Plasma levels of parent compound and metabolites after doses of either d-fenfluramine or d-3,4-methylenedioxymethamphetamine (MDMA) that produce long-term serotonergic alterations.

Plasma levels of parent compounds and metabolites were determined in adult rhesus monkeys after doses of either 5mg/kg d-fenfluramine (FEN) or 10mg/kg d-3, 4-methylenedioxymethamphetamine (MDMA) i.m. twice daily for four consecutive days. These treatment regimens have been previously shown to produce long-term serotonin (5-HT) depletions. Peak plasma levels of 2.0+/-0.4 microM FEN were reached within 40min after the first dose of FEN, and then declined rapidly, while peak plasma levels (0.4+/-0.1 microM) of the metabolite norfenfluramine (NFEN) were not reached until 6h after dosing. After the seventh (next to last) dose of FEN, peak plasma levels of FEN were 35% greater than after the first dose while peak NFEN-levels were 500% greater. The t(1/2) for FEN was 2.6+/-0.3h after the first dose and 3.2+/-0.2h after the seventh. The estimated t(1/2) for NFEN was more than 37.6+/-20.5h. Peak plasma levels of 9.5+/-2.5 microM MDMA were reached within 20min after the first dose of MDMA, and then declined rapidly, while peak plasma levels (0.9+/-0.2 microM) of the metabolite 3,4-methylenedioxyamphetamine (MDA) were not reached until 3-6h after dosing. After the seventh (next to last) dose of MDMA, peak plasma levels of MDMA were 30% greater than the first dose while peak MDA levels were elevated over 200%. The t(1/2) for MDMA was 2.8+/-0.4h after the first and 3.9+/-1.1h after the seventh dose. The estimated t(1/2) for MDA was about 8.3+/-1.0h. Variability in plasma levels of MDMA and MDA between subjects was much greater than that for FEN and NFEN. This variability in MDMA and MDA exposure levels may have lead to variability in the subsequent disruption of some behaviors seen in these same subjects. There were 80% reductions in the plasma membrane-associated 5-HT transporters 6 months after either the FEN or MDMA dosing regimen indicating that both treatments produced long-term serotonergic effects.

[1]  R. de la Torre,et al.  Cardiovascular and neuroendocrine effects and pharmacokinetics of 3, 4-methylenedioxymethamphetamine in humans. , 1999, The Journal of pharmacology and experimental therapeutics.

[2]  Z. Szabo,et al.  Positron emission tomographic evidence of toxic effect of MDMA (“Ecstasy”) on brain serotonin neurons in human beings , 1998, The Lancet.

[3]  W. Slikker,et al.  Acute effects of delta-9-tetrahydrocannabinol in rhesus monkeys as measured by performance in a battery of complex operant tests. , 1988, The Journal of pharmacology and experimental therapeutics.

[4]  W Slikker,et al.  Risk assessment for neurotoxic effects. , 1990, Neurotoxicology.

[5]  W. Slikker,et al.  Neurochemical and neurohistological alterations in the rat and monkey produced by orally administered methylenedioxymethamphetamine (MDMA). , 1988, Toxicology and applied pharmacology.

[6]  P. Milligan,et al.  Stereospecific analysis and enantiomeric disposition of 3, 4-methylenedioxymethamphetamine (Ecstasy) in humans. , 1999, Clinical chemistry.

[7]  G. Hanson,et al.  Long-term alteration in the central monoaminergic systems of the rat by 2,4,5-trihydroxyamphetamine but not by 2-hydroxy-4,5-methylenedioxymethamphetamine or 2-hydroxy-4,5-methylenedioxyamphetamine. , 1992, European journal of pharmacology.

[8]  John F. Young,et al.  Analysis of Methylmercury Disposition in Humans Utilizing A PBPK Model and Animal Pharmacokinetic Data , 2001, Journal of toxicology and environmental health. Part A.

[9]  J. Bowyer,et al.  Determination of D-fenfluramine, D-norfenfluramine and fluoxetine in plasma, brain tissue and brain microdialysate using high-performance liquid chromatography after precolumn derivatization with dansyl chloride. , 1997, Journal of chromatography. B, Biomedical sciences and applications.

