MDMA can be fatal in warm environments
NIH preclinical study suggests higher risk of death is associated with warmer brain temperature
A moderate dose of MDMA. commonly known as Ecstasy or Molly, that is typically nonfatal in cool, quiet environments can be lethal in rats exposed to conditions that mimic the hot, crowded, social settings where the drug is often used by people, a study finds. Scientists have identified the therapeutically-relevant cooling mechanism to enable effective interventions when faced with MDMA-induced hyperthermia. The study, publishing tomorrow in the Journal of Neuroscience, was conducted by researchers at the National Institute on Drug Abuse's Intramural Research Program (NIDA IRP). NIDA is a part of the National Institutes of Health.
While MDMA can have a range of adverse health effects, previous studies have shown that high doses of MDMA increase body temperature, while results with moderate doses were inconsistent. This has led some people to assume that the drug is harmless if taken in moderation. However, this study shows that in rats even moderate doses of MDMA in certain environments can be dangerous because it interferes with the body's ability to regulate temperature.
"We know that high doses of MDMA can sharply increase body temperature to potentially lead to organ failure or even death," said NIDA Director Dr. Nora D. Volkow. "However, this current study opens the possibility that even moderate doses could be deadly in certain conditions."
It is impossible to predict who will have an adverse reaction even to a low dose of MDMA. However, in this study scientists gave the rats low to moderate doses that have been shown in past studies to not be fatal. They monitored the rats to determine drug-induced changes in brain and body temperature and in the body's ability to cool itself through blood vessel dilation. When rats were alone and in a room-temperature environment, a moderate dose of MDMA modestly increased brain and body temperature and moderately diminished the rats' ability to eliminate excessive heat. However, when researchers injected the same dose in rats that were either in a warmer environment or in the presence of another rat in the cage, brain temperature increased, causing death in some rats. These fatal temperature increases were because the drug interfered with the body's ability to eliminate heat.
"These results demonstrate that the use of MDMA in certain warm, social settings could be more dangerous than commonly believed," said Dr. Eugene Kiyatkin, first author on the study and NIDA IRP scientist. "Even with moderate doses, we saw drug-induced, fatal brain hyperthermia during conditions of social interaction and in warm environments."
These findings further suggest that medical interventions aimed at increasing the efficiency of whole-body cooling by targeting blood vessel constriction in the skin could be therapeutically relevant for counteracting the development of MDMA-induced hyperthermia.
For a copy of the study, please visit http://www.jneurosci.org 
The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world's research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to inform policy and improve practice. Fact sheets on the health effects of drugs of abuse and information on NIDA research and other activities can be found on the NIDA home page athttp://www.drugabuse.gov, which is now compatible with your smartphone, iPad or tablet. To order publications in English or Spanish, call NIDA's DrugPubs research dissemination center at 1-877-NIDA-NIH or 240-645-0228 (TDD) or fax or email requests to 240-645-0227 or drugpubs@nida.nih.gov. Online ordering is available athttp://drugpubs.drugabuse.gov. NIDA's media guide can be found at http://drugabuse.gov/mediaguide, and its new easy-to-read website can be found at http://www.easyread.drugabuse.gov.
About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visitwww.nih.gov.
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