MDMA

Effects

Overview

3,4-Methylenedioxymethamphetamine (also known as ecstasy, E, XTC, emma, molly, mandy, pingers, and MDMA) is a classical entactogen substance of the amphetamine class. It is the most well-known and widely-used member of the entactogens, a diverse group that includes MDA, methylone, 4-MMC, and 6-APB. It produces its effects by promoting the release of serotonin, dopamine, and norepinephrine in the brain, particularly serotonin. PW

The world's most popular empathogen with powerful pro-social effects. Has been strongly linked to cognitive decline in excess. Popular at parties, it is often sold in powder or in pills, and may be adulterated with other similar chemicals.[1–37] TS

3,4-Methylenedioxymethamphetamine (MDMA), commonly known as ecstasy in tablet form, and molly in crystal form, is an entactogen with stimulant and minor psychedelic properties.[38–42] WP

MDMA was first synthesized in 1912 by Merck chemist Anton Köllisch. It was used to enhance psychotherapy beginning in the 1970s and became popular as a street drug in the 1980s. MDMA is commonly used by attendees of dance parties, raves, and electronic dance music festivals. Tablets sold as ecstasy may be mixed with other substances such as ephedrine, amphetamine, and methamphetamine.[43–46] WP

The lethal risk from one dose of MDMA is estimated to be from 1 death in 20,000 instances to 1 death in 50,000 instances.[47] WP

The purported pharmacological effects that may be prosocial include altered sensations, increased energy, empathy, and pleasure. When taken by mouth, effects begin in 30 to 45 minutes and last three to six hours. Short-term adverse effects include bruxism, blurred vision, sweating, and tachycardia, and extended use can also lead to addiction, amnesia, memory disorders, paranoia, and insomnia. Deaths have been reported due to increased body temperature and dehydration. MDMA acts primarily by increasing the release of the neurotransmitters serotonin, dopamine, and norepinephrine in parts of the brain. It belongs to the substituted amphetamine classes of drugs. MDMA is structurally similar to mescaline (a psychedelic), methamphetamine (a stimulant), as well as endogenous monoamine neurotransmitters such as serotonin, norepinephrine, and dopamine.[42][44][45][48–51] WP

MDMA has limited approved medical uses in a small number of countries, but is illegal in most jurisdictions. MDMA-assisted psychotherapy may substantially improve PTSD symptoms, response, and remission rates compared to psychotherapy alone, but the evidence is low to very low certainty and safety data are limited, with some increased transient adverse events. In the United States, the Food and Drug Administration (FDA) has given MDMA breakthrough therapy status (though there are no current clinical indications in the US). Canada has allowed limited distribution of MDMA upon application to and approval by Health Canada. In Australia, it may be prescribed in the treatment of PTSD by specifically authorised psychiatrists.[52–57] WP

History

United states

In an early media report on MDMA published in 1982, a Drug Enforcement Administration (DEA) spokesman stated the agency would ban the drug if enough evidence for abuse could be found. By mid-1984, MDMA use was becoming more noticed. Bill Mandel reported on "Adam" in a 10 June San Francisco Chronicle article, but misidentified the drug as methyloxymethylenedioxyamphetamine (MMDA). In the next month, the World Health Organization identified MDMA as the only substance out of twenty phenethylamines to be seized a significant number of times.[103][104] WP

After a year of planning and data collection, MDMA was proposed for scheduling by the DEA on 27 July 1984, with a request for comments and objections. The DEA was surprised when a number of psychiatrists, psychotherapists, and researchers objected to the proposed scheduling and requested a hearing. In a Newsweek article published the next year, a DEA pharmacologist stated that the agency had been unaware of its use among psychiatrists. An initial hearing was held on 1 February 1985 at the DEA offices in Washington, D.C., with administrative law judge Francis L. Young presiding. It was decided there to hold three more hearings that year: Los Angeles on 10 June, Kansas City, Missouri on 10–11 July, and Washington, D.C., on 8–11 October.[104–107] WP

