MDMA induced hyperthermia: Report of a fatality and review of current therapy

Dar, Khavar; McBrien, M. E.

doi:10.1007/bf02044131

Cited by 94 publications

(34 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Hyperthermia, a complication of MDMA use, is many times accompanied by rhabdomyolysis, which may ultimately lead to death (Dar & McBrien, 1996;Mallick & Bodenham, 1997). This study demonstrates that by using a combination of prazosin, an a 1 AR-antagonist, and SR59230A, a selective b 3 AR-antagonist, MDMA-induced hyperthermia was significantly attenuated (Figure 1a).…”

Section: Discussionmentioning

confidence: 66%

“…Renal failure often follows rhabdomyolysis, which accounts for 5-7% of all cases of acute renal failure in the United States (Slater & Mullins, 1998). Along with rhabdomyolysis, hyperthermia induced by MDMA has also been ostensibly linked to serotonergic neurotoxocity (Malberg et al, 1996), disseminated intravascular coagulation (Henry et al, 1992) and death (Dar & McBrien, 1996). Current treatment strategies for MDMA-induced hyperthermia are plagued by a lack of a thorough understanding of its thermogenic and myonecrotic mechanisms.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Attenuation of 3,4‐methylenedioxymethamphetamine (MDMA, Ecstasy)‐induced rhabdomyolysis with α₁‐ plus β₃‐adrenoreceptor antagonists

Sprague

Brutcher

Mills

et al. 2004

British J Pharmacology

View full text Add to dashboard Cite

1 Studies were designed to examine the effects of a 1 (a 1 AR)-plus b 3 -adrenoreceptor (b 3 AR) antagonists on 3,4-methylenedioxymethamphetamine (MDMA, Ecstasy)-induced hyperthermia and measures of rhabdomyolysis (creatine kinase (CK)) and renal function (blood urea nitrogen (BUN) and serum creatinine (sCr)) in male Sprague-Dawley rats. 2 MDMA (40 mg kg À1 , s.c.) induced a rapid and robust increase in rectal temperature, which was significantly attenuated by pretreatment with the a 1 AR antagonist prazosin (100 mg kg À1 , i.p.) plus the b 3 AR antagonist SR59230A (5 mg kg À1 , i.p.). 3 CK levels significantly increased (peaking at 4 h) after MDMA treatment and were blocked by the combination of prazosin plus SR59230A. 4 At 4 h after MDMA treatment, BUN and sCr levels were also significantly increased and could be prevented by this combination of a 1 AR-plus b 3 AR-antagonists. 5 The results from this study suggest that a 1 AR and b 3 AR play a critical role in the etiology of MDMA-mediated hyperthermia and subsequent rhabdomyolysis.

show abstract

Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Attenuation of 3,4‐methylenedioxymethamphetamine (MDMA, Ecstasy)‐induced rhabdomyolysis with α₁‐ plus β₃‐adrenoreceptor antagonists

Sprague

Brutcher

Mills

et al. 2004

British J Pharmacology

View full text Add to dashboard Cite

show abstract

“…However, in patients that survive the initial arrest, such as the patient in this report, hyperthermia likely contributes to the coagulopathy, rhabdomyolysis, and multisystem organ failure that result in death after the initial insult. ExDS has been described with MDMA, cocaine, and amphetamine intoxication [20,21].…”

Section: Discussionmentioning

confidence: 99%

Death Following Recreational Use of Designer Drug “Bath Salts” Containing 3,4-Methylenedioxypyrovalerone (MDPV)

Murray

Murphy

Beuhler³

2012

J. Med. Toxicol.

245

122

View full text Add to dashboard Cite

Introduction 3,4-Methylenedioxypyrovalerone (MDPV) is a designer stimulant drug that has gained popularity in the USA. Although adverse effects of MDPV have been described, to our knowledge, this is the first reported death. Case Report We report the case of a 40-year-old male who injected and snorted "bath salts" containing MDPV and subsequently became agitated, aggressive, and experienced a cardiac arrest. He was resuscitated after his initial arrest; however, he developed hyperthermia, rhabdomyolysis, coagulopathy, acidosis, anoxic brain injury, and subsequently died. Discussion This is the first case in the medical literature to report death due to isolated confirmed MDPV intoxication. The manner of death is also consistent with excited delirium syndrome.

