MDMA("Ecstasy")-Konsum - ein Überblick zu psychiatrischen und medizinischen Folgen

Abstract

Epidemiological research and Substance Abuse Warning Systems point to a sharp increase in the use of "Ecstasy" (MDMA), as well as to structural changes in the drug scene in and outside Europe. For some consumers, "Ecstasy" opens the door to the abuse of other illegal substances. Since the mid-eighties psychiatric complications and consequences of the abuse of MDMA have been reported in at least 48 cases. It is necessary to differentiate between acute psychiatric complications, which subside completely when the level of intoxication comes down, toxic psychoses and long-term psychiatric diseases as a consequence of substance abuse. The latter involve atypical and paranoid psychoses, depressions, panic disorders, depersonalisation and behavioural disorders. Convulsive seizures are among the most common problems involving the central nervous system. Furthermore, there have been reports on cerebrovascular accidents and intracranial haemorrhages. Literature reports on at least 53 cases of medical complications in abusers of MDMA, 14 of which came to a lethal end. Research still blatantly lacks prospective epidemiological and clinical studies on a sufficiently large scale to identify different developments of dependency and predictors of harmful and unhealthy consumption.

Is the Use of Ecstasy and Hallucinogens Increasing?

“…However, daily use is frequent among those with a dependence syndrome. This supports the typical 'scene' description [7] that links the use of ecstasy and related substances to rave parties and other music and socially related activities.…”

“…Although amphetamine and its derivates (similar to heroin and cocaine) are classified among the so-called 'hard drugs', lay people and people in the ecstasy scene widely regard this drug as a 'safe drug' without any risks of complications and no dependence potential. This is in sharp contrast to numerous reports of (a) several significant physiological effects (loss of appetite, nausea, muscle ache, tachycardia, hypothermia), (b) more severe cardiological and regulatory complications), (c) psychological complications (anxiety, panic attacks, recurrent acute paranoid psychotic experiences, cognitive deficiencies and depression associated with suicidal behavior) [2][3][4][5][6][7], (d) increasing number of reports about ecstasy-related deaths [8,9], and (e) severe internal medical and psychiatric complications [3,10].…”

“…A recent report by Thomasius et al [7] has comprehensively reviewed the various complications reported for ecstasy and related substances.…”

Neurotoxische Langzeitschäden bei Ecstasy (MDMA)-KonsumentenÜberblick über den aktuellen Wissensstand

“…B. zu relativ subtilen, aber möglicherweise irreversiblen Verschlechterungen kognitiver Funktionen führen [38,57,63,19]. In den letzten 3 Jahren wurden international eine Reihe von Arbeiten dazu veröf-fentlicht,die bei den letzten deutschsprachigen Übersichtsarbeiten über Ecstasy noch nicht berücksichtigt werden konnten [31,91,90]. Ziel der vorliegenden Arbeit ist die Vermittlung des neuesten Wissensstandes zur Frage der neurotoxischen Langzeitwirkungen von Ecstasy beim Menschen.…”

“…Depressive Syndrome, Angststörungen und psychotische Episoden wurden wiederholt anekdotisch in Zusammenhang mit einem Missbrauch von Ecstasy berichtet [31,91,90]. In 2 großen Kollektiven Ecstasy-erfahrener polytoxikomaner Probanden und Patienten wurde eine hohe psychiatrische Komorbidität festgestellt [80,92].…”