Interest and limits of using pharmacogenetics in MDMA-related fatalities: A case report.
Forensic science international. Genetics March 1, 2025 G Drevin, O Hahn, N Picard et al. 2 citations
Interpreting postmortem MDMA concentrations is difficult because reported levels vary widely and toxicity can be idiosyncratic. A 34-year-old white European male was found dead at home; femoral blood contained 3800 µg/L MDMA and 170 µg/L methylenedioxyamphetamine. Pharmacogenetic analysis of his CYP2C19 gene revealed a *1/*17 genotype predictive of rapid metabolism, implying greater MDMA elimination. Two variants in the COMT gene (rs4633TT, rs4680AA) were also found; carriers of rs4680AA or rs4680GA genotypes have lower enzyme activity, associated with increased cardiovascular effects and risk of hyponatremia. However, too few studies exist to draw definitive conclusions, and a holistic genetic approach including pharmacological targets is needed.