki contributors. The listed effects should be taken with a grain of salt and will rarely (if ever) occur all at once, but heavier doses will increase the chances and are more likely to induce a full range of effects. Likewise, adverse effects become much more likely on higher doses and may include injury or death.

Physical effects
Child.svg

Visual effects
Eye.svg

Cognitive effects
User.svg

Auditory effects
Volume-up.svg

Transpersonal effects
Infinity4.svg

After effects
Aftereffects (3).svg

Experience reports

Anecdotal reports which describe the effects of this compound within our experience index include:

Additional experience reports can be found here:

Forms

MDMA Pills, commonly called Ecstasy
Off-white MDMA crystals, commonly called Molly

MDMA can be found in a number of forms:

  • Pills are the most common form in which MDMA is sold, and are commonly referred to as Ecstasy. They often contain other substances or adulterants that range from anything from MDA, MDEA, amphetamine, methamphetamine, caffeine, 2C-B or mCPP to synthesis by-products such as MDP2P, MDDM or 2C-H. They can also contain an array random substances such as research chemicals, prescription drugs, over-the-counter drugs, poisons or nothing at all. It is strongly recommended to take harm reduction measures such as using a reagent testing kit when ingesting unknown pills.
  • Crystals or Powder (commonly called Molly) is a white to brownish substance which can be dissolved, crushed, put into gel capsules or edible paper ("parachutes"). It can be administered orally, sublingually, buccally or via insufflation ("snorting" or "sniffing").

Therapeutic role in medicine

MDMA-assisted psychotherapy for PTSD

In 2011, a pilot study on 20 patients demonstrated promising results in the treatment of post-traumatic stress disorder (PTSD). After two or three MDMA-assisted psychotherapy sessions, 83% of the patients no longer met the criteria for PTSD, compared to only 25% in the control group where MDMA was replaced with a placebo. The results sustained at two and twelve months after the treatment. The MDMA and placebo group both received non-drug psychotherapy before and after the sessions. In the study, a dose of 125mg MDMA plus a 62.5mg supplemental dose after 2 hours have been administered.[37]

After completion of the study, the patients from the placebo group also received MDMA-assisted psychotherapy, and a long-term follow-up study of 19 patients published in 2013 shows that even after three years the positive results maintained.[38]

Toxicity and harm potential

Radar plot showing relative physical harm, social harm, and dependence of MDMA[39]

Short-term health concerns

Short-term physical health risks of MDMA consumption include dehydration, insomnia, hyperthermia,[40][41] and hyponatremia.[42] Continuous activity without sufficient rest or rehydration may cause body temperature to rise to dangerous levels, and loss of fluid via excessive perspiration puts the body at further risk as the stimulatory and euphoric qualities of the drug may render the user oblivious to their energy expenditure for quite some time. Diuretics such as alcohol may exacerbate these risks further due to the excessive amounts of dehydration they may cause.

The exact toxic dosage is unknown, but considered to be far greater than its effective dose.[citation needed]

Long-term health concerns

Neurotoxicity

The neurotoxicity of MDMA use has long been the subject of debate. Scientific study has resulted in the general agreement that, although it is physically safe to try in a responsible context, the administration of repeated or high dosages of MDMA is most certainly neurotoxic in some form.

Administration of MDMA causes subsequent down-regulation of serotonin reuptake transporters in the brain. The rate at which the brain recovers from serotonergic changes is unclear. One study demonstrated lasting serotonergic changes in some animals exposed to MDMA.[43] Other studies have suggested that the brain may recover from serotonergic damage.[44][45][46]

It is thought that MDMA's metabolites play a large role in the in the uncertain levels of neurotoxicity. For example, a metabolite of MDMA called alpha-MethylDopamine (which is known to be toxic to dopamine neurons[47][48]) was thought believed to be involved in the toxicity of MDMA to serotonin receptors. However, one study found this to not be the case as direct administration of aMD did not cause neurotoxicity.[48] Additionally, MDMA injected directly into the brain was found to not be toxic, implying a metabolite is responsible for the toxicity when MDMA is administered via insufflation or oral consumption.[48]

This study found that although aMD is involved, it is a further metabolite of aMD involving glutathione that is primarily responsible for the selective damage to 5-HT receptors triggered by MDMA/MDA.[48]This metabolite forms in higher concentrations when core temperature is elevated. It is taken up into serotonin receptors by its transporters and metabolized by MAO-B into a reactive oxygen species which can cause neurological damage.[48][49]

Cardiotoxicity

Long-term heavy use of MDMA has been shown to be cardiotoxic and may lead to valvulopathy (heart valve damage) through its actions on the 5-HT2B receptor.[50][51] In one study, 28% of long-term users (2-3 doses per week for a mean of 6 years, mean of age 24.3 years) had developed clinically evident valvular heart disease.[52]

It is strongly recommended that one use harm reduction practices when using this substance.

