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Vasopressin and oxytocin secretion in response to the consumption of ecstasy in a clubbing population

Kingís College London, National Addiction Centre, Institute of Psychiatry, London, UK

E. M. Tsapakis

MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, London, UK

A. R. Winstock

National Addiction Centre, Institute of Psychiatry, London, UK

D. Hartley

Neuroendocrine Laboratory, GKT School of Medicine, Guys Campus, London, UK

D. Holt

Analytical Unit, St Georgeís Hospital Medical School, London, UK

M. L. Forsling

Neuroendocrine Laboratory, GKT School of Medicine, Guys Campus, London, UK

K. J. Aitchison

MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, London, UK

Despite the common use of MDMA (ecstasy) in the UK, the mechanism underlying associated potentially fatal cerebral oedema is unclear. We used a new experimental approach working directly with clubbers to perform a study on 30 (17 male) experienced clubbers (mean 6.6 years of clubbing). Pre and post-clubbing measurements were performed to compare plasma levels of pituitary hormones (vasopressin, oxytocin), plasma and urine osmolality, urinary pH, and plasma sodium and urea. Ecstasy consumption was con.rmed by using urinary drug screening preand post-clubbing. MDMA was detected in the urine samples of 17 subjects, three of which tested positive during pre-clubbing tests. Mean plasma vasopressin concentration increased in the MDMA group (1.28 ± 0.29 to 1.43 ± 0.41 pmol/l), but fell in other participants (1.23 ± 0.42 to 1.16 ± 0.0.34 pmol/l). Similarly, mean plasma oxytocin concentrations increased after ingestion of MDMA (2.02 ± 0.29 to 2.43 ± 0.24 pmol/l), but fell in the group that did not use MDMA (2.17 ± 0.36 pmol/l to 1.89 ± 0.37 pmol/l). There was a significant group by time interaction for plasma osmolality and plasma sodium (p= 0.001 and p= 0.003, respectively) and between change in urinary osmolality (p< 0.001) and MDMA use, with the pattern of change being consistent with the induction of inappropriate vasopressin secretion (also known as SIADH) by MDMA. This report demonstrates SIADH in ecstasy-using ‘clubbers’, which has important clinical implications.

Key Words: MDMA • ecstasy • water homeostasis • pituitary hormones • vasopressin • oxytocin • clubbing

Journal of Psychopharmacology, Vol. 20, No. 3, 400-410 (2006)
DOI: 10.1177/0269881106061514


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