Pharmacological aspects of the combined use of 3,4-methylenedioxymethamphetamine (MDMA, ecstasy) and gamma-hydroxybutyric acid (GHB): a review of the literature
Drug and Alcohol Review – July 01, 2005
Source: OpenAlex
Summary
The rising popularity of club drugs is concerning, with a notable increase in polydrug use, particularly the combination of ecstasy (MDMA) and gammahydroxybutyrate (GHB). This combination affects multiple neurotransmitter systems, including serotonin and dopamine. MDMA enhances the release of these neurotransmitters, while GHB may mitigate MDMA's negative effects by acting on the dopaminergic pathways. Understanding this interaction is crucial for effective prevention strategies, as limited studies exist on the subjective effects and pharmacological interactions of these psychoactive substances.
Abstract
Epidemiological studies show that the use of club drugs is on the rise. Furthermore, the last few decades have seen a rise in patterns of polydrug use. One of the combinations frequently used is ecstasy (MDMA) with gammahydroxybutyrate (GHB). For effective prevention it is important to be aware of this phenomenon and of the pharmacology of these drugs. The effects of the combination extend to different neurotransmitter systems, including serotonin, dopamine and noradrenaline. Studies investigating the effects of combinations of psychoactive substances are limited. In this review we describe the subjective effects of the MDMA/GHB combination. Furthermore, we review the individual actions of MDMA on serotonin, dopamine and noradrenaline systems. In addition, actions of GHB on these systems are discussed as a possible pharmacological basis for the interaction of both drugs. It is postulated that GHB attenuates the unpleasant or dysphoric effects of MDMA by its effect on the central dopaminergic system.