Tolerance and addiction potential

As with other stimulants, the chronic use of MDMA can be considered moderately addictive with a high potential for abuse and is capable of causing psychological dependence among certain users. When addiction has developed, cravings and withdrawal effects may occur if one suddenly stops their usage.

Tolerance to many of the effects of MDMA develops with prolonged and repeated use. This results in users having to administer increasingly larger doses to achieve the same effects. Upon a single administration, it takes about 1 month for the tolerance to be reduced to half and 2.5 months to be back at baseline (in the absence of further consumption). MDMA presents cross-tolerance with all dopaminergic and serotonergic stimulants, meaning that after the consumption of MDMA all stimulants will have a reduced effect.

Dangerous interactions

Although many psychoactive substances are safe on their own, they can become dangerous and even life-threatening when combined with other substances. The list below contains some common potentially dangerous combinations, but may not include all of them. Certain combinations may be safe in low doses of each but still increase the potential risk of death. Independent research should always be done to ensure that a combination of two or more substances is safe before consumption.

Serotonin syndrome risk

Combinations in the list below may increase the amount of neurotransmitters such as serotonin and dopamine to dangerous or even fatal levels.

There is an increased risk of serotonin syndrome when MDMA is taken with many antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). Additionally, if MDMA is taken with SSRIs and SNRIs, it will be significantly less active or may not produce any distinguishable effects at all.[citation needed]

Legal status

Handcuffs-300px.png

This legality section is a stub.

As such, it may contain incomplete or wrong information. You can help by expanding it.

