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