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In cellular models, MDMA evoked an elevation of Bax, cleaved Bid, Puma, Bak and Bim protein levels, which was accompanied by a release of cytochrome c from the mitochondria and cleavage of the apoptosis inducing factor (Montiel-Duarte et al., 2002, Jiménez et al., 2004, Capela et al., 2013, Dias da Silva et al., 2013)

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It has also been proposed that itaconate modifies and inhibits the activity of mitochondrial isocitrate dehydrogenase (IDH2), therefore restraining the production of itaconate itself by reducing the supply of its precursor, isocitrate, via reductive carboxylation 21