title: 3 cases of primary intracranial hemorrhage associated with "Molly", a purified form of 3,4-methylenedioxymethamphetamine (MDMA).
abstract: 3,4-Methylenedioxymethamphetamine (MDMA, or "Ecstasy" in tablet form) is a powerful sympathomimetic drug that is commonly perceived as safer than other stimulants such as methamphetamine or cocaine. "Molly" is a purified form of MDMA that is perceived by users as being even safer, as it is free of adulterants such as methamphetamine. Previously, all reports of intracranial hemorrhages in MDMA abusers were associated with coingestion of other sympathomimetic drugs, or with pre-existing cerebrovascular lesions. We describe a series of three young, otherwise healthy patients with various types of intracranial hemorrhages associated with "Molly" ingestion. All three patients underwent extensive workup including catheter angiography that did not demonstrate aneurysm, arteriovenous malformation, or vasculitis. We suggest that even the purified form of MDMA can cause serious intracranial hemorrhagic complications and should not be thought of as a safe recreational drug.
authors.affiliation: University of Miami Miller School of Medicine, Department of Neurology, USA. dkahn@med.miami.edu
authors.forename: D Ethan
authors.initials: DE
authors.lastname: Kahn
authors.forename: Nicholas
authors.initials: N
authors.lastname: Ferraro
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Benveniste
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects; D019969:Amphetamine-Related Disorders / Q000150:complications*; D000925:Anticoagulants / Q000009:adverse effects; D001241:Aspirin / Q000009:adverse effects; D002533:Cerebral Angiography; D003399:Craniotomy; D019299:Decompression, Surgical; D004357:Drug Synergism; D004830:Epilepsy, Tonic-Clonic / Q000209:etiology; D006261:Headache / Q000209:etiology; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology; D020300:Intracranial Hemorrhages / Q000139:chemically induced* / Q000150:complications / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D002189:Marijuana Abuse / Q000150:complications; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects* / Q000302:isolation & purification; D010291:Paresis / Q000209:etiology; D020795:Photophobia / Q000209:etiology; D013345:Subarachnoid Hemorrhage / Q000139:chemically induced / Q000473:pathology / Q000601:surgery; D014839:Vomiting / Q000209:etiology; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D018817:N-Methyl-3,4-methylenedioxyamphetamine; D001241:Aspirin