Therapeutic Drug Monitoring
March 19, 2004
Rafael de la Torre, Magı́ Farré, Pere N. Roset et al.
445 citations
MDMA (ecstasy) is a widely misused psychostimulant that increases energy, euphoria, and sociability while also producing distinctive 'entactogen' effects such as feeling close to others and increased empathy. It works by promoting the release and blocking the reuptake of serotonin, dopamine, and norepinephrine. Acute toxic effects include serotonin syndrome, characterized by muscle rigidity, hyperreflexia, and hyperthermia. MDMA metabolism involves two main pathways; one is partially regulated by the polymorphic enzyme CYP2D6, but mechanism-based inhibition after two consecutive doses limits the impact of CYP2D6 genetics on acute toxicity. Metabolism may also contribute to long-term neurotoxic effects through progressive degeneration of the serotonergic system.
Annals of the New York Academy of Sciences
August 1, 2006
Sergio Abanades, Magı́ Farré, Mireia Segura et al.
124 citations
Gamma-hydroxybutyrate (GHB) produces dose-related changes in subjective effects, showing a mixed stimulant-sedative pattern: initial feelings of euphoria, high, and liking, followed by mild-to-moderate sedation with impaired performance and balance. Single oral doses of 40, 50, 60, and 72 mg/kg were given to eight volunteers. Mean peak plasma concentrations ranged from 79.1 to 130.1 μg/L. Physiological and subjective effects were dose-dependent and related to plasma concentrations. Urinary excretion was mainly related to dose. The results suggest high abuse liability at the doses typically consumed.
Journal of Clinical Psychopharmacology
December 1, 2007
Sergio Abanades, Magı́ Farré, Diego Barral et al.
69 citations
A single oral dose of gamma-hydroxybutyric acid (GHB) at 40 or 60 mg/kg produces euphoria and pleasurable effects with slightly higher ratings than those from flunitrazepam (1.25 mg) or ethanol (0.7 g/kg) in healthy male recreational club drug users. GHB shows a biphasic time profile: an initial stimulant-like effect as plasma concentrations rise, followed by a later sedative effect unrelated to its kinetics. GHB increases blood pressure and pupil diameter, while flunitrazepam produces marked sedation. Both GHB and flunitrazepam impair psychomotor performance, including digit symbol substitution and balance tasks, whereas ethanol only mildly affects balance. The findings suggest a high abuse liability of GHB and flunitrazepam in this population.
Journal of Clinical Psychopharmacology
September 12, 2008
Brian O’Mathúna, Magı́ Farré, Amin Rostami‐hodjegan et al.
68 citations
MDMA (ecstasy) strongly inhibits the liver enzyme CYP2D6, which is responsible for metabolizing many drugs. In a controlled trial with 15 healthy men, a single 1.5 mg/kg oral dose of MDMA increased blood levels of the probe drug dextromethorphan about tenfold and reduced its breakdown product dextrorphan. The urinary metabolic ratio rose nearly 100-fold, and two-thirds of participants temporarily showed a metabolic profile typical of poor metabolizers. CYP2D6 activity recovered after 10 days, with a half-life of 46.6 hours. Users should be warned that MDMA can dangerously alter the metabolism of other medications.
Therapeutic Drug Monitoring
February 1, 2007
Sergio Abanades, Magı́ Farré, Mireia Segura et al.
66 citations
After a single oral dose of 50 mg/kg sodium GHB, mean peak plasma concentrations reached 83.1 μg/mL at 30 minutes, then declined to 0.9 μg/mL at 6 hours. GHB appeared in oral fluid at levels one-third to one-fourth of plasma concentrations, with a half-life of about 1.2 hours compared to 0.7 hour in plasma. Less than 2% of the dose was excreted in urine, and sweat contained only low concentrations. Subjective effects followed a mixed sedative-stimulant pattern, peaking between 1 and 1.5 hours and lasting 2 hours, and were related to plasma concentrations. Oral fluid and sweat were not suitable for monitoring GHB consumption.
Journal of Psychopharmacology
January 21, 2008
Susana de Sola Llopis, Mónica Miguélez-Pan, Jordi Peña‐Casanova et al.
58 citations
Recreational ecstasy use, often alongside cannabis, is linked to lasting cognitive deficits. Over two years, regular ecstasy users performed worse than cannabis-only users and non-users on tests of verbal fluency, working memory, and processing speed. Heavier users (more than 100 tablets) also showed impairments in episodic memory. These deficits persisted across the study period. The findings suggest that ecstasy, possibly combined with cannabis, causes subtle but lasting cognitive harm, though pre-existing differences between groups cannot be ruled out.
Rapid communications in mass spectrometry : RCM
January 1, 2005
Simona Pichini, Sergio Abanades, Magí Farré et al.
58 citations
A gas chromatography–mass spectrometry method was developed and validated to measure Salvinorin A, the main active compound in the hallucinogenic plant Salvia divinorum, in plasma, urine, saliva, and sweat. The method uses 17-alpha-methyltestosterone as an internal standard and extracts the compound with a chloroform/isopropanol mixture. It was validated over a concentration range of 0.015–5 microg/mL for plasma, urine, and saliva, and 0.01–5 microg/patch for sweat, with mean recoveries of 77.1–92.7% and precision and accuracy better than 15%. When applied to two consumers after smoking 75 mg of plant leaves, Salvinorin A was detected in urine (2.4 and 10.9 ng/mL) and saliva (11.1 and 25.0 ng/mL), but not in sweat patches.
Addiction
May 22, 2007
Roberta Pacifici, Piergiorgio Zuccaro, Magı́ Farré et al.
39 citations
People who use both MDMA (ecstasy) and cannabis show long-term changes in immune function, including lower levels of interleukin-2 and higher levels of anti-inflammatory transforming growth factor beta-1, along with fewer total lymphocytes, CD4 cells, and natural killer cells. These immune alterations persisted over one year. Regular users of both drugs had a higher rate of mild infections compared to occasional users and those who used only cannabis or neither drug. Cannabis-only users showed intermediate immune changes. The findings suggest that sustained disruption of immune balance may lead to poorer general health and greater susceptibility to infections.