MDMA intoxication

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Introduction

Although not exactly a disease, MDMA intoxication occurs after ingesting MDMA and typically comes with dysphoria, agitation or insomnia.

MDMA interferes with the clearance of serotonin, dopamine and adrenalin/epinephrin from the brain, causing their levels to rise and ultimately leads to the serotonin syndrome.

As the cannabinoid system is involved in serotonergic, dopaminergic and adrenergic signalling cannabinoids have potential to counteract the serotonin syndrome.

In line with this, many recreational users of MDMA often use cannabis to soften the MDMA intoxication.

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Prescription Advice

Preclinical data suggests THC may be therapeutic in MDMA intoxication.

Given the nature of the disease, oral application or sublingual application may be beneficial. Also, smoked or inhaled THC (cannabis) may be beneficial.

For inhalation, inhale until the symptoms subside or the side-effects become intolerable.

For oral/sublingual application, please follow generic prescription advice.

Please note that, while based on preclinical and/or clinical research, this prescription advice is solely intended as a guideline to help physicians determine the right prescription. We intend to continuously update our prescription advice based on patient and/or expert feedback. If you have information that this prescription advice is inaccurate, incomplete or outdated please contact us here.

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Literature Discussion

MDMA causes hyperthermia, oxidative stress and neuronal damage while THC produces hypothermia and is anti-oxidant and anti-inflammatory. In mice that received 4 x 20 mg/kg MDMA, application of 4 x 3 mg/kg THC prevented hyperthermia, glial activation and dopaminergic terminal loss. This effect was fully CB1-dependent and partially CB2-dependent (Touriño et al., 2010).

Similarly, in rhesus monkeys, 0.3 mg/kg THC (intramuscular) prevented MDMA-induced hyperthermia (1.78 mg/kg oral) in a CB1-dependent manner (Taffe, 2012).

In rats, the after-effects of MDMA (2 x 10 mg/kg) include hyperthermia, increased anxiety-like behavior and reduced exploration. Administration of THC reduced these behavioral effects. In addition, THC normalized serotonin levels and prevented MDMA-induced neurotoxicity (Shen et al., 2011).

References:

Shen, E.Y., Ali, S.F., and Meyer, J.S. (2011). Chronic administration of THC prevents the behavioral effects of intermittent adolescent MDMA administration and attenuates MDMA-induced hyperthermia and neurotoxicity in rats. Neuropharmacology 61, 1183–1192.

Taffe, M.A. (2012). Δ9-Tetrahydrocannabinol attenuates MDMA-induced hyperthermia in rhesus monkeys. Neuroscience 201, 125–133.

Touriño, C., Zimmer, A., and Valverde, O. (2010). THC Prevents MDMA Neurotoxicity in Mice. PLoS ONE 5.