An unusual case of Ecstasy poisoning

Hall, Andrew P.; Lyburn, I. D.; Spears, F. D.; Riley, Bernard

doi:10.1007/bf01709744

Cited by 20 publications

(10 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The highest recorded peak CPK in a survivor is 555 000 u litre À1 . 25 Denborough and Hopkinson 12 suggested that there might be a direct effect of Ecstasy on muscle. They showed some augmentation of the halothane and caffeine induced muscle contraction produced in vitro while testing muscle biopsy specimens in the investigation of possible malignant hyperthermia (MH).…”

Section: Mdma and Sudden Deathmentioning

confidence: 99%

Acute toxic effects of ‘Ecstasy’ (MDMA) and related compounds: overview of pathophysiology and clinical management

Hall

Henry

2006

British Journal of Anaesthesia

249

212

View full text Add to dashboard Cite

Since the late 1980s 'Ecstasy' (3,4-methylenedioxymethamphetamine, MDMA) has become established as a popular recreational drug in western Europe. The UK National Criminal Intelligence Service estimates that 0.5-2 million tablets are consumed weekly in Britain. It has been reported that 4.5% of young adults (15-34 yr) in the UK have used MDMA in the previous 12 months. Clinically important toxic effects have been reported, including fatalities. While the phenomenon of hyperpyrexia and multi-organ failure is now relatively well known, other serious effects have become apparent more recently. Patients with acute MDMA toxicity may present to doctors working in Anaesthesia, Intensive Care and Emergency Medicine. A broad knowledge of these pathologies and their treatment is necessary for anyone working in an acute medical speciality. An overview of MDMA pharmacology and acute toxicity will be given followed by a plan for clinical management.

show abstract

Section: Mdma and Sudden Deathmentioning

confidence: 99%

Acute toxic effects of ‘Ecstasy’ (MDMA) and related compounds: overview of pathophysiology and clinical management

Hall

Henry

2006

British Journal of Anaesthesia

249

212

View full text Add to dashboard Cite

show abstract

“…Volume depletion and hypotension further compound the nephrotoxic insult of myoglobinuria. In some cases, disseminated intravascular coagulation occurs and is likely contributory in the development of AKI (25,33).…”

Section: Acute Kidney Injury Associated With Ecstasymentioning

confidence: 99%

The Agony of Ecstasy

Campbell

Rosner

2008

Clinical Journal of the American Society of Nephrology

107

View full text Add to dashboard Cite

Ecstasy (MDMA, 3,4-methylenedioxymethamphetamine) is commonly used by college-aged individuals. Ecstasy leads to feelings of euphoria, emotional empathy, and increased energy. These effects come at a significant risk for complications. Ecstasy has been associated with acute kidney injury that is most commonly secondary to nontraumatic rhabdomyolysis but also has been reported in the setting of drug-induced liver failure and drug-induced vasculitis. More common, ecstasy has led to serious hyponatremia and hyponatremia-associated deaths. Hyponatremia in these cases is due to a "perfect storm" of ecstasy-induced effects on water balance. Ecstasy leads to secretion of arginine vasopressin as well as polydipsia as a result of its effects on the serotonergic nervous pathways. Compounding these effects are the ready availability of fluids and the recommendation to drink copiously at rave parties where ecstasy is used. The effects of ecstasy on the kidney as well as therapeutic measures for the treatment of ecstasy-induced hyponatremia are presented.

show abstract

“…Some of the clinical features such as metabolic acidosis, hyperkalemia, CK elevation, hyperthermia, and rhabdomyolysis in illicit MDMA users (Henry, 1992;Screaton et al, 1992;Hall et al, 1996) could be the result of a primary damage of skeletal muscle, e.g., MH (O'Leary et al, 2001). The response of such adverse MDMA effects to the MH antidote dantrolene supported this view (Hall et al, 1996), but the beneficial effects such as reduced myoplasmic Ca 2ϩ and heat production are not restricted to MH crises (Hadad et al, 2005). We have tested the effects of MDMA on MHS muscle: None of the MHS muscles exhibited an in vitro contracture at 100 M MDMA.…”

Section: Mdma Acts On Skeletal Musclementioning

confidence: 99%

“…Since muscle fasciculations, muscle cramps, and muscle ache also have been typically reported by illicit MDMA users (Henry, 1992;Screaton et al, 1992;Hall et al, 1996), the underlying cause should be proximal to muscle, that means at the neuromuscular junction. nAChR are present in both the postsynaptic and at presynaptic parts, and from the latter, electric activity can spread out in retrograde direction along the motor unit and cause fasciculations and cramps (Guiloff and Modarres-Sadeghi, 1992).…”

Section: Mdma Acts On Skeletal Musclementioning

confidence: 99%

“…More severe complications such as rapidly progressing hyperthermia, hyperkalemia, metabolic acidosis, excessive creatine kinase (CK) elevation, and rhabdomyolysis have been reported rarely but even at low MDMA dosages (Screaton et al, 1992;Hall et al, 1996). These adverse effects point to the skeletal muscle or the neuromuscular junction as a target of MDMA outside the central nervous system.…”

mentioning

confidence: 99%

See 1 more Smart Citation

3,4-Methylenedioxymethamphetamine (Ecstasy) Activates Skeletal Muscle Nicotinic Acetylcholine Receptors

Klingler

Heffron²,

Jurkat‐Rott³

et al. 2005

J Pharmacol Exp Ther

View full text Add to dashboard Cite

Adverse 3,4-methylenedioxymethamphetamine (MDMA; ecstasy) effects are usually ascribed to neurotransmitter release in the central nervous system. Since clinical features such as fasciculations, muscle cramps, rapidly progressing hyperthermia, hyperkalemia, and rhabdomyolysis point to the skeletal muscle as additional target, we studied the effects of MDMA on native and cultured skeletal muscle. We addressed the question whether malignant hyperthermia (MH)-susceptible (MHS) muscle is predisposed to adverse MDMA reactions. Force measurements on muscle strips showed that 100 M MDMA, a concentration close to that determined in some MDMA users, regularly enhanced the sensitivity of skeletal muscle to caffeine-induced contractures but did not cause contractures on its own. The left-shift of the dose-response curve induced by MDMA was greater in normal than in MHS muscle. Furthermore, MDMA did not release Ca 2ϩ from isolated sarcoplasmic reticulum vesicles. These findings do not support the view of an MH-triggering effect on muscle. However, MDMA induced Ca 2ϩ

show abstract

An unusual case of Ecstasy poisoning

Cited by 20 publications

References 9 publications

Acute toxic effects of ‘Ecstasy’ (MDMA) and related compounds: overview of pathophysiology and clinical management

Acute toxic effects of ‘Ecstasy’ (MDMA) and related compounds: overview of pathophysiology and clinical management

The Agony of Ecstasy

3,4-Methylenedioxymethamphetamine (Ecstasy) Activates Skeletal Muscle Nicotinic Acetylcholine Receptors

Contact Info

Product

Resources

About