Analysis of 4-methylthioamphetamine
in clinical specimens

Elliott SP.
Regional Laboratory for Toxicology,
City Hospital NHS Trust, Birmingham, UK.
Ann Clin Biochem 2001 Jul;38(Pt 4):339-47


There has been much publicity, particularly in Europe, regarding a new phenylethylamine-based compound called 4-methylthioamphetamine (4-MTA), also known as para-methylthioamphetamine (p-MTA), MTA or 'Flatliner'. Chemically, 4-MTA is an amphetamine derivative and is a potent, non-neurotoxic serotonin-releasing agent and reversible inhibitor of rat monoamine oxidase-A. Its effects, therefore, appear different from those of amphetamine. Analysis of various plasma and urine specimens in three clinical cases implicating 'Ecstasy' ingestion revealed the presence of 4-MTA. Presumed metabolites were also detected, with one compound identified as being 4-MTA sulphoxide. The concentrations of 4-MTA measured in the plasma ranged from 0.131 mg/L to 0.760 mg/L. In one patient the 4-MTA concentration was determined in a series of plasma samples and this allowed a presumptive half-life of approximately 7 h to be estimated. This paper describes the first reported data regarding possible pharmacokinetics of 4-MTA in humans and presents the first reported non-fatal instances of 4-MTA intoxication in the UK.

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Protect and survive
4-MTA and serotonin
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Serotonin-releasing agents as fast-acting antidepressants?

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