See also

External links

References

  1. The origin of MDMA (‘Ecstasy’) – separating the facts from the myth | http://www.ingentaconnect.com/content/govi/pharmaz/2006/00000061/00000011/art00015
  2. Ann Shulgin; Alexander Shulgin (1991). PiHKAL: A Chemical Love Story. Part I. Chapter 12. Transform Press.
  3. Pharmaceutical company unravels drug's chequered past | http://www.mdma.net/merck/history-ecstasy.html
  4. The Pharmacology and Clinical Pharmacology of 3,4-Methylenedioxymethamphetamine (MDMA, “Ecstasy”) - A. Richard Green et al. | http://pharmrev.aspetjournals.org/content/55/3/463.short
  5. 3 cases of primary intracranial hemorrhage associated with “Molly”, a purified form of 3,4-methylenedioxymethamphetamine (MDMA) | http://www.jns-journal.com/article/S0022-510X(12)00483-2/abstract
  6. Global drug survey: 2014. | https://www.globaldrugsurvey.com/past-findings/the-global-drug-survey-2014-findings/
  7. ClinicalTrials. (n.d.). MDMA-assisted Therapy for Social Anxiety in Autistic Adults - Full Text View - ClinicalTrials.gov. Retrieved from https://www.clinicaltrials.gov/ct2/show/NCT02008396?term=mdma+social+anxiety&rank=1
  8. Multidisciplinary Association for Psychedelic Studies. (n.d.). MAPS - MDMA-Assisted Psychotherapy for Anxiety Associated with Life-Threatening Illness. Retrieved from http://www.maps.org/research/mdma/anxiety/life-threatening-illness
  9. 9.0 9.1 3,4-methylenedioxymethamphetamine (MDMA): current perspectives - Jerrold S Meyer | https://www.dovepress.com/34-methylenedioxymethamphetamine-mdma-current-perspectives-peer-reviewed-article-SAR
  10. 10.0 10.1 The potential dangers of using MDMA for psychotherapy - Parrott AC | https://www.ncbi.nlm.nih.gov/pubmed/24830184
  11. 11.0 11.1 Sessa, B. (2017). The experience and the drugs. In The Psychedelic Renaissance: Reassessing the Role of Psychedelic Drugs in 21st Century Psychiatry and Society (2nd ed., p. 60). London: Muswell Hill Press.
  12. "3,4-Methylenedioxymethamphetamine". 'Hazardous Substances Data Bank. National Library of Medicine. 28 August 2008. Retrieved 22 August 2014.
  13. 13.0 13.1 13.2 13.3 13.4 13.5 13.6 13.7 Miller, G. M. (2011). The emerging role of trace amine‐associated receptor 1 in the functional regulation of monoamine transporters and dopaminergic activity. Journal of Neurochemistry, 116(2), 164-176. https://doi.10.1111/j.1471-4159.2010.07109.x
  14. 14.0 14.1 14.2 14.3 Eiden LE, Weihe E. VMAT2: a dynamic regulator of brain monoaminergic neuronal function interacting with drugs of abuse. Ann. N. Y. Acad. Sci. 1216(1)1. 86–98. January 2011. https://doi.org/10.1111/j.1749-6632.2010.05906.x
  15. Fitzgerald JL, Reid JJ. Effects of methylenedioxymethamphetamine on the release of monoamines from rat brain slices. European Journal of Pharmacology. 191(2). 217–20. 1990. https://doi.org/10.1016/0014-2999(90)94150-V}}
  16. Eiden LE, Weihe E (January 2011). "VMAT2: a dynamic regulator of brain monoaminergic neuronal function interacting with drugs of abuse". Ann. N. Y. Acad. Sci. 1216 (1): 86–98. http://doi.org/10.1111/j.1749-6632.2010.05906.x.
  17. Bogen IL, Haug KH, Myhre O, Fonnum F. Short- and long-term effects of MDMA ("ecstasy") on synaptosomal and vesicular uptake of neurotransmitters in vitro and ex vivo. Neurochemistry International. 43. 4–5. 393–400. 2003 https://doi.org/10.1016/S0197-0186(03)00027-5
  18. Nelson, Lewis S.; Lewin, Neal A.; Howland, Mary Ann; Hoffman, Robert S.; Goldfrank, Lewis R.; Flomenbaum, Neal E. (2011). Goldfrank's toxicologic emergencies (9th ed.). New York: McGraw-Hill Medical. ISBN 978-0071605939.
  19. Battaglia G, Brooks BP, Kulsakdinun C, De Souza EB. Pharmacologic profile of MDMA (3,4-methylenedioxymethamphetamine) at various brain recognition sites.European Journal of Pharmacology. 149(1–2)1. 59–63. (1988).https://doi.org/10.1016/0014-2999(88)90056-8
  20. Lyon RA, Glennon RA, Titeler M . (1986) 3,4-Methylenedioxymethamphetamine (MDMA): stereoselective interactions at brain 5-HT1 and 5-HT2 receptors. Psychopharmacology. 88(4). 525–6. https://doi.org/10.1007/BF00178519
