MDMA Flashcards
SOME IMPORTANT DATES IN
IT’S HISTORY
- 1912
– Merck filed patent for an anti-bleeding medication
for which MDMA was precursor - 1953
– Army Chemical Center in US funded secret testing
of MDMA re: use as espionage or brainwashing
agent - 1978
– First published human study (Shulgin) —> cross b/t alcohol (free) and psychedelic -> advocate for it in psycho therapy to help people open up (induced introspection) – got people talking - becoame widely used in therapy
HISTORY CONT’D
- From Late 1970s to Early 1980s
– Use of MDMA advocated in psychotherapy
– WAS not scheduled or illegal drug, recreational use
began*****
HISTORY CONT’D
* Between 1984 and 1986
– DEA used law (re: public safety) to “temporarily”
place drug in Schedule I category
– Hearings attended by scientists, psychiatrists,
psychotherapists, lawyers argued risks and benefits –> useful in therapy (problem was all anecdotal evidence) No control used** –> does it advance psychology at all??
- to keep at schedule 1: finding that this drug causes holes in brain (prions), also found brain damage (neuronal death) in rats (but not with MDMA but with MDA–> the amphetamine aspect AS WELL AS being injected into rats at much higher amounts than an oral dose)
- Between 1986 and 1988
– Numerous trials and appeals conducted on
scheduling of drug
– End result: classified as a Schedule I *****
- but appeals to use MDMA in therapy occured
Between 1985 and 1986
– Recommendation: classify drug as Schedule III
– Recommendation ignored
Mid 1980s
– Rave movement began
– Reportedly raves can involve up to 30,000 people
-
ADME
- Taken orally (tablet or capsule) or intravenously
- or absorbed through snorting
- or parachuting
- sublingually –> can avoid first pass metabolism
ADME
- Taken orally (tablet or capsule) or intravenously (75-100mg)
- can take up to 3 doses (300mg)
- Effects realized within 30 to 60 minutes
- Effects last 3-6 hours
- Half life of 8 hours (40 hours to MDMA to leave the body)
- Metabolized by specific enzyme in liver that is deficient in small percentage of white and asian populations (effects can last much longer)
- problems with purchasing at rave (tablets will have more substances in it) up to 70 diff substance can be foudn in MDMA tablet –> 2004 TB talks about purity of MDMA is not as much of a concern as it used to be
- there are testing kits (Dance Safe)
Pharmacological Actions
- Inhibits Serotonin Re-uptake
- Induces Release of Serotonin
- Induces Release of Dopamine
- Increases NE levels
increase oxytocin uptake
Basic Behavioral & Psychological Effects
- Increased Wakefulness — > elevated levels of NE
- Increased Endurance –> NE
- Heightened Sense of Emotional Closeness to Others –> from increases oxytocin hormone and reduction of fear response (love drug–> ironic cuz it is an SNS stimulant so you cant get an erection or orgasm)
- Heightened Self-Awareness –> discuss and explain their feelings (therapy)
- Feelings of Peace and Tranquility –> empathogen and enactogen as classification
Some Adverse Psychological Effects
- Psychosis-Like States UNCOMMON –> hallucination (not common but can occur), paranoia and fear (someone is after you), disorganized thinking or speech (tangential),
- advocates of E –> have a genetic vulnerability to the drug (emotions exprerienced could be triggerd by other response ) –> trigger for preexisiting condition within them
- Pronounced Anxiety–> not paranoia but highly anxious
- Depersonalization and Derealization NOT COMMON –> depersonil (feel like they are separated from rest of world (glass separating them), detached form environment
- derealiz: enivormnent seems meaningless, people dont look real (cardboard)
- adovcates: say they occur spontaneously in the everyday world
- Depression (variable duration and intensity) –> come down
- can range in intensity or severity (low mood) –> loss of pleasure
- length of dep cna be variable (can be one day w/ low mood to showing clinical depression for 6 months)
- longer lasting depression = damage to serotinergic terminals (take 6 months for damage to be resolved)
- Cognitive Deficits? –> chronic use causes impaired attention, concentration and memory
- studies show mild mem deficits in delayed mem , some studies who NO deficit
- poly drug users can worse mems
- poor control in controlling for fatigue and premorbid attention problems
- Sleep Disturbances–> 3 days- months
-longer lasting sleep problems is accompanied by excessive dreaming and scary nightmares
Medical Risks Associated with MDMA Use
* Hyperthermia (increase in body temps)
– Factors contributing to hyperthermia (2)
- Prolonged exertion, warm environment
- Elevated levels of serotonin
- common cause of death from hyperthermia: disseminated intravascular coagulopathy******* (DIC) –> get blood clots forming throughout the body and they burst (internal bleeding!!!!)
study by Kalant (2001) et al: of 87 deaths 30 were due to hyperthermia
- most common cause of death of MDMA
- but if you get quick medical attention you will not die
- repetitive movement in club from NE, you can disregard the warning signals
- 9 were due to swelling of brain (hyponatremia)
- 4 were due to liver damage
Medical Risks Associated with MDMA Use
* Acute Hyponatremia
– Low plasma sodium level due to dilution of blood with water
– Occurs as a result of: (2)
* Excess water intake (repetitive behaviour from MDMA) –> overdo it
* MDMA caused secretion of anti-diuretic hormone (ADH) , which promotes water retention by kidneys
Medical Risks Associated with MDMA Use
- Hepatitis (NOT COMMON) 50 reported cases all time –> damage and inflammation of liver
– Severity ranges (mild to severe)
– Repeat users may suffer from jaundice
- if liver damageis substantial –> can lead to death
- 4/87 from kalant
Tolerance
- Tolerance develops to most of the positive
effects in a few days - Tolerance dissipates within a few days to a week
- With chronic use, amphetamine like effects are effects primarily seen –> increased endurance, alertness
- MDMA (mix of mescaline and amph) –> increased endurance, wakefulness
