1
|
Wexler A, Dubinskaya A, Suyama J, Komisaruk BR, Anger J, Eilber K. Does MDMA have treatment potential in sexual dysfunction? A systematic review of outcomes across the female and male sexual response cycles. Sex Med Rev 2023; 12:26-34. [PMID: 37888490 DOI: 10.1093/sxmrev/qead046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023]
Abstract
INTRODUCTION Sexual health, an integral component of overall well-being, is frequently compromised by common yet underdiagnosed sexual dysfunctions. Traditional interventions encompass pharmaceutical and psychological treatments. Unconventional therapies, like MDMA, offer hope for sexual dysfunction. This review delves into MDMA's effects on sexual responsiveness and its potential role in treating sexual dysfunction. OBJECTIVES The purpose of this review is to elucidate effects of MDMA on different domains of the female and male sexual response cycles. METHODS We conducted a systematic review on the effects of MDMA on each domain of the female and male sexual response cycles. PubMed, MEDLINE, and EMBASE were queried, and results were screened using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Search terms utilized were "MDMA" or "ecstasy" in combination with "desire," "arousal," "lubrication," "orgasm," "pleasure," "libido," "erection," and "ejaculation." Inclusion criteria for this review were MDMA use by study subjects and sexual outcomes in at least 1 domain of the female and/or male sexual response cycles were described and measured. Randomized controlled trials, cohort studies (both prospective and retrospective), surveys, and literature reviews published between January 2000 and June 2022 were included. Case reports and studies that did not address conditions of interest were excluded from analysis. Duplicated search results were screened out. The remaining studies were then read in full text to ensure they met inclusion and exclusion criteria for analysis. RESULTS We identified 181 studies, of which 6 met criteria for assessment of the female sexual response cycle and 8 met criteria for assessment of the male sexual response cycle. Four of 6 studies reported increased sexual desire with MDMA use among women. Arousal and lubrication were improved with MDMA use in 3 of 4 studies, but they were not affected in 1 randomized control study. In men, 7 studies evaluated the effects of MDMA on desire and/or arousal, 5 studies measured impact on erection, 3 on orgasm, and 2 on ejaculation. Sixty percent of interview-based studies reported increased sexual desire in men, while 40% reported mixed or no effect. Two studies reported impairment of erection, 2 reported mixed effects, and 1 reported fear of erection impairment. In both men and women, all studies evaluating orgasm reported delay in achieving orgasm but increased intensity and pleasure if achieved. Primary outcome measures were variable and largely qualitative. CONCLUSION Our findings suggest that MDMA generally increases sexual desire and intensifies orgasm when achieved. While producing conflicting evidence on sexual arousal in both sexes, MDMA may impair erectile and ejaculatory function in men.
Collapse
Affiliation(s)
- Ava Wexler
- The Hebrew University- Hadassah Medical School, Jerusalem, 9112001, Israel
| | - Alexandra Dubinskaya
- Los Angeles Institute for Pelvic and Sexual Medicine, Beverly Hills, CA, 90210, United States
| | - Julie Suyama
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, CA, 90213, United States
| | - Barry R Komisaruk
- Psychology Department, Rutgers University, Newark, NJ, 07102, United States
| | - Jennifer Anger
- Division of Gender Affirming Surgery, Urologic Reconstruction, and Female Pelvic Medicine, Department of Urology, University of California San Diego, La Jolla, CA, 92093, United States
| | - Karyn Eilber
- Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Beverly Hills, 90048, CA, United States
| |
Collapse
|
2
|
Mustafa NS, Bakar NHA, Mohamad N, Adnan LHM, Fauzi NFAM, Thoarlim A, Omar SHS, Hamzah MS, Yusoff Z, Jufri M, Ahmad R. MDMA and the Brain: A Short Review on the Role of Neurotransmitters in Neurotoxicity. Basic Clin Neurosci 2021; 11:381-388. [PMID: 33613876 PMCID: PMC7878040 DOI: 10.32598/bcn.9.10.485] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 08/10/2018] [Accepted: 02/19/2019] [Indexed: 11/24/2022] Open
Abstract
N-Methyl-3, 4-methylenedioxyamphetamine (MDMA), or ecstasy is a recreational drug of abuse. It is a synthetic substance that affects the body’s systems, which its mechanism of action and treatment should be more investigated. MDMA provides an immediate enjoyable feeling by stimulating the release of neurotransmitters, such as dopamine and serotonin in the brain. Unfortunately, abnormal regulation of the brain neurotransmitters, as well as the increased oxidative stress causes damage to the brain neurons after the MDMA exposure. Only a few studies have been done regarding its treatment. Thus, the treatment of MDMA complications should be further explored mainly by targeting its mechanism of action in the neurotransmitter systems. Hence, this study presents a short review regarding the recent findings on the role of neurotransmitters to cause MDMA neurotoxicity. The results will be useful for future research in elucidating the potential treatment based on the targeted mechanisms to treat the neurotoxic effects of MDMA.