show abstract

“…The substituted amphetamine 3,4-methylenedioxymethamphetamine (MDMA, ecstasy) is commonly associated with an increase in body temperature in both humans (Dar and McBrien, 1996;Mallick and Bodenham, 1997) and rodents (Gordon et al, 1991). Because of its association with weekends and rave parties, emergency room personnel often refer to severe forms of this hyperthermia as "Saturday Night Fever" (Williams et al, 1998), which can be associated with rhabdomyolysis, multiorgan failure, and death (Walubo and Seger, 1999).…”

mentioning

confidence: 99%

Hypothalamic-Pituitary-Thyroid Axis and Sympathetic Nervous System Involvement in Hyperthermia Induced by 3,4-Methylenedioxymethamphetamine (Ecstasy)

Sprague¹,

Banks²,

Cook³

et al. 2003

J Pharmacol Exp Ther

View full text Add to dashboard Cite

An acute and potentially life-threatening complication associated with the recreational use of the 3,4-methylenedioxymethamphetamine (MDMA, Ecstasy) is hyperthermia. In the present study, Sprague-Dawley rats treated with MDMA (40 mg/kg s.c.) responded with a significant increase (maximal at 1 h) in rectal and skeletal muscle temperatures that lasted for at least 3 h post-treatment. Hypophysectomized (HYPO) and thyroparathyroidectomized (TX) animals treated with MDMA (40 mg/kg s.c.) did not become hyperthermic and in fact displayed a significant hypothermia. The HYPO and TX animals were also resistant to the serotonergic neurotoxic effects of MDMA assessed by serotonin measurements 4 to 7 days later in the striatum and hippocampus. MDMA (40 mg/kg s.c.) induced a significant increase in thyroxine levels 1 h post-treatment. Thyroid hormone replacement in TX animals returned the hyperthermic response seen after MDMA. Prazosin, an ␣ 1 -antagonist (0.2 mg/kg i.p.), administered 30 min before MDMA significantly attenuated the MDMA-induced increase in rectal temperature, but had no effect on skeletal muscle temperature. Cyanopindolol, a ␤ 3 -antagonist (4 mg/kg s.c.), administered 30 min before MDMA (40 mg/kg s.c.) significantly attenuated the increase in skeletal muscle temperature, but had no effect on the rise in rectal temperature. The combination of prazosin and cyanopindolol resulted in an abolishment of MDMA-induced hyperthermia. The mechanisms of thermogenesis induced by MDMA seem to result from an interaction between the hypothalamicpituitary-thyroid axis and the sympathetic nervous system, wherein mechanisms leading to core and skeletal muscle hyperthermia after MDMA exposure seem to be differentially regulated by ␣ 1 -and ␤ 3 -adrenergic receptors.

show abstract

MDMA induced hyperthermia: Report of a fatality and review of current therapy

Cited by 94 publications

References 13 publications

Attenuation of 3,4‐methylenedioxymethamphetamine (MDMA, Ecstasy)‐induced rhabdomyolysis with α₁‐ plus β₃‐adrenoreceptor antagonists

Attenuation of 3,4‐methylenedioxymethamphetamine (MDMA, Ecstasy)‐induced rhabdomyolysis with α₁‐ plus β₃‐adrenoreceptor antagonists

Death Following Recreational Use of Designer Drug “Bath Salts” Containing 3,4-Methylenedioxypyrovalerone (MDPV)

Hypothalamic-Pituitary-Thyroid Axis and Sympathetic Nervous System Involvement in Hyperthermia Induced by 3,4-Methylenedioxymethamphetamine (Ecstasy)

Contact Info

Product

Resources

About

MDMA induced hyperthermia: Report of a fatality and review of current therapy

Cited by 94 publications

References 13 publications

Attenuation of 3,4‐methylenedioxymethamphetamine (MDMA, Ecstasy)‐induced rhabdomyolysis with α1‐ plus β3‐adrenoreceptor antagonists

Attenuation of 3,4‐methylenedioxymethamphetamine (MDMA, Ecstasy)‐induced rhabdomyolysis with α1‐ plus β3‐adrenoreceptor antagonists

Death Following Recreational Use of Designer Drug “Bath Salts” Containing 3,4-Methylenedioxypyrovalerone (MDPV)

Hypothalamic-Pituitary-Thyroid Axis and Sympathetic Nervous System Involvement in Hyperthermia Induced by 3,4-Methylenedioxymethamphetamine (Ecstasy)

Contact Info

Product

Resources

About

Attenuation of 3,4‐methylenedioxymethamphetamine (MDMA, Ecstasy)‐induced rhabdomyolysis with α₁‐ plus β₃‐adrenoreceptor antagonists

Attenuation of 3,4‐methylenedioxymethamphetamine (MDMA, Ecstasy)‐induced rhabdomyolysis with α₁‐ plus β₃‐adrenoreceptor antagonists