Sensational media attention was given to the proposed criminalization and the reaction of MDMA proponents, effectively advertising the drug. In response to the proposed scheduling, the Texas Group increased production from 1985 estimates of 30,000 tablets a month to as many as 8,000 per day, potentially making two million ecstasy tablets in the months before MDMA was made illegal. By some estimates the Texas Group distributed 500,000 tablets per month in Dallas alone. According to one participant in an ethnographic study, the Texas Group produced more MDMA in eighteen months than all other distribution networks combined across their entire histories. By May 1985, MDMA use was widespread in California, Texas, southern Florida, and the northeastern United States. According to the DEA there was evidence of use in twenty-eight states and Canada. Urged by Senator Lloyd Bentsen, the DEA announced an emergency Schedule I classification of MDMA on 31 May 1985. The agency cited increased distribution in Texas, escalating street use, and new evidence of MDA (an analog of MDMA) neurotoxicity as reasons for the emergency measure. The ban took effect one month later on 1 July 1985 in the midst of Nancy Reagan's "Just Say No" campaign.[103][106][108–116] WP

As a result of several expert witnesses testifying that MDMA had an accepted medical usage, the administrative law judge presiding over the hearings recommended that MDMA be classified as a Schedule III substance. Despite this, DEA administrator John C. Lawn overruled and classified the drug as Schedule I. Harvard psychiatrist Lester Grinspoon then sued the DEA, claiming that the DEA had ignored the medical uses of MDMA, and the federal court sided with Grinspoon, calling Lawn's argument "strained" and "unpersuasive", and vacated MDMA's Schedule I status. Despite this, less than a month later Lawn reviewed the evidence and reclassified MDMA as Schedule I again, claiming that the expert testimony of several psychiatrists claiming over 200 cases where MDMA had been used in a therapeutic context with positive results could be dismissed because they were not published in medical journals. In 2017, the FDA granted breakthrough therapy designation for its use with psychotherapy for PTSD. However, this designation has been questioned and problematized.[106][117][118][119] WP

United nations

While engaged in scheduling debates in the United States, the DEA also pushed for international scheduling. In 1985, the World Health Organization's Expert Committee on Drug Dependence recommended that MDMA be placed in Schedule I of the 1971 United Nations Convention on Psychotropic Substances. The committee made this recommendation on the basis of the pharmacological similarity of MDMA to previously scheduled drugs, reports of illicit trafficking in Canada, drug seizures in the United States, and lack of well-defined therapeutic use. While intrigued by reports of psychotherapeutic uses for the drug, the committee viewed the studies as lacking appropriate methodological design and encouraged further research. Committee chairman Paul Grof dissented, believing international control was not warranted at the time and a recommendation should await further therapeutic data. The Commission on Narcotic Drugs added MDMA to Schedule I of the convention on 11 February 1986.[108][120][121] WP

Post-scheduling

The use of MDMA in Texas clubs declined rapidly after criminalization, but by 1991, the drug became popular among young middle-class whites and in nightclubs. In 1985, MDMA use became associated with acid house on the Spanish island of Ibiza. Thereafter, in the late 1980s, the drug spread alongside rave culture to the United Kingdom and then to other European and American cities. Illicit MDMA use became increasingly widespread among young adults in universities and later, in high schools. Since the mid-1990s, MDMA has become the most widely used amphetamine-type drug by college students and teenagers. MDMA became one of the four most widely used illicit drugs in the US, along with cocaine, heroin, and cannabis. According to some estimates as of 2004, only marijuana attracts more first time users in the United States.[103][109][122][123] WP

After MDMA was criminalized, most medical use stopped, although some therapists continued to prescribe the drug illegally. Later, Charles Grob initiated an ascending-dose safety study in healthy volunteers. Subsequent FDA-approved MDMA studies in humans have taken place in the United States in Detroit (Wayne State University), Chicago (University of Chicago), San Francisco (UCSF and California Pacific Medical Center), Baltimore (NIDA–NIH Intramural Program), and South Carolina. Studies have also been conducted in Switzerland (University Hospital of Psychiatry, Zürich), the Netherlands (Maastricht University), and Spain (Universitat Autònoma de Barcelona).[124] WP⚠ Wikipedia itself has flagged this text: when?.

