title: [Clinical and toxicologic aspects of the use of Ecstasy].
abstract: Methylenedioxymethamphetamine (MDMA, the active compound of ecstacy (XTC) tablets) is a psychoactive amphetamine congener which in humans has a stimulatory effect and enhances feelings of openness and solidarity. MDMA is neurotoxic in animals. It depletes axonal serotonin stores, it inhibits serotonin synthesis by inhibiting tryptophan hydroxylase, and it inhibits the reuptake of serotonin into the neuron. These events lead to destruction of serotonergic axon terminals in animal brain. Selective serotonin reuptake inhibitors protect against the neurotoxic effects of MDMA. Binding of (+)[11C]McN-5652, a selective neuroligand for the serotonin transporter, is decreased in the brains of XTC-users. This indicates that XTC damages serotonergic axon terminals in human brain, also. We strongly advise against the use of XTC as the long-term clinical consequences are not known. In man, somatic life-threatening complications after XTC use include hyperthermia, hyponatraemia and liver failure. Psychiatric complications include psychosis, depression, panic disorder, and impulsive behaviour. The chronic psychosis responds poorly to therapy.
authors.affiliation: Leids Universitair Medisch Centrum, afd. Klinische Chemie, Leiden.
authors.forename: E J
authors.initials: EJ
authors.lastname: Pennings
authors.forename: K Z
authors.initials: KZ
authors.lastname: Konijn
authors.forename: F A
authors.initials: FA
authors.lastname: de Wolff
mesh_terms: D000818:Animals; D001369:Axons / Q000187:drug effects; D001923:Brain Chemistry / Q000187:drug effects; D003863:Depression / Q000139:chemically induced; D005260:Female; D005334:Fever / Q000139:chemically induced; D006801:Humans; D007175:Impulsive Behavior / Q000139:chemically induced; D007177:Inappropriate ADH Syndrome / Q000139:chemically induced; D017093:Liver Failure / Q000139:chemically induced; D008297:Male; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects* / Q000633:toxicity*; D016584:Panic Disorder / Q000139:chemically induced; D011605:Psychoses, Substance-Induced / Q000209:etiology / Q000628:therapy; D051381:Rats; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000633:toxicity*
chemical_list: D018817:N-Methyl-3,4-methylenedioxyamphetamine; D017367:Selective Serotonin Reuptake Inhibitors
vernacular_title: Klinische en toxicologische aspecten van ecstasygebruik.