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Acute Effects of R- and S-MDMA in Healthy Subjects

Phase 1
Completed
Conditions
Healthy
Interventions
Drug: R-3,4-methylenedioxymethamphetamine (250 mg)
Drug: 3,4-methylenedioxymethamphetamine
Drug: S-3,4-methylenedioxymethamphetamine
Drug: R-3,4-methylenedioxymethamphetamine (125 mg)
Other: Placebo
Registration Number
NCT05277636
Lead Sponsor
University Hospital, Basel, Switzerland
Brief Summary

Racemic ±3,4-methylenedioxymethamphetamine (MDMA) is a psychoactive substance and prototypical empathogen acutely inducing feelings of heightened mood, empathy, trust and closeness to others. These acute subjective effects of MDMA may be helpful to assist psychotherapy and MDMA is currently investigated in phase 3 trials as a possible treatment in post-traumatic stress disorder.

Detailed Description

MDMA is a racemic substance containing equal amounts of the enantiomers S(+)- and R(-)-MDMA. Preclinical research indicates that S-MDMA mainly releases dopamine, norepinephrine, serotonin, and oxytocin while R-MDMA may act more directly on 5-HT2A receptors and release prolactin. Animal studies also indicate that the two enantiomers act synergistically to produce the subjective effects of MDMA and that S-MDMA is mainly responsible for psychostimulation while R-MDMA may have fewer adverse effects and have greater prosocial effects. However, acute effects of S- and R-MDMA have never been validly examined in a human study. Therefore, the present study compares acute responses to R-MDMA, S-MDMA, MDMA, and placebo in a cross-over study in healthy subjects.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
24
Inclusion Criteria
  1. Age between 18 and 65 years.
  2. Understanding of the German language.
  3. Understanding the procedures and the risks that are associated with the study.
  4. Participants must be willing to adhere to the protocol and sign the consent form.
  5. Participants must be willing to refrain from taking illicit psychoactive substances during the study.
  6. Participants must be willing to drink only alcohol-free liquids and no coffee, black or green tea, or energy drink after midnight of the evening before the study session, as well as during the study day.
  7. Participants must be willing not to drive a traffic vehicle or to operate machines within 48 h after substance administration.
  8. Willing to use double-barrier birth control throughout study participation.
  9. Body mass index between 18-29 kg/m2.
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Exclusion Criteria
  1. Chronic or acute medical condition
  2. Current or previous major psychiatric disorder
  3. Psychotic disorder in first-degree relatives, not including psychotic disorders secondary to an apparent medical reason, e.g. brain injury, dementia, or lesions of the brain.
  4. Hypertension (SBP>140/90 mmHg) or hypotension (SBP<85 mmHg)
  5. Illicit substance use (not including cannabis) more than 20 times or any time within the previous month
  6. Pregnant or nursing women.
  7. Participation in another clinical trial (currently or within the last 30 days).
  8. Use of medications that may interfere with the effects of the study medications.
  9. Tobacco smoking (>10 cigarettes/day).
  10. Consumption of alcoholic drinks (>15 drinks/week).
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Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
250 mg R-MDMAR-3,4-methylenedioxymethamphetamine (250 mg)R-MDMA (250 mg)
125 mg MDMA3,4-methylenedioxymethamphetamineMDMA (125 mg)
125 mg S-MDMAS-3,4-methylenedioxymethamphetamineS-MDMA (125 mg)
125 mg R-MDMAR-3,4-methylenedioxymethamphetamine (125 mg)R-MDMA (125 mg)
PlaceboPlaceboPlacebo
Primary Outcome Measures
NameTimeMethod
Subjective effects I18 months

5 Dimensions of Altered States of Consciousness (5D-ASC) consisting of 94 items to be rated on a visual analog scale (0-100 mm), with higher values indicating stronger effects with higher scores representing more intense effects. Assessed once on each study day

Subjective effects II18 months

Stimulation on the Visual Analog Scales (VAS) assessing the intensity and duration of the stimulant effect on a scale from 0 - 100 percent with higher scores representing more intense effects. Assessed 18 times on each study day

Secondary Outcome Measures
NameTimeMethod
Autonomic effects I18 months

Assessed 18 times on each study day via systolic and diastolic blood pressure

Autonomic effects II18 months

Assessed 18 times on each study day via heart rate

Autonomic effects III18 months

Assessed 18 times on each study day via tympanic body temperature

Adverse effects18 months

Assessed 3 times on each study day with the list of complaints (LC)

Mood after study day I18 months

Assessed once 3 days after administration via the Beck Depressionindex questionnaire (BDI) with low values indicating normal mood and high values indicating severe depression

Mood after study day II18 months

Assessed once 3 days after administration via Symptom checklist 90R (SCL-90R) to evaluate a number of different psychological symptoms.