"Molly", short for 'molecule', was recognized as a slang term for crystalline or powder MDMA in the 2000s.[125][126] WP

In 2010, the BBC reported that use of MDMA had decreased in the UK in previous years. This may be due to increased seizures during use and decreased production of the precursor chemicals used to manufacture MDMA. Unwitting substitution with other drugs, such as mephedrone and methamphetamine, as well as legal alternatives to MDMA, such as BZP, MDPV, and methylone, are also thought to have contributed to its decrease in popularity.[127][128] WP

In 2017, it was found that some pills being sold as MDMA contained pentylone, which can cause very unpleasant agitation and paranoia.[129] WP

According to David Nutt, when safrole was restricted by the United Nations in order to reduce the supply of MDMA, producers in China began using anethole instead, but this gives para-methoxyamphetamine (PMA, also known as "Dr Death"), which is much more toxic than MDMA and can cause overheating, muscle spasms, seizures, unconsciousness, and death. People wanting MDMA are sometimes sold PMA instead.[130] WP

In 2025, the BBC reported on a study of 650 survivors from the Nova music festival massacre. Two-thirds were under the influence of recreational drugs (MDMA, LSD, marijuana or psilocybin) when Hamas attacked the festival on October 7, 2023. MDMA appeared to have a protective effect against later problems with sleeping and emotional distress.[131][132] WP

Film

MDMA and ecstasy have featured in a number of films, including Trainspotting, Clubbed to Death, Nowhere, Human Traffic, Go, Groove, 24 Hour Party People, Bad Boys II, Party Monster, Layer Cake, Rolling, Enter The Void, Irvine Welsh's Ecstasy, Spring Breakers, MDMA and Beats.[133] WP

Music

MDMA and ecstasy have featured in a number of songs, including Miley Cyrus's "We Can't Stop", Jay-Z and Alicia Keys' "Empire State of Mind", Fujiya & Miyagi's "Seratonin Rushes", Soulwax's "E Talking", Nonpoint's "Double Stacked", Green Velvet's "La La Land", Primal Scream's "Don't Fight It, Feel It", The Streets' "Blinded by the Lights", The Shamen's "Ebeneezer Goode", Missy Elliott's "4 My People", Pulp's "Sorted for E's & Wizz" and Hot Chip's "Over and Over".[134] WP

Legal status

• Internationally, MDMA was added to the UN Convention on Psychotropic Substances as a Schedule I controlled substance in February 1986.[121] PW
• Australia: MDMA is a Schedule 8 (Controlled Drugs) drug in Australia, starting July 1st 2023. Personal quantities under 1.5 grams (or 5 single doses, such as when in tablet form) are decriminalized in the Australian Capital Territory (ACT) as of 28 October 2023.[135][136] PW
• Austria: MDMA is illegal to possess, produce and sell under the SMG (Suchtmittelgesetz Österreich).[137] PW
• Belgium: MDMA is illegal to possess, produce and sell in Belgium.[138] PW
• Brazil: MDMA is illegal to possess, produce and sell under Portaria SVS/MS nº 344.[139] PW
• Canada: MDMA is a Schedule I drug in Canada.[140] PW
• Denmark: MDMA is illegal to possess, produce and sell in Denmark.[141] PW
• Egypt: MDMA is a Schedule III drug in Egypt. PW⚠ PsychonautWiki itself has flagged this text: citation needed.
• Finland: MDMA is illegal to possess, produce and sell in Finland. PW⚠ PsychonautWiki itself has flagged this text: citation needed.
• France: MDMA is scheduled as a "stupéfiant", i.e. a recognized drug of abuse. It is illegal to possess, buy, sell or manufacture.[142] PW
• Germany: MDMA is controlled under Anlage I BtMG (Narcotics Act, Schedule I) as of August 1, 1986. It is illegal to manufacture, possess, import, export, buy, sell, procure or dispense it without a license.[143][144][145] PW
• Latvia: MDMA is a Schedule I drug in Latvia.[146] PW
• Luxembourg: MDMA is a prohibited substance.[147] PW
• The Netherlands: MDMA is illegal to possess, produce and sell in the Netherlands.[148] PW
• New Zealand: MDMA is a Class B1 drug in New Zealand.[149] PW
• Norway: MDMA is illegal to possess, produce and sell in Norway. PW⚠ PsychonautWiki itself has flagged this text: citation needed.
• Portugal: MDMA is illegal to produce, sell or trade in Portugal. However, since 2001, individuals found in possession of small quantities (up to 1 gram) are considered sick individuals instead of criminals. The drugs are confiscated and the suspects may be forced to attend a dissuasion session at the nearest CDT (Commission for the Dissuasion of Drug Addiction) or pay a fine, in most cases.[150] PW
• Russia: MDMA is classified as a Schedule I prohibited substance.[151] PW
• Sweden: MDMA is illegal to possess, produce and sell in Sweden. PW⚠ PsychonautWiki itself has flagged this text: citation needed.
• Switzerland: MDMA is a controlled substance specifically named under Verzeichnis D.[152] PW
• United Kingdom: MDMA is a Class A drug in the UK.[153] PW
• United States: MDMA is classified as a Schedule I drug under the Controlled Substance Act. This means it is illegal to manufacture, buy, possess, process, or distribute without a license from the Drug Enforcement Administration (DEA).[154] PW
• Czech Republic: MDMA is a Schedule I controlled substance.[155] PW