  21. Nash JF, Roth BL, Brodkin JD, Nichols DE, Gudelsky GA. Effect of the R(-) and S(+) isomers of MDA and MDMA on phosphatidylinositol turnover in cultured cells expressing 5-HT2A or 5-HT2C receptors. Neuroscience Letters. 177(1–2). 111–5 . (1994). https//doi.org/10.1016/0304-3940(94)90057-4
  22. Setola V, Hufeisen SJ, Grande-Allen KJ, Vesely I, Glennon RA, Blough B, Rothman RB, Roth BL. 3,4-methylenedioxymethamphetamine (MDMA, "Ecstasy") induces fenfluramine-like proliferative actions on human cardiac valvular interstitial cells in vitro. Molecular Pharmacology. 63(6). 1223–9 (2003). https://doi.org/10.1124/mol.63.6.1223
  23. Betzler, Felix; Viohl, Leonard; Romanczuk-Seiferth, Nina; Foxe, John (January 2017). "Decision-making in chronic ecstasy users: a systematic review." European Journal of Neuroscience. 45 (1): 34–44. https://doi:10.1111/ejn.13480...the addictive potential of MDMA itself is relatively small.
  24. Dumont GJ, Sweep FC, van der Steen R, Hermsen R, Donders AR, Touw DJ, van Gerven JM, Buitelaar JK, Verkes RJ. Increased oxytocin concentrations and prosocial feelings in humans after ecstasy (3,4-methylenedioxymethamphetamine) administration. Social Neuroscencei. 4(4). 359–366. (2009). https://doi.org/10.1080/17470910802649470
  25. Baumann MH, Rothman RB. Neural and cardiac toxicities associated with 3,4-methylenedioxymethamphetamine (MDMA). International Review of Neurobiology. 88(1). 257–296. 6 November 2009. PMID: 19897081. https://doi.org/10.1016/S0074-7742(09)88010-0. ISBN: 9780123745040. International Review of Neurobiology
  26. Matsumoto RR. Targeting Sigma Receptors: Novel Medication Development for Drug Abuse and Addiction. Expert Rev Clin Pharmacology. 2(4), 351–8. July 2009. https://doi.org/10.1586/ecp.09.18
  27. The pharmacology and toxicology of “ecstasy” (MDMA) and related drugs | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC81503/
  28. Effects of MDMA, MDA and MDEA on blood pressure, heart rate, locomotor activity and body temperature in the rat involve a-adrenoceptors - Sotiria Bexis & James R. Docherty | http://onlinelibrary.wiley.com/doi/10.1038/sj.bjp.0706688/full
  29. The pharmacology and toxicology of “ecstasy” (MDMA) and related drugs | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC81503/
  30. Effects of MDMA on body temperature in humans - Matthias E Liechti | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008716/
  31. 3,4-Methylenedioxymethamphetamine (MDMA, Ecstasy) and Driving Impairment - Logan, BK & Couper, FJ | https://www.astm.org/DIGITAL_LIBRARY/JOURNALS/FORENSIC/PAGES/JFS15166J.htm
  32. http://www.idmu.co.uk/therapeutic-uses-of-ecstasy.htm
  33. A method of conducting therapeutic sessions with MDMA. - Greer GR, Tolbert R. | https://www.ncbi.nlm.nih.gov/pubmed/9924843
  34. http://www.maps.org/mdma-cancer/5523-a-dose-response-human-pilot-study-–-safety-and-efficacy-of-mdma-in-modification-of-physical-pain-and-psychological-distress-in-end-stage-cancer-patients
  35. Bruxism after 3,4-methylenedioxymethamphetamine (ecstasy) abuse - Bruxism and ecstasy Ricardo Jorge Dinis-Oliveira et al. | http://www.tandfonline.com/doi/abs/10.3109/15563650.2010.489903
  36. Urban Dictionary page on "gurning" http://www.urbandictionary.com/define.php?term=gurning
  37. Mithoefer, Michael C., et al. “Durability of Improvement in Post-Traumatic Stress Disorder Symptoms and Absence of Harmful Effects or Drug Dependency after 3,4-Methylenedioxymethamphetamine-Assisted Psychotherapy: A Prospective Long-Term Follow-up Study.” Journal of Psychopharmacology (Oxford, England) 27.1 (2013): 28–39. https://doi.org/ 10.1177/0269881112456611
  38. Mithoefer, Michael C., et al. “Durability of Improvement in Post-Traumatic Stress Disorder Symptoms and Absence of Harmful Effects or Drug Dependency after 3,4-Methylenedioxymethamphetamine-Assisted Psychotherapy: A Prospective Long-Term Follow-up Study.” Journal of Psychopharmacology (Oxford, England) 27.1 (2013): 28–39. https://doi.org/10.1177/0269881112456611