[10]  M. Kalia Reversible, short-lasting, and dose-dependent effect of (+)-fenfluramine on neocortical serotonergic axons , 1991, Brain Research.

[11]  B. Clineschmidt,et al.  Fenfluramine: long-term reduction in brain serotonin (5-hydroxytryptamine). , 1976, European journal of pharmacology.

[12]  E. Wouters,et al.  Pulmonary hypertension and fenfluramine. , 1990, The European respiratory journal.

[13]  L. Seiden,et al.  Role of hypothermia in the mechanism of protection against serotonergic toxicity. I. Experiments using 3,4-methylenedioxymethamphetamine, dizocilpine, CGS 19755 and NBQX. , 1995, The Journal of pharmacology and experimental therapeutics.

[14]  Toxicity of methylenedioxymethamphetamine (MDMA) in the dog and the rat , 1987 .

[15]  S. Peroutka,et al.  Subjective effects of 3,4-methylenedioxymethamphetamine in recreational users. , 1988, Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology.

[16]  S. Labrune,et al.  Pulmonary hypertension and dexfenfluramine , 1992, The Lancet.

[17]  A. Poklis,et al.  Distribution of 3,4-methylenedioxymethamphetamine (MDMA) and 3,4-methylenedioxyamphetamine (MDA) stereoisomers in a fatal poisoning. , 1996, Forensic science international.

[18]  J. Marcusson,et al.  Characterization of [3H]Paroxetine Binding in Rat Brain , 1988, Journal of neurochemistry.

[19]  M. Paule Use of the NCTR Operant Test Battery in nonhuman primates. , 1990, Neurotoxicology and teratology.

[20]  R. Weindruch,et al.  Calorie restriction lowers body temperature in rhesus monkeys, consistent with a postulated anti-aging mechanism in rodents. , 1996, Proceedings of the National Academy of Sciences of the United States of America.

[21]  L. Seiden,et al.  Effect of depletion of brain serotonin by repeated fenfluramine on neurochemical and anorectic effects of acute fenfluramine. , 1988, The Journal of pharmacology and experimental therapeutics.

[22]  J. Piette,et al.  Pulmonary hypertension and dexfenfluramine , 2004, European Journal of Clinical Pharmacology.

[23]  A. Cho,et al.  Disposition of methylenedioxymethamphetamine and three metabolites in the brains of different rat strains and their possible roles in acute serotonin depletion. , 1996, Biochemical pharmacology.

[24]  U. McCann,et al.  Severe Dopaminergic Neurotoxicity in Primates After a Common Recreational Dose Regimen of MDMA ("Ecstasy") , 2002, Science.

[25]  W. Ritschel AUC-RPP: BASIC computer program for compartment model independent pharmacokinetic analysis. , 1986, Methods and findings in experimental and clinical pharmacology.

[26]  J. O'Callaghan,et al.  Environment-, drug- and stress-induced alterations in body temperature affect the neurotoxicity of substituted amphetamines in the C57BL/6J mouse. , 1994, The Journal of pharmacology and experimental therapeutics.

[27]  A. Crane,et al.  Regional distribution of monoamines in the cerebral cortex and subcortical structures of the rhesus monkey: concentrations and in vivo synthesis rates , 1979, Brain Research.

[28]  L. Seiden,et al.  Administration of fenfluramine at different ambient temperatures produces different core temperature and 5-HT neurotoxicity profiles , 1997, Brain Research.

[29]  U. McCann,et al.  Dexfenfluramine and serotonin neurotoxicity: further preclinical evidence that clinical caution is indicated. , 1994, The Journal of pharmacology and experimental therapeutics.

[30]  G. Cimbura 3,4-methylenedioxyamphetamine (MDA): analytical and forensic aspects of fatal poisoning. , 1972, Journal of forensic sciences.

[31]  R. Byard,et al.  Amphetamine derivative fatalities in South Australia--is "Ecstasy" the culprit? , 1998, The American journal of forensic medicine and pathology.

[32]  A. G. Zacchei,et al.  FENFLURAMINE AND BRAIN SEROTONIN , 1978, Annals of the New York Academy of Sciences.

[33]  U. McCann,et al.  3,4-Methylenedioxymethamphetamine (MDMA, "Ecstasy"): pharmacology and toxicology in animals and humans. , 1994, Addiction.

