Neurobiology and Pharmacokinets of Acute MDMA Administration
- 3,4-Methylenedioxymethamphetamine (MDMA), commonly known as ecstasy, is a synthetic psychoactive drug that has shown a steep increase in recreational use and abuse by young people in recent years. Research studies have reported that chronic MDMA users who also consume other legal and illegal substance show memory deficits; however, because of the combination of drugs often involved, it is difficult to determine MDMA's contribution to these effects.
- Only a few studies have examined the immediate physical and behavioral effects of MDMA given at dose levels commonly used in young adults. Researchers are interested in using functional magnetic resonance imaging (fMRI) to examine changes in brain activity and function in MDMA users compared with users of other drugs and non-drug-using individuals.
- To evaluate the effects of MDMA on thinking and brain function.
- Individuals between 18 and 30 years of age who are (1) current users of MDMA (2), current drug users who do not use MDMA, or (3) healthy non-drug-using volunteers.
- Participants will complete one training session and three scanning sessions.
- Before the start of the study, participants will complete questionnaires about medical and psychological history, and provide information about past or current drug use. Researchers will introduce the tasks to be performed during the scanning session(s), and will allow participants to practice the tests.
- Participants will provide urine, saliva, and hair samples for testing before the start of the study, and multiple times during each scanning session.
- Participants who use MDMA and participants who use other drugs will stay overnight at the clinical center prior to each scanning session. Participants who do not use drugs can spend the night prior to scanning or arrive at the clinical center on the morning of the scanning session.
- Participants who use MDMA will receive either MDMA or a placebo during the scanning sessions, and will not be told which one they have received. Because of the nature of MDMA, participants will be required to stay at the clinical center until the effects of the drug have worn off, and will be required to return to the clinical center on the following day for a follow-up examination.
- During the study, participants will be asked to do one or more tasks selected by the researchers. The tasks will be performed on a computer in an MRI mach...
Background: 3,4-Methylenedioxymethamphetamine (MDMA), commonly known as ecstasy, is a synthetic compound that has shown a steep increase in abuse by young people in recent years. In animals, when high and multiple doses of MDMA were given, serotonergic toxicity was observed. Clinically, the number of severe ecstasy related acute toxicities is low in relation to the extent of recreational use. Data from some retrospective studies report memory deficits in abstinent chronic users who often abuse MDMA with other illicit and licit substances; therefore, it is difficult to determine MDMA's contribution to observed cognitive deficits. There are few prospective controlled MDMA human administration studies that describe its acute physiological and behavioral effects following doses commonly used in young adults. We propose a functional magnetic resonance imaging (fMRI) study to examine specific changes in brain activity and cognitive performance and to correlate these changes with plasma MDMA concentrations.
Goals: The primary goals are identification of MDMA effects on human brain function and elucidation of the relationship of effects to plasma MDMA concentrations. We propose a within-subject design of changes in memory, attention, affect, semantic processing and decision-making performance following placebo and two recreational MDMA doses with simultaneous fMRI monitoring and plasma collections. Secondly, pharmacokinetic data will be collected on the disposition of MDMA and metabolites in plasma, urine, oral fluid, sweat, breath, and hair. These data are needed to accurately interpret drug concentrations in alternative biological matrices in order for drug tests to function as a deterrent to drug use in drug abuse treatment, law enforcement, military, and workplace drug testing programs. Pharmacokinetic data will also enable drug tests to serve as valid diagnostic tools in emergency medicine and public safety settings, as well as useful objective outcome measures in treatment research.
Subject Population: Eighteen current MDMA users will complete the neurocognitive and pharmacokinetics group. Thirty-six MDMA non-using controls will include 18 non-drug using participants and 18 drug using (primarily cannabis) participants. Controls in each group will be matched to MDMA users in the neurocognitive and pharmacokinetics group. All participants must be between the ages of 18 and 40. The estimated target enrollment, based on ecstasy use by race/ethnic group and Baltimore demographics, will be 41% female and 59% male, 83% Caucasian, 14% African American, 3% Asian, and 2% Hispanic.
Experimental Design and Methods: A randomized, balanced, double blind, within-subject drug administration study with placebo, low (1.0 mg/kg, approximately 70 mg) and high (1.6 mg/kg, approximately 112 mg) doses of MDMA is proposed. The non-drug using and drug using control groups will be matched to MDMA users in the neurocognitive and pharmacokinetics group for sex, age, IQ, education level and intersession interval. The drug using control group will control for cannabis and other drug usage in the MDMA group. The drug using control group is necessary because many MDMA users also use other drugs, primarily cannabis. Control groups allow for a between-subjects analysis for trait differences between the population groups, as well as provide normative data for the cognitive tasks. Drug using control group participants will stay on the clinical research unit overnight prior to each of the three sessions; non-drug using control group participants will arrive the morning of each session. Participants from the MDMA group will complete three separate stays, each lasting approximately 26 hours, within one year. While under the influence of MDMA, qualified participants will perform memory, attention, semantic processing, affect and decision-making tasks before, during, and after fMRI scanning. Physiological, behavioral and biochemical measures of all MDMA users will be monitored throughout the study to determine onset, magnitude and duration of pharmacodynamic effects. Blood, urine, oral fluid, sweat, breath, and hair specimens will be collected from MDMA users for analysis of MDMA and metabolite concentrations by GC/MS and/or LC/MS/MS to determine the disposition and pharmacokinetics of MDMA.
Risks and Benefits: A main potential risk of this study is associated with acute cardiovascular responses to MDMA administration; however, these doses have proven safe and well tolerated in previous human studies conducted within the US and abroad. In addition, impaired cognitive function has been reported following long-term MDMA use in some but not all studies. A potential benefit of the proposed study is to understand how MDMA affects human brain function at doses employed by recreational users. Additionally, advances will be made in understanding MDMA pharmacokinetics.
Allocation: Randomized, Control: Placebo Control, Endpoint Classification: Pharmacokinetics/Dynamics Study, Intervention Model: Crossover Assignment, Masking: Double-Blind
MDMA, (+/-)3,4-methylenedioxymethamphetamine Hydrochloride, MDMA HCI Capsules
National Institute on Drug Abuse, Biomedical Research Center (BRC)
National Institutes of Health Clinical Center (CC)
Results (where available)
- Source: http://clinicaltrials.gov/show/NCT01148342
- Information obtained from ClinicalTrials.gov on July 15, 2010
Medical and Biotech [MESH] Definitions
Drugs designed and synthesized, often for illegal street use, by modification of existing drug structures (e.g., amphetamines). Of special interest are MPTP (a reverse ester of meperidine), MDA (3,4-methylenedioxyamphetamine), and MDMA (3,4-methylenedioxymethamphetamine). Many drugs act on the aminergic system, the physiologically active biogenic amines.
Disorders related to substance abuse, the side effects of a medication, toxin exposure, and ALCOHOL-RELATED DISORDERS.
An N-substituted amphetamine analog. It is a widely abused drug classified as a hallucinogen and causes marked, long-lasting changes in brain serotonergic systems. It is commonly referred to as MDMA or ecstasy.
An envelope of loose gel surrounding a bacterial cell which is associated with the virulence of pathogenic bacteria. Some capsules have a well-defined border, whereas others form a slime layer that trails off into the medium. Most capsules consist of relatively simple polysaccharides but there are some bacteria whose capsules are made of polypeptides.
Disorders related or resulting from abuse or mis-use of opioids.
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