JAMA network open
November 4, 2024
Cihan Atila, Isabelle Straumann, Patrick Vizeli et al.
15 citations
A single dose of MDMA (ecstasy) caused acute hyponatremia (low blood sodium) in 31% of 96 healthy participants across four placebo-controlled trials. Hyponatremia occurred in 37% of those with unrestricted fluid intake but in none of the 15 participants whose fluid intake was restricted, suggesting fluid restriction may prevent this complication. The drop in sodium levels correlated with a sharp rise in oxytocin (433% increase) but not with copeptin, a marker of vasopressin. This challenges the long-held belief that MDMA-induced hyponatremia is caused by vasopressin release and instead points to oxytocin mimicking vasopressin's water-retaining effect in the kidneys due to structural similarity.
European journal of endocrinology
March 27, 2025
Cihan Atila, Andi Nikaj, Svenja Leibnitz et al.
9 citations
Neurophysin I (NP-I), a stable byproduct of the oxytocin precursor, can serve as a reliable biomarker for oxytocin secretion when stimulated by MDMA. In a double-blind, placebo-controlled crossover study, 15 patients with hypothalamic-posterior-pituitary dysfunction and 15 matched healthy controls received a single 100 mg dose of MDMA or placebo. In healthy controls, MDMA caused an 8-fold increase in oxytocin (peak: 624 pM) and a 20-fold increase in NP-I (peak: 1508 pM). Patients showed no notable oxytocin increase (peak: 92 pM) and only a mild NP-I rise (peak: 263 pM). The difference in NP-I area under the curve between groups was significant (2340 pM·5 h; 95% CI, 1462-3218). NP-I measurement offers a way to assess oxytocin secretion, aiding research into conditions like autism, anxiety, and depression.
Endocrine connections
June 1, 2025
Cihan Atila, Sara-Jessica Camerin, Matthias E Liechti et al.
2 citations
A single oral dose of MDMA (100 mg) strongly activates the hypothalamic-pituitary-adrenal (HPA) axis in healthy adults. Plasma ACTH increased from 12 ng/L to 38 ng/L and cortisol from 347 nmol/L to 566 nmol/L within 120 minutes. Prolactin showed a mild, non-significant change. MDMA did not affect other anterior pituitary hormones (TSH, LH, GH) or their peripheral hormones (fT4, testosterone, estradiol). The findings suggest MDMA may serve as a novel stimulation test for simultaneously assessing the HPA axis and oxytocin systems, but further validation in larger populations is needed.
Journal of the Endocrine Society
October 1, 2023
Cihan Atila, Friederike Holze, Rakithan Murugesu et al.
Patients with arginine vasopressin deficiency (central diabetes insipidus) show heightened anxiety, alexithymia, and depressed mood at baseline compared with healthy controls. When given a single 100 mg oral dose of MDMA, patients had only a minimal oxytocin increase of 66 pg/ml, whereas healthy controls showed an increase of 658 pg/ml—a 15.8-fold difference. This blunted oxytocin response was accompanied by reduced subjective effects including trust, happiness, openness, and fear reduction. The findings suggest that an oxytocin deficiency may underlie the psychological symptoms in these patients, establishing oxytocin deficiency as a potential hypothalamic-pituitary entity.