Collapse
Affiliation(s)
- Nor Suliana Mustafa
- Centre for Research in Addiction (CentRenA), University of Sultan Zainal Abidin, Terengganu, Malaysia.,Faculty of Medicine, City Campus, University of Sultan Zainal Abidin, Terengganu, Malaysia
| | - Nor Hidayah Abu Bakar
- Centre for Research in Addiction (CentRenA), University of Sultan Zainal Abidin, Terengganu, Malaysia.,Faculty of Medicine, City Campus, University of Sultan Zainal Abidin, Terengganu, Malaysia
| | - Nasir Mohamad
- Centre for Research in Addiction (CentRenA), University of Sultan Zainal Abidin, Terengganu, Malaysia.,Faculty of Medicine, City Campus, University of Sultan Zainal Abidin, Terengganu, Malaysia
| | - Liyana Hazwani Mohd Adnan
- Centre for Research in Addiction (CentRenA), University of Sultan Zainal Abidin, Terengganu, Malaysia.,Faculty of Medicine, City Campus, University of Sultan Zainal Abidin, Terengganu, Malaysia
| | - Nurul Farah Aina Md Fauzi
- Centre for Research in Addiction (CentRenA), University of Sultan Zainal Abidin, Terengganu, Malaysia.,Faculty of Medicine, City Campus, University of Sultan Zainal Abidin, Terengganu, Malaysia
| | - Abdulsoma Thoarlim
- Centre for Research in Addiction (CentRenA), University of Sultan Zainal Abidin, Terengganu, Malaysia.,Faculty of Islamic Contemporary Studies, University of Sultan Zainal Abidin, Terengganu, Malaysia
| | - Syed Hadzrullathfi Syed Omar
- Centre for Research in Addiction (CentRenA), University of Sultan Zainal Abidin, Terengganu, Malaysia.,Research Institute for Islamic Products, Malay Civilization University of Sultan Zainal Abidin, Terengganu, Malaysia
| | - Mohd Shafiee Hamzah
- Faculty of Medicine, City Campus, University of Sultan Zainal Abidin, Terengganu, Malaysia.,Faculty of Islamic Contemporary Studies, University of Sultan Zainal Abidin, Terengganu, Malaysia
| | - Zawawi Yusoff
- Faculty of Medicine, City Campus, University of Sultan Zainal Abidin, Terengganu, Malaysia.,Faculty of Islamic Contemporary Studies, University of Sultan Zainal Abidin, Terengganu, Malaysia
| | - Mahdi Jufri
- Faculty of Pharmacy, University of Indonesia, Indonesia
| | - Rashidi Ahmad
- Academic Unit of Emergency Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
3
|
García-Pardo M, LLansola M, Felipo V, De la Rubia Ortí J, Aguilar M. Blockade of nitric oxide signalling promotes resilience to the effects of social defeat stress on the conditioned rewarding properties of MDMA in mice. Nitric Oxide 2020; 98:29-32. [DOI: 10.1016/j.niox.2020.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/06/2020] [Accepted: 03/01/2020] [Indexed: 12/15/2022]
|
4
|
Aguilar MA, García-Pardo MP, Parrott AC. Of mice and men on MDMA: A translational comparison of the neuropsychobiological effects of 3,4-methylenedioxymethamphetamine ('Ecstasy'). Brain Res 2020; 1727:146556. [PMID: 31734398 DOI: 10.1016/j.brainres.2019.146556] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 11/09/2019] [Accepted: 11/12/2019] [Indexed: 11/19/2022]
Abstract
MDMA (3,4-methylendioxymethamphetamine), also known as Ecstasy, is a stimulant drug recreationally used by young adults usually in dance clubs and raves. Acute MDMA administration increases serotonin, dopamine and noradrenaline by reversing the action of the monoamine transporters. In this work, we review the studies carried out over the last 30 years on the neuropsychobiological effects of MDMA in humans and mice and summarise the current knowledge. The two species differ with respect to the neurochemical consequences of chronic MDMA, since it preferentially induces serotonergic dysfunction in humans and dopaminergic neurotoxicity in mice. However, MDMA alters brain structure and function and induces hormonal, psychomotor, neurocognitive, psychosocial and psychiatric outcomes in both species, as well as physically damaging and teratogen effects. Pharmacological and genetic studies in mice have increased our knowledge of the neurochemical substrate of the multiple effects of MDMA. Future work in this area may contribute to developing pharmacological treatments for MDMA-related disorders.
