Sympathetic activation and thermoregulatory dysregulation in MDMA-induced hyperthermia. (IMAGE)
Caption
Sympathetic activation and thermoregulatory dysregulation in MDMA-induced hyperthermia. MDMA acutely elevates central monoamines (serotonin, norepinephrine, and dopamine), producing sympathetic hyperactivation that increases heart rate and blood pressure, induces peripheral vasoconstriction, and amplifies muscle activity (e.g., jaw clenching and tremor), thereby raising metabolic heat production. Concurrent thermoregulatory impairment—including reduced sweating and cutaneous heat loss—combined with environmental/behavioral stressors (crowded, warm venues; prolonged exertion) limits heat dissipation and precipitates hyperthermia. Emerging evidence also links MDMA to gut microbiota dysbiosis and altered bile acid profiles, which may further influence thermogenesis and heat clearance
Credit
Kenji Hashimoto
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CC BY