Acute effects of MDMA, MDA, lysine-MDMA, and lysine-MDA in a randomized, double-blind, placebo-controlled, crossover trial in healthy participants
Abstract
3,4-Methylenedioxymethamphetamine (MDMA) is used recreationally, as a research tool, and in MDMA-assisted therapy in patients with posttraumatic stress disorder. 3,4-Methylenedioxyamphetamine (MDA) is a psychoactive metabolite of MDMA. Acute effects of MDMA and MDA have never been directly compared in humans. Lysine-conjugated amphetamines slowly release active amphetamine once absorbed, suggesting pharmaceutical strategies to enhance tolerability and reduce abuse potential. Therefore, lysine-MDMA (Lys-MDMA) and lysine-MDA (Lys-MDA) were developed as prodrugs of MDMA and MDA, respectively. We used a double-blind, randomized, placebo-controlled, crossover design to compare acute responses to MDMA (100 mg), MDA (92 mg), Lys-MDMA (172 mg), and Lys-MDA (164 mg) at equimolar doses and placebo in 23 healthy participants (12 women, 11 men). Outcome measures included acute subjective, autonomic, and endocrine effects and pharmacokinetics. Compared with placebo, MDMA and MDA produced pronounced subjective and autonomic effects. After Lys-MDMA administration, no MDMA was detected in blood samples, and no corresponding subjective or autonomic effects were observed. MDA produced stronger and longer-lasting subjective “any drug effects” compared with MDMA, with effect durations of (mean ± SEM) 6.1 ± 0.5 vs 4.1 ± 0.4 h, respectively. Additionally, compared with MDMA, MDA induced greater subjective “stimulant effects,” more negative “bad drug effects,” more “fear,” and more “visual…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 23 participants or records.
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