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NEUROENDOCRINOLOGY LETTERS
including Psychoneuroimmunology, Neuro
psychopharmacology,
Reproductive Medicine, Chronobiology
and Human Ethology
ISSN 0172–780X

NEL Vol.23 No.3, June 2002

ORIGINAL RESEARCH REPORT
Plasma concentrations of 5-HT, 5-HIAA, norepinephrine, epinephrine and dopamine in ecstasy users

2002; 23:259-261
pii: NEL230302A10
PMID: 12080289

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Plasma concentrations of 5-HT, 5-HIAA, norepinephrine, epinephrine and dopamine in ecstasy users
H.J. Stuerenburg (M.D.),1
K. Petersen (Ph.D.),2
T. Bäumer (M.D.),1
M. Rosenkranz (M.D.),1
C. Buhmann (M.D.),1
R. Thomasius (M.D.)2

1. Neurological Department, University Hospital Hamburg - Eppendorf, Martinistrasse 52, 20246 Hamburg, GERMANY.
2. Department for Psychiatry and Psychotherapy, University Hospital Hamburg - Eppendorf, Martinistrasse 52, 20246 Hamburg, GERMANY.

Submitted: June 6, 2002
Accepted: June 7, 2002

Keywords:
ecstasy; MDMA; monoamines; sympathetic hyperactivity; stress; psychotic episodes


Abstract

Recreational use of the synthetic methamphetamine derivative MDMA (3,4-methylenedioxymethamphetamine), the main constituent of the illegal drug "ecstasy", has increased dramatically in recent years. The reasons for ecstasy-associated cardiovascular complications like tachycardia, arrhythmias and hypertensive crises and psychiatric symptoms like psychotic episodes are not well understood. We have measured the plasma concentrations of 5-HIAA, 5-HT, norepinephrine, epinephrine and dopamine in 159 ecstasy users and controls. Ecstasy users showed elevated resting sympathetic activity, reflected in increased norepinephrine, epinephrine and dopamine levels. The levels of these catecholamines correlated positively with the cumulative dose and also with consumption during the last 30 days and 12 months. Although it is known that significant changes in 5-HT and 5-HIAA appear in the cerebrospinal fluid in ecstasy users, we could not detect alterations in serotonergic neurotransmitters in plasma in this large sample of subjects. Thus, in the drug-free interval, ecstasy users show lowered central serotonergic activity (lowered 5-HT and 5-HIAA concentrations in CSF) along with unchanged central noradrenergic and dopaminergic activity (HVA and MHPG unchanged in CSF) and elevated peripheral noradrenergic, dopaminergic and adrenergic activity along with unchanged peripheral serotonergic activity (plasma levels). We conclude, that the data presented here could argue for a noradrenergic hyperreactivity in the drug-free interval in ecstasy users resulting from previous ecstasy consumption. Also for an association with psychotic episodes and cardiovascular complications like tachycardia, arrhythmias.

Introduction
Recreational use of the synthetic methamphetamine derivative MDMA, the main constituent of the illegal drug "ecstasy", has increased dramatically in recent years. It is primarily used by adolescents and young adults. Neurochemical studies on the degradation products of the serotonergic neurotransmitters in the cerebrospinal fluid (CSF) of ecstasy users have revealed a significant reduction of 5-hydroxyindoleacetic acid (5-HIAA) concentrations in the CSF (Ricaurte et al. 1988, McCann et al. 1994). The radioligand [11C]McN5652, which binds specifically to the serotonin transporter, showed reduced serotonin transporter binding in ecstasy users (Bolla et al. 1998). As part of a comprehensive study (Thomasius et al. 1998) we also measured 5-HT, 5-HIAA, norepinephrine, epinephrine and dopamine in plasma (using HPLC with electrochemical detection) in these subjects.

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Patients, Materials and Methods

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