Ecstasy intoxication: the toxicological basis for treatment

Abstract

Youngsters are increasingly using 3,4 methylenedioxymethamphetamine, known as ecstasy, because it is wrongly believed that it does not induce harm. However, there are many reports of adverse effects, including acute intoxication, abuse potential, and possible neurotoxic effects. Therefore, health care providers need to promptly recognize the symptoms of systemic intoxication in order to initiate early treatment. The drug is used by the oral route for long hours during crowded dance parties. Acutely, ecstasy increases the release of serotonin and decreases its reuptake, leading to hypertension, hyperthermia, trismus, and vomiting. There is debate on whether recreational doses of ecstasy cause permanent damage to human serotonergic neurons. Ecstasy users showed a high risk of developing psychopathological disturbances. The prolonged use of ecstasy might induce dependence, characterized by tolerance and hangover. Acute ecstasy intoxication needs emergency-type treatment to avoid the dose-dependent increase in adverse reactions and in severity of complications. There are no specific antidotes to be used during acute intoxication. Supportive measures and medical treatment for each one of the complications should be implemented, keeping in mind that symptoms originate mainly from the central nervous system and the cardiovascular system.

3,4-methylenedioxymethamphetamine (MDMA): current perspectives

“…However, users who present with signs of MDMA overdose must first be treated for the symptoms of acute drug intoxication, which may entail the administration of appropriate medications. 139 …”

Cocaine and the Club Drugs

“…37 The drug produces euphoria, heightened alertness, increased emotional lability, and sexual arousal. 38 Serotonin stores are depleted by MDMA and repeated doses are associated with increased adverse effects with less desirable effects (eg, euphoria).…”

“What goes up must go down”: An exploration of the relationship between drug-related pleasure and harm experienced by a sample of regular “party drug” users

“…At the same time, party drug use has been linked to negative outcomes such as short-term memory loss, problems with concentration and low mood and depression in the days(s) following use (Gouzoulous-Mayfrank & Daumann, 2006;Gowing, Henry-Edwards, Irvine, & Ali, 2002), as well acute consequences such as increased blood pressure and heart rate, hypertension, hyperthermia, hyponatremia, tremors, irritability, anxiety, paranoia, aggression, fatigue, nausea, decreased appetite, dehydration and trismus (Britt & McCance-Katz, 2005;Degenhardt, Copeland, & Dillon, 2005;Ferigolo, Machado, Oliveira, & Barros, 2003).…”