  39. Nutt, D., King, L. A., Saulsbury, W., & Blakemore, C. (2007). Development of a Rational Scale to Assess the Harm of Drugs of Potential Misuse, 1047–1053. http://dx.doi.org/10.1016/S0140-6736(07)60464-4
  40. Nimmo, S. M., Kennedy, B. W., Tullett, W. M., Blyth, A. S., & Dougall, J. R. (1993). Drug‐induced hyperthermia. Anaesthesia, 48(10), 892-895. https://doi.org/10.1111/j.1365-2044.1993.tb07423.x
  41. Malberg, J. E., & Seiden, L. S. (1998). Small changes in ambient temperature cause large changes in 3, 4-methylenedioxymethamphetamine (MDMA)-induced serotonin neurotoxicity and core body temperature in the rat. Journal of Neuroscience, 18(13), 5086-5094. PMID: 9634574. https://www.ncbi.nlm.nih.gov/pubmed/9634574
  42. Wolff, K., Tsapakis, E. M., Winstock, A. R., Hartley, D., Holt, D., Forsling, M. L., & Aitchison, K. J. (2006). Vasopressin and oxytocin secretion in response to the consumption of ecstasy in a clubbing population. Journal of Psychopharmacology, 20(3), 400-410. https://doi.org/10.1177/0269881106061514
  43. Reorganization of ascending 5-HT axon projections in animals previously exposed to the recreational drug (+/-)3,4-methylenedioxymethamphetamine (MDMA, "ecstasy") (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/7643196
  44. Scheffel, U., Szabo, Z., Mathews, W. B., Finley, P. A., Dannals, R. F., Ravert, H. T., ... & Ricaurte, G. A. (1998). In vivo detection of short‐ and long‐term MDMA neurotoxicity—a positron emission tomography study in the living baboon brain. Synapse, 29(2), 183-192. https://doi.org/10.1002/(SICI)1098-2396(199806)29:2<183::AID-SYN9>3.0.CO;2-3
  45. Reneman, L., Lavalaye, J., Schmand, B., de Wolff, F. A., van den Brink, W., den Heeten, G. J., & Booij, J. (2001). Cortical serotonin transporter density and verbal memory in individuals who stopped using 3, 4-methylenedioxymethamphetamine (MDMA or ecstasy): preliminary findings. Archives of General Psychiatry, 58(10), 901-906. Chicago. https://doi.org/10.1001/archpsyc.58.10.901
  46. Selvaraj, S., Hoshi, R., Bhagwagar, Z., Murthy, N. V., Hinz, R., Cowen, P., ... & Grasby, P. (2009). Brain serotonin transporter binding in former users of MDMA (‘ecstasy’). The British Journal of Psychiatry, 194(4), 355-359. https://doi.org/10.1192/bjp.bp.108.050344
  47. Neurotoxic thioether adducts of 3,4-methylenedioxymethamphetamine identified in human urine after ecstasy ingestion (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/19349378 | http://dmd.aspetjournals.org/content/37/7/1448.full.pdf
  48. 48.0 48.1 48.2 48.3 48.4 2,5-Bis-(glutathion-S-yl)-alpha-methyldopamine, a putative metabolite of (+/-)-3,4-methylenedioxyamphetamine, decreases brain serotonin concentrations (PubMed.gov / NCBI) - Miller RT et al. | http://www.ncbi.nlm.nih.gov/pubmed/9128836
  49. Drug-induced Valvulopathy: An Update - Chandikumar S. Elangbam | http://tpx.sagepub.com/content/38/6/837.full
  50. Huang, X. P., Setola, V., Yadav, P. N., Allen, J. A., Rogan, S. C., Hanson, B. J., ... & Roth, B. L. (2009). Parallel functional activity profiling reveals valvulopathogens are potent 5-hydroxytryptamine2B receptor agonists: implications for drug safety assessment. Molecular Pharmacology, 76(4), 710-722. https://doi.org/10.1161/01.CIR.102.23.2836
  51. Drug-induced Valvulopathy: An Update - Chandikumar S. Elangbam | http://tpx.sagepub.com/content/38/6/837.full
  52. Possible association between 3,4-methylenedioxymethamphetamine abuse and valvular heart disease. (PubMed.gov / NCBI) | https://www.ncbi.nlm.nih.gov/pubmed/17950805
  53. Gillman, P. K. (2005). Monoamine oxidase inhibitors, opioid analgesics and serotonin toxicity. British Journal of Anaesthesia, 95(4), 434-441. https://doi.org/10.1093/bja/aei210
  54. Gillman, P. K. (2005). Monoamine oxidase inhibitors, opioid analgesics and serotonin toxicity. British Journal of Anaesthesia, 95(4), 434-441. https://doi.org/10.1093/bja/aei210
  55. Canada controlled drugs and substances | http://laws-lois.justice.gc.ca/eng/acts/C-38.8/
  56. Noteikumi par Latvijā kontrolējamajām narkotiskajām vielām, psihotropajām vielām un prekursoriem (3,4-Metilēndioksifeniletānamīni) | http://likumi.lv/doc.php?id=121086