Methylenedioxymethamphetamine (MDMA): Serotonergic and dopaminergic mechanisms related to its use and misuse
Journal of Neurochemistry March 12, 2021 Susan Schenk, Quenten Highgate 47 citations
MDMA, an amphetamine analogue, primarily stimulates serotonin release with smaller increases in synaptic dopamine. The ratio of dopamine to serotonin increase predicts abuse liability, with higher ratios indicating greater risk. Despite a lower ratio, MDMA is misused. Repeated exposure produces neuroadaptive changes in both serotonin and dopamine systems, explaining the development and maintenance of self-administration in animals and substance use disorder in humans. Research shows serotonin inhibits the acquisition of MDMA self-administration, while dopamine is critical for its maintenance. The paper describes circuitry and serotonin receptors that modulate dopamine activity and reviews limited research on MDMA's effects on these receptor mechanisms.