[34]  E. Szebenyi Atlas of Macaca mulatta , 1970 .

[35]  L. Seiden,et al.  Hallucinogenic amphetamine selectively destroys brain serotonin nerve terminals. , 1985, Science.

[36]  M. Molliver,et al.  Anatomic evidence for a neurotoxic effect of (±)-fenfluramine upon serotonergic projections in the rat , 1990, Brain Research.

[37]  O. H. Lowry,et al.  Protein measurement with the Folin phenol reagent. , 1951, The Journal of biological chemistry.

[38]  M. Wilson,et al.  Dexfenfluramine neurotoxicity in brains of non-human primates , 1991, The Lancet.

[39]  W. Slikker,et al.  Age-dependent sensitivity of rats to the long-term effects of the serotonergic neurotoxicant (+/-)-3,4-methylenedioxymethamphetamine (MDMA) correlates with the magnitude of the MDMA-induced thermal response. , 1995, The Journal of pharmacology and experimental therapeutics.

[40]  J. Osterloh,et al.  Multiple severe complications from recreational ingestion of MDMA ('Ecstasy') , 1987, JAMA.

[41]  J. Contrera,et al.  Fenfluramine selectively and differentially decreases the density of serotonergic nerve terminals in rat brain: evidence from immunocytochemical studies. , 1989, The Journal of pharmacology and experimental therapeutics.

[42]  J. Harvey,et al.  Fenfluramine: evidence for a neurotoxic action on midbrain and a long-term depletion of serotonin. , 1975, Psychopharmacology communications.

[43]  S Garattini,et al.  Oral kinetics of dexfenfluramine and dexnorfenfluramine in non-human primates. , 1995, Xenobiotica; the fate of foreign compounds in biological systems.

[44]  W. Slikker,et al.  Elevated environmental temperatures can induce hyperthermia during d-fenfluramine exposure and enhance 5-hydroxytryptamine (5-HT) depletion in the brain. , 1997, The Journal of pharmacology and experimental therapeutics.

[45]  L. Schmued,et al.  d-Fenfluramine produces neuronal degeneration in localized regions of the cortex, thalamus, and cerebellum of the rat. , 1999, Toxicological sciences : an official journal of the Society of Toxicology.

[46]  R. Walls,et al.  Toxicity of methylenedioxymethamphetamine (MDMA) in the dog and the rat. , 1987, Fundamental and applied toxicology : official journal of the Society of Toxicology.

[47]  B. Guy-grand,et al.  Dexfenfluramine and neurotoxicity. , 1992, Lancet.

[48]  R. Walsh,et al.  Phenomenology and Sequelae of 3,4-Methylenedioxymethamphetamine Use , 1992, The Journal of nervous and mental disease.

[49]  W. Slikker,et al.  Biologically based, quantitative risk assessment of neurotoxicants. , 1996, Fundamental and applied toxicology : official journal of the Society of Toxicology.

[50]  M. Paule Validation of a Behavioral Test Battery for Monkeys , 2000 .

[51]  W. Slikker,et al.  Oral administration of 3,4-methylenedioxymethamphetamine (MDMA) produces selective serotonergic depletion in the nonhuman primate. , 1993, Neurotoxicology and teratology.

[52]  T. Insel,et al.  3,4-Methylenedioxymethamphetamine ("ecstasy") selectively destroys brain serotonin terminals in rhesus monkeys. , 1989, The Journal of pharmacology and experimental therapeutics.

[53]  G. Greer,et al.  A method of conducting therapeutic sessions with MDMA. , 1998, Journal of psychoactive drugs.

[54]  J. Buccafusco Methods of Behavior Analysis in Neuroscience , 2000 .

[55]  J Weissenburger,et al.  The pharmacokinetics of dexfenfluramine in obese and non-obese subjects. , 1995, British journal of clinical pharmacology.

[56]  A. Walubo,et al.  Fatal multi-organ failure after suicidal overdose with MDMA, `Ecstasy': case report and review of the literature , 1999, Human & experimental toxicology.

[57]  S. Dawling,et al.  Toxicity and deaths from 3,4-methylenedioxymethamphetamine ("ecstasy") , 1992, The Lancet.