Chemistry, Pharmacology, Toxicology, and Hepatic Metabolism of Designer Drugs of the Amphetamine (Ecstasy), Piperazine, and Pyrrolidinophenone Types
Therapeutic Drug Monitoring March 19, 2004 Hans H. Maurer, Thomas Kræmer, Dietmar Springer et al. 147 citations
Designer drugs such as MDMA, MDEA, MDA, and various piperazine and pyrrolidinophenone compounds, often used as rave drugs, produce euphoria, energy, and sociability. Despite their reputation as safe, studies in rats and primates along with human epidemiological investigations indicate potential risks, including serotonin syndrome, liver toxicity, neurotoxicity, and psychological problems. Metabolites may contribute to some toxic effects, so understanding metabolism is crucial for risk assessment. The enzyme CYP2D6, which is polymorphically expressed, catalyzes the major metabolic steps of piperazine- and pyrrolidinophenone-derived designer drugs, though it remains unclear whether this genetic polymorphism is clinically relevant.