Mood after study day III18 months

Assessed once 3 days after administration via list of complaints (LC)

Mood after study day IV18 months

Assessed once 3 days after administration via adjective mood rating scale (AMRS)

Plasma levels of cortisol18 months

Assessed 3 times on each study day

Plasma levels of prolactin18 months

Assessed 3 times on each study day

Plasma levels of oxytocin18 months

Assessed 4 times on each study day

Plasma levels of vasopressin18 months

Assessed 4 times on each study day

Plasma levels of S-MDMA18 months

Assessed 17 times on each study day

Plasma levels of R-MDMA18 months

Assessed 17 times on each study day

Plasma levels of S-MDA18 months

Assessed 17 times on each study day

Plasma levels of R-MDA18 months

Assessed 17 times on each study day

Additional subjective effects I18 months

Visual Analog Scales (VAS) assessing the intensity and duration of subjective effects on a scale from 0 - 100 percent with higher scores representing more intense effects. Assessed 18 times on each study day

Additional subjective effects II18 months

Adjective Mood Rating Scale (AMRS) assesses the occurrence and intensity of 60 moods on a 4-point Likert scale ranging from "not at all" to "extremely" assessed 4 times on each study day

States of Consciousness Questionnaire18 months

Assesses the emergence and intensity of phenomenons occurring in altered states of consciousness on a 6-point Likert scale ranging from 0 ("not at all") to 5 ("extremely") once on each study day

Spiritual Realms Questionnaire18 months

Assesses the spiritual phenomenons elicited by psychedelic substances through 11 main questions to be answered on a total of 65 sub-ordered 100mm visual analog scales once on each study day

Psychological Insight Questionnaire18 months

Assesses the degree of psychological insight caused by a psychedelic experience through 14-items to be answered on a 6-point Likert scale ranging from 0 ("not at all") to 5 ("extremely") once on each study day

NEO-Five-Factor-Inventory (NEO-FFI)Baseline

The NEO-FFI is a self-description questionnaire with 60 items for the measurement of the "big five": neuroticism, extraversion, openness, agreeableness, and consciousness. It uses a 5-point Likert scale ranging from "completely disagree" to "fully agree".

Freiburger Personality Inventory (FPI-R)Baseline

The FPI-R version comprises 138 items and covers 12 dimensions of personality: life satisfaction, social orientation, performance orientation, inhibition, excitability, aggressiveness, stress, physical complaints, health concerns, openness, as well as the secondary factors according to Eysenck's Extraversion and Emotionality (Neuroticism). It uses a 2-point scale ("true" and "not true").

Saarbrücker Personality Questionnaire (SPF)Baseline

The SPF defines empathy as the "reactions of one individual to the observed experiences of another." It assesses 28-items on a 5-point Likert scale ranging from "Does not describe me well" to "Describes me very well". The measure has 4 subscales (Perspective Taking, Fantasy, Empathic Concern, Personal Distress) each made up of 7 different items.

HEXACO personality inventoryBaseline

The HEXACO personality inventory is a six-dimensional model of human personality with 100 items.The six factors are: Honesty-Humility, Emotionality, Extraversion, Agreeableness, Conscientiousness and Openness to Experience.

Defense Style Questionnaire (DSQ-40)Baseline

The DSQ-40 can provide scores for 20 individual defenses, and scores for the three factors "mature", "neurotic", and "immature". Each item is evaluated on a scale from 1 to 9, where "1" indicates "completely disagree" and "9" indicates "fully agree".

Trial Locations

Locations (1)

University Hospital Basel

🇨🇭

Basel, Switzerland

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