Interesting. I thought that oxidative stress mediated the neurotoxicity of methamphetamine. (i.e. taking a megadose of vitamin c or ALA would ameliorate nearly all the neurotoxicity from the free radicals that reulted from breakdown of massively elevated dopamine). What mechanism enables 5HT to enhance the neurotoxic potential?
One of the most prominent hypotheses about the neurotoxicity of dopamine +/- serotonin releasers is that dopamine itself is "toxic," spontaneously oxidizing and producing free radicals (via dopamine quinone) within the cytoplasm of the presynaptic neuron as well as within the synapse (I believe as to the location, but correct me if I'm wrong). Thus, if dopamine release is increased, the amount of free radicals produced increases, increasing oxidative stress, modifying proteins and producing free radical chain reactions, which is thought to underly the neurotoxicity.
Where does serotonin comes in, you ask? Well it is known that serotonin, dopamine, and norepinephrine are relatively similar in chemical structure and functional groups. In vitro studies have shown that serotonin, dopamine, and norepinephrine transporters can each transport all 3 monoamines across the axon terminal membrane, although each transporter transports monoamines other than the one it is named for with a lower potency than it transports the monoamine it is named for. Thus, serotonin transporter (SERT) transports dopamine, but at normal levels it does so only slightly because SERT doesn't bind dopamine particularly tightly and because there is competition for transport with serotonin. But when dopamine levels rise and/or serotonin levels decrease, the amount of dopamine transported by SERT increases.
Now, to put it all together. Some researchers hypothesize (with pretty strong evidence) that once a large proportion of vesicular serotonin is depleted from serotonin neurons by a serotonin releaser (like MDMA, which seems to readily deplete vesicular serotonin stores in animal models; some evidence suggests that meth releases serotonin though that is not well-established) and the serotonin is cleared from the synapse by metabolism or diffusion, there is little competition for dopamine to bind to and be transported by SERT into serotonin axon terminals, so dopamine is transported into serotonin neurons. Furthermore, the elevated dopamine levels in the area of the serotonin neuron axon terminals due to considerable release of dopamine by MDMA or meth further increases the rate of transport across the serotonin axon terminal membrane. Serotonin neurons are well-known to be much more sensitive to many kinds of insults and damage than catecholamine (dopamine and norepinephrine) neurons, so the increased oxidative stress inside these serotonin neuron axon terminals caused by the high dopamine concentrations within them damages the neurons. This is hypothesized to be a primary source of neurotoxicity of MDMA and, some think, meth. This makes sense since the neurotoxicity is thought to be largely damage to serotonin neurons, as evidenced by decreased expression of SERT protein and SERT availability as well as decreased serotonin content of the brain in animal studies of neurotoxic regimens of MDMA. In addition, under these conditions, serotonin neuron axons often retract from the cerebral cortex back towards their cell bodies in the raphe nuclei in the brainstem.
Therefore, serotonin doesn't enhance the neurotoxic potential of dopamine releasers, but the depletion of serotonin does!
-Jaguraguguru