Legal status

MDMA is legally controlled in most of the world under the UN Convention on Psychotropic Substances and other international agreements, although exceptions exist for research and limited medical use. In general, the unlicensed use, sale or manufacture of MDMA are all criminal offences. WP

Australia

In Australia, MDMA was rescheduled on 1 July 2023 as a schedule 8 substance (available on prescription) when used in the treatment of PTSD, while remaining a schedule 9 substance (prohibited) for all other uses. For the treatment of PTSD, MDMA can only be prescribed by psychiatrists with specific training and authorisation. In 1986, MDMA was declared an illegal substance because of its allegedly harmful effects and potential for misuse. Any non-authorised sale, use or manufacture is strictly prohibited by law. Permits for research uses on humans must be approved by a recognized ethics committee on human research.[156][157] WP

In Western Australia under the Misuse of Drugs Act 1981 4.0g of MDMA is the amount required determining a court of trial, 2.0g is considered a presumption with intent to sell or supply and 28.0g is considered trafficking under Australian law.[158] WP

The Australian Capital Territory passed legislation to decriminalise the possession of small amounts of MDMA, which took effect in October 2023.[159][160] WP

Canada

In Canada, MDMA is listed as a Schedule 1 as it is an analogue of amphetamine. The Controlled Drugs and Substances Act was updated as a result of the Safe Streets and Communities Act changing amphetamines from Schedule III to Schedule I in March 2012. In 2022, the federal government granted British Columbia a 3-year exemption, legalizing the possession of up to 2.5 g of MDMA in the province from February 2023 until February 2026.[161–164] WP⚠ The source also gives this in other units.

Finland

Scheduled in the "government decree on substances, preparations and plants considered to be narcotic drugs". Ecstasy is considered a very dangerous illegal drug.[165][166] WP

Netherlands

In 2024, a Dutch state commission issued a report advocating for MDMA to be made available to patients with PTSD.[167] WP

In June 2011, the Expert Committee on the List (Expertcommissie Lijstensystematiek Opiumwet) issued a report which discussed the evidence for harm and the legal status of MDMA, arguing in favor of maintaining it on List I.[168][169][170] WP

United kingdom

In the United Kingdom, MDMA was made illegal in 1977 by a modification order to the existing Misuse of Drugs Act 1971. Although MDMA was not named explicitly in this legislation, the order extended the definition of Class A drugs to include various ring-substituted phenethylamines. The drug is therefore illegal to sell, buy, or possess without a licence in the UK. Penalties include a maximum of seven years and/or unlimited fine for possession; life and/or unlimited fine for production or trafficking.[171][172] WP

