Distribution Study of 3,4-Methylenedioxymethamphetamine and 3,4-Methylenedioxyamphetamine in a Fatal Overdose
Els A. de Letter, Karine M. Clauwaert, Willy E. Lambert, Jan F. van Bocxlaer, A.p. de Leenheer, M Piette
Journal of Analytical Toxicology March 1, 2002 DOI: 10.1093/jat/26.2.113 via OpenAlex
Summary
AI-generated from the abstractIn a fatal overdose of MDMA (ecstasy) and its metabolite MDA, concentrations varied widely across different body sites. Central blood samples (heart and great vessels) showed different levels than peripheral blood (subclavian and femoral). High levels were found in liver, lungs, and kidneys, while vitreous humor also contained MDMA, suggesting it could be used when blood is unavailable. The findings confirm that peripheral vein blood is best for accurate measurement, and that postmortem redistribution must be considered when interpreting toxicology results from other sites.
Study at a glance
| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A single decedent from a fatal MDMA overdose |
| Topics | MDMA |
| Keywords | Chemistry Forensic toxicology Metabolite Urine |
| Citations | 47 |
| Key finding | Peripheral blood sampling is recommended for MDMA and MDA quantification, and vitreous humor may serve as an alternative when blood is unavailable, due to substantial postmortem concentration differences across body sites. |
Abstract
In this study, regional tissue distributions of the amphetamine analogue 3,4-methylenedioxymethamphetamine (MDMA, "ecstasy") and its metabolite 3,4-methylenedioxyamphetamine (MDA) in a fatal overdose are presented. Quantitation of MDMA and MDA levels occurred in blood samples taken centrally (right and left heart and main adjacent great vessels) and peripherally (subclavian and femoral blood). In addition, MDMA and MDA concentrations were determined in cardiac and iliopsoas muscle, both lungs, liver, both kidneys, spleen, the four brain lobes, cerebellum and brainstem, and adipose tissue. Finally, MDMA and MDA levels were determined in serum, vitreous humor, urine, and bile. For all samples, a fully validated high-pressure liquid chromatography procedure with fluorescence detection was used. The found substances were also identified with liquid chromatography-tandem mass spectrometry. Our data confirm that blood sampling from an isolated peripheral vein is recommended for MDMA and MDA. In addition, the vitreous humor MDMA level indicates that this fluid can be an interesting alternative when a suitable blood sample is missing. Considering the substantial differences in concentrations in blood samples taken from various sites in the body and the high levels in some tissues (e.g., in liver), we concluded that the influence of postmortem redistribution should be taken into account in the interpretation of toxicological data when an appropriate peripheral sample cannot be obtained or when blood samples are not available because of putrefaction.