Survival after massive ecstasy overdose.
BACKGROUND
The toxicity profile of the amphetamine derivative 3,4-methylenedioxymethamphetamine (MDMA, "Ecstasy") is well known. This designer drug is usually taken at "house parties" and may cause severe complications, sometimes leading to death, even when taken in relatively small units (1 or 2 tablets). Up to now, only a few cases of survival after ingestion of an overdose of Ecstasy have been described. In most cases the users developed hyperthermia, disseminated intravascular coagulation, rhabdomyolysis, and renal failure.


METHODS
We describe a man who, after ingesting 50 tablets of Ecstasy (in combination with oxazepam and alcohol) at home, recovered within 2 days. Presenting features were unconsciousness, apnea, and convulsions. It is suggested that in most cases severe 3,4-methylenedioxymethamphetamine toxicity results from an interaction between direct pharmacological effects of the drug and the prevailing environmental conditions (high ambient temperature, dancing in trance, little fluid intake).
Ramcharan
S
S
Slotervaart Hospital, Amsterdam, The Netherlands.
Meenhorst
P L
PL
Otten
J M
JM
Koks
C H
CH
de Boer
D
D
Maes
R A
RA
Beijnen
J H
JH
D000328:Adult; D062787:Drug Overdose; D016231:Fluorescence Polarization Immunoassay; D008401:Gas Chromatography-Mass Spectrometry; D005751:Gastric Lavage; D006213:Hallucinogens / Q000097:blood / Q000737:chemistry / Q000506:poisoning* / Q000652:urine; D006801:Humans; D008297:Male; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000097:blood / Q000737:chemistry / Q000506:poisoning* / Q000652:urine; D013237:Stereoisomerism; D013406:Suicide, Attempted
D006213:Hallucinogens; D018817:N-Methyl-3,4-methylenedioxyamphetamine