Pharmacology of MDMA in humans

Introduction

De and colleagues situate MDMA (3,4-methylenedioxymethamphetamine) as an amphetamine derivative with both stimulant and serotonergic (hallucinogenic-like) actions that distinguish it from classical amphetamines. Earlier human reports have documented prominent sympathomimetic cardiovascular and autonomic effects (increased blood pressure, pulse, mydriasis, diaphoresis, jaw clenching) together with subjective confusion and modest psychomotor impairment. Metabolically, MDMA undergoes N‑demethylation to MDA and subsequent O‑demethylenation and O‑methylation steps producing HMMA and HMA; however, plasma data and urinary quantitative recoveries for these metabolites remain limited. This paper reports experimental data from a new clinical trial administering a single oral 100 mg dose of MDMA to healthy volunteers and compares those findings with prior controlled doses (50, 75, 125, and 150 mg) examined in the authors’ earlier pilot and controlled studies. The study aims to characterise physiologic, psychomotor, neuroendocrine, and pharmacokinetic effects of MDMA and its main metabolites across the recreational dose range, including examination of dose–response patterns and possible nonlinear kinetics.