PTSDSafety & Risk ManagementMedicinal Chemistry & Drug DevelopmentMDMA

In vivo effects of 3,4-methylenedioxymethamphetamine (MDMA) and its deuterated form in rodents: Drug discrimination and thermoregulation.

This rat study (n=41) compared the hyperthermic side effects of MDMA ( and a deuterium-substituted analog d2-MDMA in rats and found that d2-MDMA produced increases in body temperature that were shorter-lasting and of lower magnitude compared to equivalent doses of MDMA.

Authors

  • Berquist, M. D.
  • Leth-Petersen, S.
  • Kristensen, J. L.

Published

Drug and Alcohol Dependence
individual Study

Abstract

Background

Recent clinical studies support the use of 3,4-methylenedioxymethamphetamine (MDMA) as an adjunct treatment for post-traumatic stress disorder (PTSD). Despite these promising findings, MDMA administration in controlled settings can increase blood pressure, heart rate, and body temperature. Previous studies indicate that O-demethylated metabolites of MDMA contribute to its adverse effects. As such, limiting the conversion of MDMA to reactive metabolites may mitigate some of its adverse effects and potentially improve its safety profile for therapeutic use.

Methods

We compared the interoceptive and hyperthermic effects of a deuterium-substituted form of MDMA (d2-MDMA) to MDMA using rodent drug discrimination and biotelemetry procedures, respectively.

Results

Compared to MDMA, d2-MDMA produced full substitution for a 1.5 mg/kg MDMA training stimulus with equal potency and effectiveness in the drug discrimination experiment. In addition, d2-MDMA produced increases in body temperature that were shorter-lasting and of lower magnitude compared to equivalent doses of MDMA. Last, d2-MDMA and MDMA were equally effective in reversing the hypothermic effects of the selective 5-HT2A/2C antagonist ketanserin.

Conclusion

These findings indicate that deuterium substitution of hydrogen at the methylenedioxy ring moiety does not impact MDMA’s interoceptive effects, and compared to MDMA, d2-MDMA has less potential for producing hyperthermic effects and likely has similar pharmacodynamic properties. Given that d2-MDMA produces less adverse effects than MDMA, but retains similar desirable effects that are thought to relate to the effective treatment of PTSD, additional investigations into its effects on cardiovascular functioning and pharmacokinetic properties are warranted.

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Research Summary of 'In vivo effects of 3,4-methylenedioxymethamphetamine (MDMA) and its deuterated form in rodents: Drug discrimination and thermoregulation.'

Introduction

Berquist and colleagues situate this work in the context of renewed clinical interest in 3,4-methylenedioxymethamphetamine (MDMA) as an adjunct pharmacotherapy for post-traumatic stress disorder (PTSD). Earlier clinical and preclinical studies have reported persistent symptom reductions after MDMA-assisted therapy and generally acceptable tolerability, but acute adverse effects—most notably increases in blood pressure, heart rate and body temperature—remain a concern, particularly in patients with comorbid cardiovascular or renal disease. Prior laboratory work implicates O-demethylated MDMA metabolites (HHMA and HHA) in some acute and long-term adverse outcomes; these metabolites can be oxidised to reactive species that form neurotoxic adducts and have cardiovascular actions in rodents.

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