Mechanism of action

MDMA ingestion leads to an acute increase in central serotonergic effects by causing the calcium-dependent release of serotonin from nerve terminals. To a lesser extent there is also dopamine reuptake blockade. MDMA also results in a rapid inhibition of tryptophan hyrdroxylase, the rate-limiting enzyme in serotonin synthesis, although the mechanism of inactivation in uncertain. This is followed by acute depletion of central serotonin levels which may contribute to the fall in mood that some users notice after use.

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