Collapse
Affiliation(s)
- Maria A Aguilar
- Department of Psychobiology, Faculty of Psychology, Valencia University, Valencia, Spain.
| | | | - Andrew C Parrott
- Department of Psychology, Swansea University, Swansea, United Kingdom; Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia
| |
Collapse
|
5
|
Schiavone S, Neri M, Maffione AB, Frisoni P, Morgese MG, Trabace L, Turillazzi E. Increased iNOS and Nitrosative Stress in Dopaminergic Neurons of MDMA-Exposed Rats. Int J Mol Sci 2019; 20:E1242. [PMID: 30871034 PMCID: PMC6429174 DOI: 10.3390/ijms20051242] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 02/28/2019] [Accepted: 03/05/2019] [Indexed: 12/29/2022] Open
Abstract
Several mechanisms underlying 3,4-Methylenedioxy-N-methylamphetamine (MDMA) neurotoxicity have been proposed, including neurochemical alterations and excitotoxicity mediated by reactive oxygen species (ROS), nitric oxide (NO), and reactive nitrogen species (RNS). However, ROS, NO, and RNS sources in the brain are not fully known. We aimed to investigate possible alterations in the expression of the ROS producer NOX enzymes (NOX2, NOX1, and NOX4), NO generators (iNOS, eNOS, and nNOS), markers of oxidative (8-hydroxy-2'-deoxyguanosine, 8OHdG), and nitrosative (3-nitrotyrosine, NT) stress, as well as the colocalization between cells positive for the dopamine transporter (DT1) and cells expressing the neuronal nuclei (NeuN) marker, in the frontal cortex of rats receiving saline or MDMA, sacrificed 6 h, 16 h, or 24 h after its administration. MDMA did not affect NOX2, NOX1, and NOX4 immunoreactivity, whereas iNOS expression was enhanced. The number of NT-positive cells was increased in MDMA-exposed animals, whereas no differences were detected in 8OHdG expression among experimental groups. MDMA and NT markers colocalized with DT1 positive cells. DT1 immunostaining was found in NeuN-positive stained cells. Virtually no colocalization was observed with microglia and astrocytes. Moreover, MDMA immunostaining was not found in NOX2-positive cells. Our results suggest that iNOS-derived nitrosative stress, but not NOX enzymes, may have a crucial role in the pathogenesis of MDMA-induced neurotoxicity, highlighting the specificity of different enzymatic systems in the development of neuropathological alterations induced by the abuse of this psychoactive compound.
Collapse
Affiliation(s)
- Stefania Schiavone
- Department of Clinical and Experimental Medicine, University of Foggia, Via Napoli, 20, 71122 Foggia, Italy.
| | - Margherita Neri
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Via Fossato di Mortara, 70, 44100 Ferrara, Italy.
| | - Angela Bruna Maffione
- Department of Clinical and Experimental Medicine, University of Foggia, Via Napoli, 20, 71122 Foggia, Italy.
| | - Paolo Frisoni
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Via Fossato di Mortara, 70, 44100 Ferrara, Italy.