Some researchers such as David Nutt have criticized the scheduling of MDMA, which he determined to be a relatively harmless drug. An editorial he wrote in the Journal of Psychopharmacology, where he compared the risk of harm for horse riding (1 adverse event in 350) to that of ecstasy (1 in 10,000) resulted in his dismissal, leading to the resignation of several of his colleagues from the ACMD.[173][174][175] WP

United states

In the United States, MDMA is listed in Schedule I of the Controlled Substances Act. In a 2011 federal court hearing, the American Civil Liberties Union successfully argued that the sentencing guideline for MDMA/ecstasy is based on outdated science, leading to excessive prison sentences. Other courts have upheld the sentencing guidelines. The United States District Court for the Eastern District of Tennessee explained its ruling by noting that "an individual federal district court judge simply cannot marshal resources akin to those available to the Commission for tackling the manifold issues involved with determining a proper drug equivalency."[168][176][177] WP

Europe

In 2008, the European Monitoring Centre for Drugs and Drug Addiction noted that although there were some reports of tablets being sold for as little as €1, most countries in Europe then reported typical retail prices in the range of €3 to €9 per tablet, typically containing 25–65 mg of MDMA. By 2014 the EMCDDA reported that the range was more usually between €5 and €10 per tablet, typically containing 57–102 mg of MDMA, although MDMA in powder form was becoming more common.[178][179] WP

North america

The United Nations Office on Drugs and Crime stated in its 2014 World Drug Report that US ecstasy retail prices range from US$1 to $70 per pill, or from $15,000 to $32,000 per kilogram. A new research area named Drug Intelligence aims to automatically monitor distribution networks based on image processing and machine learning techniques, in which an Ecstasy pill picture is analyzed to detect correlations among different production batches. These novel techniques allow police scientists to facilitate the monitoring of illicit distribution networks.[180][181] WP

As of October 2015, most of the MDMA in the United States is produced in British Columbia, Canada and imported by Canada-based Asian transnational criminal organizations. The market for MDMA in the United States is relatively small compared to methamphetamine, cocaine, and heroin. In the United States, about 0.9 million people used ecstasy in 2010.[44][182] WP

Australia

MDMA is particularly expensive in Australia, costing A$15–A$30 per tablet. In terms of purity data for Australian MDMA, the average is around 34%, ranging from less than 1% to about 85%. The majority of tablets contain 70–85 mg of MDMA. Most MDMA enters Australia from the Netherlands, the UK, Asia, and the US.[183] WP

Corporate logos on pills

A number of ecstasy manufacturers brand their pills with a logo, often that of an unrelated corporation. Some pills depict logos of products or media popular with children, such as Shaun the Sheep.[184][185] WP

Pharmacology

Pharmacodynamics

MDMA is an entactogen or empathogen, as well as a stimulant, euphoriant, and weak psychedelic. It is a substrate of the monoamine transporters (MATs) and acts as a monoamine releasing agent (MRA). The drug is specifically a well-balanced serotonin–norepinephrine–dopamine releasing agent (SNDRA). To a lesser extent, MDMA also acts as a serotonin–norepinephrine–dopamine reuptake inhibitor (SNDRI). MDMA enters monoaminergic neurons via the MATs and then, via poorly understood mechanisms, reverses the direction of these transporters to produce efflux of the monoamine neurotransmitters rather than the usual reuptake. Induction of monoamine efflux by amphetamines in general may involve intracellular Na⁺ and Ca²⁺ elevation and PKC and CaMKIIα activation. MDMA also acts on the vesicular monoamine transporter 2 (VMAT2) on synaptic vesicles to increase the cytosolic concentrations of the monoamine neurotransmitters available for efflux. By inducing release and reuptake inhibition of serotonin, norepinephrine, and dopamine, MDMA increases levels of these neurotransmitters in the brain and periphery and thereby indirectly activates the receptors of these neurotransmitters. There are species differences in the balance of MAT activities of MDMA, with it showing greater influence on serotonin in rodents than in humans.[40][198–205] WP

