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Drug and MDMA Interactions Implications for Public Health

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Handbook of Substance Misuse and Addictions

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Abstract

Public health focused on drug use is considered a balancing act between preventing illicit use of drugs of abuse and ensuring access to drugs/medicines with abuse potential for a medical condition. Whereas clinically relevant drug interactions for medicines are widely recognized and are included in most pharmacovigilance systems, drug interactions with drugs of abuse are mainly underexplored, and their assessment is not part of clinical routine. An excellent example of this paradigm is 3,4-methylenedioxymethamphetamine (MDMA, ecstasy, or molly), one of the most popular recreative psychostimulants, which is being currently evaluated for the treatment of post-traumatic stress disorder. Considering both aspects of MDMA, as a consolidated recreational drug of abuse and a potential medicine, it is crucial to understand which inter- and intraindividual factors, modulation factors, and potential interactions could lead to risk of intoxication in recreational drug users as well as in patients with possible future MDMA-assisted therapy.

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Abbreviations

5-HT:

5-hydroxytryptamine (serotonin)

5-HTT:

5-hydroxytryptamine transporter

5-HTTLPR:

5-hydroxytryptamine transporter-linked promoter region

AERS:

Adverse event reporting system

AMRS:

Adjective Mood Rating Scale

ARCI:

Addiction Research Center Inventory

ASC:

Altered States of Consciousness

AUC:

Area under cover

BP:

Blood pressure

CNS:

Central nervous system

COMT:

Catechol-O-methyltransferase

CYP1A2:

Cytochrome P450 1A2

CYP2B6:

Cytochrome P450 2B6

CYP2C19:

Cytochrome P450 2C19

CYP2D6:

Cytochrome P450 2D6

DA:

Dopamine

DBP:

Diastolic blood pressure

EM:

Extensive metabolizer

EMCCDA:

European Monitoring Centre for Drugs and Drug Addiction

FAERS:

FDA Adverse Event Reporting System

FDA:

Food and Drug Administration

GDS:

Global Drug Survey

HHA:

3,4-dihydroxyamphetamine

HHMA:

3,4-dihydroxymethamphetamine

HR:

Heart rate

IM:

Intermediate metabolizer

LSD:

Lysergic acid diethylamide

MAOI:

Monoamine oxidase inhibitor

MAP:

Mean arterial pressure

MAPS:

Multidisciplinary Association for Psychedelic Studies

MBI:

Mechanism-based inhibition

MDA:

3,4-methylenedioxyamphetamine

MDEA:

Methylenedioxyethylamphetamine

MDMA:

3,4-methylenedioxymethamphetamine

mmHg:

Millimeters of mercury

MTF:

Monitoring the Future

NE:

Norepinephrine

NET:

Norepinephrine transporter

NSP:

Novel psychoactive substances

OXTR:

Oxytocin receptor

PD:

Pharmacodynamics

PK:

Pharmacokinetics

PM:

Poor metabolizer

PMA:

Paramethoxyamphetamine

POMS:

Profile of Mood States

PTSD:

Post-traumatic stress disorder

SBP:

Systolic blood pressure

SERT:

Serotonin transporter

SIADH:

Syndrome of inappropriate antidiuretic hormone secretion

SNP:

Single-nucleotide polymorphisms

SSRI:

Selective serotonin reuptake inhibitor

STAI:

State-Trait Anxiety Inventory

T:

Temperature

THC:

Delta-9-tetrahydrocannabinol

UM:

Ultrarapid metabolizer

US:

United States

WHO:

World Health Organization

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Authors and Affiliations

  1. Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol, Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain

    Esther Papaseit, Magí Farré & Clara Pérez-Mañá

  2. Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain

    Esther Papaseit, Magí Farré & Clara Pérez-Mañá

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  1. Esther Papaseit
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  2. Magí Farré
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  3. Clara Pérez-Mañá
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Correspondence to Clara Pérez-Mañá .

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Editors and Affiliations

  1. School of Life Sciences, University of Westminster, London, UK

    Vinood B. Patel

  2. School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, UK

    Victor R. Preedy

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Papaseit, E., Farré, M., Pérez-Mañá, C. (2022). Drug and MDMA Interactions Implications for Public Health. In: Patel, V.B., Preedy, V.R. (eds) Handbook of Substance Misuse and Addictions. Springer, Cham. https://doi.org/10.1007/978-3-030-92392-1_121

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