title: Acute toxic effects of 'Ecstasy' (MDMA) and related compounds: overview of pathophysiology and clinical management.
abstract: 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.
authors.affiliation: Department of Anaesthesia and Intensive Care Medicine, University Hospitals of Leicester NHS Trust, Leicester Royal Infirmary, Leicester LE1 5WW, UK. andrew.p.hall@uhl-tr.nhs.uk
authors.forename: A P
authors.initials: AP
authors.lastname: Hall
authors.forename: J A
authors.initials: JA
authors.lastname: Henry
mesh_terms: D000293:Adolescent; D000328:Adult; D003645:Death, Sudden / Q000209:etiology; D005334:Fever / Q000139:chemically induced; D006213:Hallucinogens / Q000633:toxicity*; D006801:Humans; D007010:Hyponatremia / Q000139:chemically induced; D009102:Multiple Organ Failure / Q000139:chemically induced; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000633:toxicity*; D012206:Rhabdomyolysis / Q000139:chemically induced
chemical_list: D006213:Hallucinogens; D018817:N-Methyl-3,4-methylenedioxyamphetamine