Interactions between 3,4-methylenedioxymethamphetamine and ethanol in humans and rodents

Methylenedioxymethamphetamine (MDMA, ecstasy) is a widely used recreational drug, often associated with dance parties. Users self-report euphoria, a sense of well-being and increased feelings of affiliation. In experimental animals, MDMA produces an acute, rapid release of serotonin and, to a lesser extent, dopamine and norepinephrine in the brain. It can also produce a dose-dependent, life-threatening hyperthermia in rodents, primates and humans. Moreover, there is evidence of long-term neurological and psychological effects in heavy users. In rats, MDMA increases the locomotor activity. When used recreationally, MDMA is often taken with other drugs including amphetamine, cannabis, cocaine or ethanol (EtOH). Epidemiological data suggest that MDMA-EtOH is one of the most common combinations. In rats, EtOH potentiates MDMA-induced hyperactivity but may attenuate its hyperthermic effect, depending on the ambient temperature. The possibility that EtOH may modify the pharmacokinetics and pharmadynamics of MDMA is of concern in terms of liability for misuse abuse. In this short review, we focus on the known interactions between MDMA and EtOH in humans and rodents.