In addition to its actions as an SNDRA, MDMA directly interacts with a number of monoamine and other receptors. With varying potencies ranging from high to low, it is a partial agonist of several of the serotonin 5-HT₁ receptors, including the serotonin 5-HT1A, 5-HT1B, and 5-HT1D receptors, and is a partial agonist of the serotonin 5-HT₂ receptors, including the serotonin 5-HT2A, 5-HT2B, and 5-HT2C receptors. The drug also interacts with α₂-adrenergic receptors, with the sigma σ₁ and σ₂ receptors, with the imidazoline I₁ receptor, and with other targets. Along with the preceding receptor interactions, MDMA is a potent partial agonist of the rodent trace amine-associated receptor 1 (TAAR1). Conversely however, due to species differences, it is far weaker in terms of potency as an agonist of the human TAAR1. The drug appears to act as a weak partial agonist of the human TAAR1 rather than as an efficacious agonist. In relation to the preceding findings, MDMA has been said to be essentially inactive as a human TAAR1 agonist. TAAR1 activation is thought to auto-inhibit and constrain the effects of amphetamines that possess TAAR1 agonism, for instance MDMA in rodents.[40][186–190][195][196][199][206–212] WP

Elevation of serotonin, norepinephrine, and dopamine levels by MDMA is believed to mediate most of the drug's effects, including its entactogenic, stimulant, euphoriant, hyperthermic, and sympathomimetic effects. The entactogenic effects of MDMA, including increased sociability, empathy, feelings of closeness, and reduced aggression, are thought to be mainly due to induction of serotonin release. The exact serotonin receptors responsible for MDMA's entactogenic effects are unclear, but may include the serotonin 5-HT1A receptor, 5-HT1B receptor, and 5-HT2A receptor, as well as 5-HT1A receptor-mediated oxytocin release and consequent activation of the oxytocin receptor. The role of oxytocin in the effects of MDMA was demonstrated in people with arginine vasopressin deficiency (central diabetes insipidus), who have oxytocin deficiency and in whom MDMA fails to elevate oxytocin levels and shows greatly blunted entactogenic effects. Induction of dopamine release is thought to be importantly involved in the stimulant and euphoriant effects of MDMA, while induction of norepinephrine release and serotonin 5-HT2A receptor stimulation are believed to mediate its sympathomimetic effects. Activation of serotonin 5-HT1B and 5-HT2A receptors is also thought to be involved in the stimulant and euphoriant effects of MDMA, while serotonin 5-HT2C receptor activation is thought to constrain these effects and limit MDMA's reinforcing potential. Serotonin 5-HT2B receptor signaling appears to be required for MDMA-induced serotonin release and effects. MDMA has been associated with a unique subjective "magic" or euphoria that few or no other known entactogens are said to fully reproduce. The mechanisms underlying this property of MDMA are unknown, but it has been theorized to be due to a specific mixture and balance of pharmacological activities, including combined serotonin, norepinephrine, and dopamine release and direct serotonin receptor agonism.[40][198][199][205][206][213–241] WP

MDMA is often said to have mild or weak psychedelic effects. These effects are said to be dose-dependent, such that greater hallucinogenic effects are produced at higher doses. The mild hallucinogenic effects of MDMA include perceptual changes like intensification of visual, auditory, and tactile perception (e.g., brightened colors), a state of dissociation with feelings of depersonalization and derealization (e.g., "oceanic boundlessness"), and thinking disturbances. Conversely, overt hallucinations do not occur, MDMA's hallucinogenic effects are described as "non-problematic" for users, and are said to be much less than those of 3,4-methylenedioxyamphetamine (MDA) or especially those of fully effective serotonergic psychedelics like psilocybin. The hallucinogenic effects of MDMA have been theorized to be mediated by serotonin 5-HT2A receptor activation analogously to the case of classical psychedelics. Accordingly, the serotonin 5-HT2A receptor antagonist ketanserin has been reported to reduce MDMA-induced perceptual changes in humans. Conversely however, it failed to affect MDMA-induced feelings of dissociation and oceanic boundlessness. In contrast, the serotonin reuptake inhibitor citalopram, which blocks MDMA-induced serotonin release, diminished all of the psychoactive and hallucinogenic effects of MDMA. It has been noted that N-methylation of psychedelic phenethylamines, as in the structural difference between MDA and MDMA, has invariably greatly reduced or abolished their psychedelic activity. Whereas MDA and psychedelics like psilocybin induce the head-twitch response in rodents, a behavioral proxy of psychedelic effects, findings on MDMA and the head-twitch response are mixed and conflicting. In addition, whereas MDA fully substitutes for psychedelics like LSD and DOM in rodent drug discrimination tests, MDMA does not do so, nor do psychedelics generally fully substitute for MDMA.[42][215][216][242–256] WP

