Pharmacogenetic studies of change in cortisol on ecstasy (MDMA) consumption

• Published in: Journal of psychopharmacology (Oxford) Vol. 26; no. 3; pp. 419 - 428
• Main Authors: Wolff, Kim, Tsapakis, Evangelia M, Pariante, Carmine M, Kerwin, Robert W, Forsling, Mary L, Aitchison, Katherine J
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-03-2012; Sage Publications Ltd
• Subjects: Adult; Amino Acid Substitution; Biomarkers - blood; Biotransformation; Catechol O-Methyltransferase - genetics; Catechol O-Methyltransferase - metabolism; Cohort Studies; Cytochrome P-450 CYP2D6 - genetics; Cytochrome P-450 CYP2D6 - metabolism; Drug use; Ecstasy; Female; Genetic Association Studies; Genotype & phenotype; Humans; Hydrocortisone - blood; Hypothalamo-Hypophyseal System - drug effects; Hypothalamo-Hypophyseal System - physiopathology; Illicit Drugs - pharmacokinetics; Illicit Drugs - toxicity; Illicit Drugs - urine; Male; N-Methyl-3,4-methylenedioxyamphetamine - pharmacokinetics; N-Methyl-3,4-methylenedioxyamphetamine - toxicity; N-Methyl-3,4-methylenedioxyamphetamine - urine; Neurotoxicity Syndromes - blood; Neurotoxicity Syndromes - genetics; Neurotoxicity Syndromes - metabolism; Neurotoxicity Syndromes - physiopathology; Pituitary-Adrenal System - drug effects; Pituitary-Adrenal System - physiopathology; Polymorphism; Polymorphism, Genetic; Polymorphism, Single Nucleotide; Psychopharmacology; Serotonin Plasma Membrane Transport Proteins - genetics; Serotonin Plasma Membrane Transport Proteins - metabolism; Steroids; Young Adult; genetic; recreational drugs; cortisol; glucocorticoid; CYP2D6; N-methyl-3; serotonin transporter; ecstasy; Catechol O-methyltransferase (COMT); polymorphism; 4-methylenedioxyamphetamine (MDMA)
• ISSN: 0269-8811; 1461-7285
• DOI: 10.1177/0269881111415737

In this study we investigate the association of cytochrome P450 enzyme CYP2D6, catechol-O-methyl transferase (COMT, Val158Met) and serotonin transporter promoter (5-HTTLPR) genotypes on change in cortisol concentration following 3, 4-methylenedioxy-methamphetamine (MDMA, ‘ecstasy’) consumption. Forty-eight subjects (30 males, mean age 23 years), self-nominating regular clubbers provided ‘in the field’ pre- and post-clubbing biological samples and associated information. Of the 39 subjects who provided a post-clubbing urine sample, 21 were positive for MDMA. Plasma cortisol concentrations increased in subjects (n = 48) tested for cortisol, with changes being significantly greater in the MDMA-positive group (736.9 ± 83.2 vs. 350.9 ± 34.5 mmol/l, p = 0.001). We found a positive association between the low activity COMT genotype (Met/Met) and MDMA-induced change in cortisol and also between this and change in cortisol in the whole sample (p = 0.039, Bonferroni corrected). For CYP2D6, there was an association between genotype and change in cortisol, confined to subjects with MDMA-positive urine post-clubbing (p = 0.003, Bonferroni corrected). There was no association with 5-HTTLPR genotype. These associations suggest that chronic use of MDMA may lead to HPA axis dysregulation and that the magnitude of this may be moderated by genetic polymorphism, and warrant further investigation in a larger sample of those who consume the drug on a regular basis.