| | - Maria Grazia Morgese
- Department of Clinical and Experimental Medicine, University of Foggia, Via Napoli, 20, 71122 Foggia, Italy.
| | - Luigia Trabace
- Department of Clinical and Experimental Medicine, University of Foggia, Via Napoli, 20, 71122 Foggia, Italy.
| | - Emanuela Turillazzi
- Section of Legal Medicine, Department of Surgical, Medical, Molecular and Critical Pathology, University of Pisa, Via Roma 55, 56126 Pisa, Italy.
| |
Collapse
|
6
|
Duraffourd C, Huckstepp RTR, Braren I, Fernandes C, Brock O, Delogu A, Prysyazhna O, Burgoyne J, Eaton P. PKG1α oxidation negatively regulates food seeking behaviour and reward. Redox Biol 2018; 21:101077. [PMID: 30593979 PMCID: PMC6306694 DOI: 10.1016/j.redox.2018.101077] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/06/2018] [Accepted: 12/11/2018] [Indexed: 12/20/2022] Open
Abstract
Genes that are highly conserved in food seeking behaviour, such as protein kinase G (PKG), are of interest because of their potential role in the global obesity epidemic. PKG1α can be activated by binding of cyclic guanosine monophosphate (cGMP) or oxidant-induced interprotein disulfide bond formation between the two subunits of this homodimeric kinase. PKG1α activation by cGMP plays a role in reward and addiction through its actions in the ventral tegmental area (VTA) of the brain. ‘Redox dead’ C42S PKG1α knock-in (KI) mice, which are fully deficient in oxidant-induced disulfide-PKG1α formation, display increased food seeking and reward behaviour compared to wild-type (WT) littermates. Rewarding monoamines such as dopamine, which are released during feeding, are metabolised by monoamine oxidase to generate hydrogen peroxide that was shown to mediate PKG1α oxidation. Indeed, inhibition of monoamine oxidase, which prevents it producing hydrogen peroxide, attenuated PKG1α oxidation and increased sucrose preference in WT, but not KI mice. The deficient reward phenotype of the KI mice was rescued by expressing WT kinase that can form the disulfide state in the VTA using an adeno-associated virus, consistent with PKG1α oxidation providing a break on feeding behaviour. In conclusion, disulfide-PKG1α in VTA neurons acts as a negative regulator of feeding and therefore may provide a novel therapeutic target for obesity.
Collapse
Affiliation(s)
- Celine Duraffourd
- King's College London, School of Cardiovascular Medicine & Sciences, the Rayne Institute, St. Thomas' Hospital, London SE1 7EH, United Kingdom
| | | | - Ingke Braren
- University Medical Center Eppendorf, Vector Facility, Inst. for Exp. Pharmacology and Toxikology, N30, Room 09, Martinistr. 52, 20246 Hamburg, Germany
| | - Cathy Fernandes
- SGDP Research Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; MRC Centre for Neurodevelopmental Disorders, King's College London, London, United Kingdom
| | - Olivier Brock
- Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Alessio Delogu
- Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Oleksandra Prysyazhna
- King's College London, School of Cardiovascular Medicine & Sciences, the Rayne Institute, St. Thomas' Hospital, London SE1 7EH, United Kingdom
| | - Joseph Burgoyne
- King's College London, School of Cardiovascular Medicine & Sciences, the Rayne Institute, St. Thomas' Hospital, London SE1 7EH, United Kingdom
| | - Philip Eaton
- King's College London, School of Cardiovascular Medicine & Sciences, the Rayne Institute, St. Thomas' Hospital, London SE1 7EH, United Kingdom.