Long-term repeated activation of serotonin 5-HT2B receptors by MDMA is thought to result in increased risk of organ complications such as valvular heart disease (VHD) and primary pulmonary hypertension (PPH). MDMA has been associated with serotonergic neurotoxicity. This may be due to formation of toxic MDMA metabolites and/or induction of simultaneous serotonin and dopamine release, with consequent uptake of dopamine into serotonergic neurons and breakdown into toxic species. Serotonin 5-HT₂ receptor agonists or serotonergic psychedelics may potentiate the neurotoxicity of MDMA.[41][216][240][257–266] WP

MDMA is a racemic mixture of two enantiomers, (S)-MDMA and (R)-MDMA. (S)-MDMA is much more potent as an SNDRA in vitro and in producing MDMA-like subjective effects in humans than (R)-MDMA. By contrast, (R)-MDMA acts as a lower-potency serotonin–norepinephrine releasing agent (SNRA) with weak or negligible effects on dopamine. Relatedly, (R)-MDMA shows weak or negligible stimulant-like and rewarding effects in animals. Both (S)-MDMA and (R)-MDMA produce entactogen-type effects in animals and humans. In addition, both (S)-MDMA and (R)-MDMA are weak agonists of the serotonin 5-HT₂ receptors. (R)-MDMA is more potent and efficacious as a serotonin 5-HT2A and 5-HT2B receptor agonist than (S)-MDMA, whereas (S)-MDMA is somewhat more potent as an agonist of the serotonin 5-HT2C receptor. Due to it being a more potent serotonin 5-HT2A receptor agonist than (S)-MDMA, (R)-MDMA has been hypothesized to have greater psychedelic effects than (S)-MDMA or racemic MDMA. However, this proved not to be the case in a direct clinical comparison of (R)-MDMA, (S)-MDMA, and racemic MDMA, with equivalent hallucinogen-like effects instead found between the three interventions.[201][206][207][208][225][248][267–270] WP

MDMA produces MDA as a minor active metabolite. Peak levels of MDA are about 5 to 10% of those of MDMA and total exposure to MDA is almost 10% of that of MDMA with oral MDMA administration. As a result, MDA may contribute to some extent to the effects of MDMA. MDA is an entactogen, stimulant, and weak psychedelic similarly to MDMA. Like MDMA, it acts as a potent and well-balanced SNDRA and as a weak serotonin 5-HT₂ receptor agonist. However, MDA shows much more potent and efficacious serotonin 5-HT2A, 5-HT2B, and 5-HT2C receptor agonism than MDMA. Accordingly, MDA produces greater psychedelic effects than MDMA in humans and might particularly contribute to the mild psychedelic-like effects of MDMA. On the other hand, MDA may also be importantly involved in toxicity of MDMA, such as cardiac valvulopathy.[201][207][208][216][222][225][247][258][271][272] WP

The duration of action of MDMA (3–6 hours) is much shorter than its elimination half-life (8–9 hours) would imply. In relation to this, MDMA's duration and the offset of its effects appear to be determined more by rapid acute tolerance rather than by circulating drug concentrations. Similar findings have been made for amphetamine and methamphetamine. One mechanism by which tolerance to MDMA may occur is internalization of the serotonin transporter (SERT). Although MDMA and serotonin are not significant TAAR1 agonists in humans, TAAR1 activation by MDMA may result in SERT internalization, for instance in rodents in whom MDMA is a potent TAAR1 agonist. It is thought that brain serotonin levels are depleted after MDMA administration but that levels typically return to normal within 24 to 48 hours.[195][222][273–285] WP⚠ A table follows this text in the source and is not copied here. Open the source to see it.

