Key interindividual determinants in MDMA pharmacodynamics

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5 Citations (Scopus)


© 2018 Informa UK Limited, trading as Taylor & Francis Group. Introduction: MDMA, 3,4-methylenedioxymethamphetamine, is a synthetic phenethylamine derivative with structural and pharmacological similarities to both amphetamines and mescaline. MDMA produces characteristic amphetamine-like actions (euphoria, well-being), increases empathy, and induces pro-social effects that seem to motivate its recreational consumption and provide a basis for its potential therapeutic use. Areas covered: The aim of this review is to present the main interindividual determinants in MDMA pharmacodynamics. The principal sources of pharmacodynamic variability are reviewed, with special emphasis on sex-gender, race-ethnicity, genetic differences, interactions, and MDMA acute toxicity, as well as possible therapeutic use. Expert opinion: Acute MDMA effects are more pronounced in women than they are in men. Very limited data on the relationship between race-ethnicity and MDMA effects are available. MDMA metabolism includes some polymorphic enzymes that can slightly modify plasma concentrations and effects. Although a considerable number of studies exist about the acute effects of MDMA, the small number of subjects in each trial limits evaluation of the different interindividual factors and does not permit a clear conclusion about their influence. These issues should be considered when studying possible MDMA therapeutic use.
Original languageEnglish
Pages (from-to)183-195
JournalExpert Opinion on Drug Metabolism and Toxicology
Issue number2
Publication statusPublished - 1 Feb 2018


  • 3,4-methylenedioxymethamphetamine
  • genetic polymorphisms
  • MDMA
  • pharmacodynamics
  • pharmacokinetics
  • race-ethnicity
  • sex-gender


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