| |
Collapse
|
7
|
García‐Pardo MP, Miñarro J, Llansola M, Felipo V, Aguilar MA. Role ofNMDAandAMPAglutamatergic receptors in the effects of social defeat on the rewarding properties ofMDMAin mice. Eur J Neurosci 2018; 50:2623-2634. [DOI: 10.1111/ejn.14190] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 09/14/2018] [Accepted: 09/20/2018] [Indexed: 12/12/2022]
Affiliation(s)
- M. P. García‐Pardo
- Unidad de Investigación Psicobiología de las Drogodependencias Departamento de Psicobiología Facultad de Psicología Universidad de Valencia Avda. Blasco Ibáñez, 21 46010 Valencia Spain
- Unitat Predepartamental de Medicina Facultat de Ciències de la Salut Universitat Jaume I. Castelló de la Plana Castelló Spain
| | - J. Miñarro
- Unidad de Investigación Psicobiología de las Drogodependencias Departamento de Psicobiología Facultad de Psicología Universidad de Valencia Avda. Blasco Ibáñez, 21 46010 Valencia Spain
| | - M. Llansola
- Laboratory of Neurobiology Centro Investigación Príncipe Felipe Valencia Spain
| | - V. Felipo
- Laboratory of Neurobiology Centro Investigación Príncipe Felipe Valencia Spain
| | - M. A. Aguilar
- Unidad de Investigación Psicobiología de las Drogodependencias Departamento de Psicobiología Facultad de Psicología Universidad de Valencia Avda. Blasco Ibáñez, 21 46010 Valencia Spain
| |
Collapse
|
8
|
García-Pardo M, Miñarro J, Aguilar M. Role of AMPA glutamate receptors in the conditioned rewarding effects of MDMA in mice. Behav Brain Res 2018. [DOI: 10.1016/j.bbr.2018.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
9
|
Costa G, Morelli M, Simola N. Repeated Administration of 3,4-Methylenedioxymethamphetamine (MDMA) Elevates the Levels of Neuronal Nitric Oxide Synthase in the Nigrostriatal System: Possible Relevance to Neurotoxicity. Neurotox Res 2018; 34:763-768. [PMID: 29629511 DOI: 10.1007/s12640-018-9892-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 03/01/2018] [Accepted: 03/20/2018] [Indexed: 12/12/2022]
Abstract
Previous studies have consistently demonstrated that the amphetamine-related drug 3,4-methylenedioxymethamphetamine (MDMA) induces dopaminergic damage in the mouse brain, and that this effect is most marked in the nigrostriatal system. Moreover, it has been suggested that the overproduction of nitric oxide (NO) may participate in the dopaminergic damage induced by MDMA. To further elucidate this issue, we evaluated the levels of the enzyme nitric oxide synthase (nNOS), which catalyzes the production of NO, in mice treated with regimens of MDMA that induce progressive and persistent neurotoxicity in the dopaminergic nigrostriatal system. Mice received 14, 28, or 36 administrations of MDMA (10 mg/kg i.p.), twice a day/twice a week, and were sacrificed at different time-points after treatment discontinuation. Thereafter, the number of nNOS-positive neurons was quantified by immunohistochemistry in the caudate-putamen (CPu) and substantia nigra pars compacta (SNc). MDMA elevated the numbers of nNOS-positive neurons in the CPu of mice that received 28 or 36 drug administrations. This effect was still detectable at 3 months after treatment discontinuation. Moreover, MDMA elevated the numbers of nNOS-positive neurons in the SNc. However, this effect occurred only in mice that received 28 drug administrations and were sacrificed 3 days after treatment discontinuation. These results are in line with the hypothesis that activation of the NO cascade participates in the toxic effects induced by MDMA in the dopaminergic nigrostriatal system. Moreover, they suggest that activation of the NO cascade induces toxic effects that are more marked in striatal terminals, compared with nigral neurons.
Collapse
Affiliation(s)
- Giulia Costa
- Department of Biomedical Sciences, Section of Neuropsychopharmacology, University of Cagliari, Building A, Monserrato University Campus, SP 8, Km 0.700, 09042, Monserrato, Italy
| | - Micaela Morelli
- Department of Biomedical Sciences, Section of Neuropsychopharmacology, University of Cagliari, Building A, Monserrato University Campus, SP 8, Km 0.700, 09042, Monserrato, Italy. .,National Research Council of Italy (CNR), Neuroscience Institute, Cagliari, Italy. .,National Institute of Neuroscience (INN), University of Cagliari, Cagliari, Italy.
| | - Nicola Simola
- Department of Biomedical Sciences, Section of Neuropsychopharmacology, University of Cagliari, Building A, Monserrato University Campus, SP 8, Km 0.700, 09042, Monserrato, Italy.,National Institute of Neuroscience (INN), University of Cagliari, Cagliari, Italy
| |
Collapse
|