Absorption

The MDMA concentration in the bloodstream starts to rise after about 30 minutes, and reaches its maximal concentration between 1.5 and 3 hours after oral administration. It is then slowly metabolized and excreted, with levels of MDMA and its metabolites decreasing to half their peak concentration over the next several hours. The duration of action of MDMA is about 3 to 6 hours.[216][286][287][288] WP

Distribution

The plasma protein binding of MDMA is unknown.[289] WP

Metabolism

Metabolites of MDMA that have been identified in humans include 3,4-methylenedioxyamphetamine (MDA), 4-hydroxy-3-methoxymethamphetamine (HMMA), 4-hydroxy-3-methoxyamphetamine (HMA), 3,4-dihydroxyamphetamine (DHA) (also called alpha-methyldopamine (α-Me-DA)), 3,4-dhydroxymethamphetamine (HHMA), 3,4-methylenedioxyphenylacetone (MDP2P), and 3,4-methylenedioxy-N-hydroxyamphetamine (MDOH). The contributions of these metabolites to the psychoactive and toxic effects of MDMA are an area of active research. 80% of MDMA is metabolised in the liver, and about 20% is excreted unchanged in the urine.[290] WP

MDMA is known to be metabolized by two main metabolic pathways: (1) O-demethylenation followed by catechol-O-methyltransferase (COMT)-catalyzed methylation or glucuronide/sulfate conjugation; and (2) N-dealkylation, deamination, and oxidation to the corresponding benzoic acid derivatives conjugated with glycine. The metabolism may be primarily by cytochrome P450 (CYP450) enzymes CYP2D6 and CYP3A4 and COMT. Complex, nonlinear pharmacokinetics arise via autoinhibition of CYP2D6 and CYP2D8, resulting in zeroth order kinetics at higher doses. It is thought that this can result in sustained and higher concentrations of MDMA if the user takes consecutive doses of the drug.[271][291] WP

Elimination

MDMA and metabolites are primarily excreted as conjugates, such as sulfates and glucuronides. MDMA is a chiral compound and has been almost exclusively administered as a racemate. However, the two enantiomers have been shown to exhibit different kinetics. The disposition of MDMA may also be stereoselective, with the S-enantiomer having a shorter elimination half-life and greater excretion than the R-enantiomer. Evidence suggests that the area under the blood plasma concentration versus time curve (AUC) was two to four times higher for the (R)-enantiomer than the (S)-enantiomer after a 40 mg oral dose in human volunteers. Likewise, the plasma half-life of (R)-MDMA was significantly longer than that of the (S)-enantiomer (5.8 ± 2.2 hours vs 3.6 ± 0.9 hours). However, because MDMA excretion and metabolism have nonlinear kinetics, the half-lives would be higher at more typical doses (100 mg is sometimes considered a typical dose).[287][292–295] WP

Detection in body fluids

MDMA and MDA may be quantitated in blood, plasma or urine to monitor for use, confirm a diagnosis of poisoning, or assist in the forensic investigation of a traffic or other criminal violation or a sudden death. Some drug abuse screening programs rely on hair, saliva, or sweat as specimens. Most commercial amphetamine immunoassay screening tests cross-react significantly with MDMA or its major metabolites, but chromatographic techniques can easily distinguish and separately measure each of these substances. The concentrations of MDA in the blood or urine of a person who has taken only MDMA are, in general, less than 10% those of the parent drug.[291][296][297] WP

Receptor binding · Wikipedia

Activities of MDMA

Every row cites [40][186–197]

Chemistry

Formula

C11H15NO2 PC

CAS number

42542-10-9 PC

Molar mass (g/mol)

193.24 PC

IUPAC name (computed by PubChem)

1-(1,3-benzodioxol-5-yl)-N-methylpropan-2-amine PC

SMILES

CC(CC1=CC2=C(C=C1)OCO2)NC PC

InChIKey

SHXWCVYOXRDMCX-UHFFFAOYSA-N PC

PubChem CID

1615

Pop culture

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References

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