Ecstasy (MDMA) toxicity often involves multiple substances, complicating the clinical picture. Among 52 patients presenting to an emergency department, most had also consumed alcohol (51.9%) or other illicit drugs (71.1%). Common reasons for seeking care were collapse or loss of consciousness (36.5%), palpitations (19.2%), dizziness or weakness (15.4%), and anxiety (13.5%). Co-use of cocaine was linked to panic reactions (30.7% vs. 7.7% without cocaine). Deep coma occurred in 68.8% of patients who also used GHB or opiates, but in none who took Ecstasy alone. Severe complications included cardiac arrest, hyperthermia, rhabdomyolysis, and one death.
Methoxetamine, a chemical relative of ketamine, is a new recreational drug not yet tightly regulated in most countries. This report describes the first confirmed case of intravenous methoxetamine abuse, in a 19-year-old man. His symptoms—rapid heart rate, high blood pressure, confusion, agitation, stupor, poor coordination, dilated pupils, and involuntary eye movements—matched known ketamine effects and resolved with supportive treatment. Based on this case, user reports, and the drug's structure, methoxetamine produces ketamine-like effects, and full recovery is expected with medical care.