Rare but relevant: MDMA and hyponatraemia
María Rita Concepción García, Nelson G. M. Gomes, Diana Dias Da Silva
Addiction December 8, 2025 DOI: 10.1111/add.70255 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | MDMA |
| Keywords | Hyponatremia Electrolyte disorder Incidence geometry Recreational drug Electrolyte imbalance Rhabdomyolysis Pathophysiology Epidemiology Intensive care medicine Pathological Odds ratio Fluid intake |
| Key findings | MDMA-induced hyponatraemia is a life-threatening condition, particularly among women, who have higher incidence rates and increased odds of severe clinical effects. |
Abstract
Conventionally used for its stimulant, empathogenic and entactogenic effects, 3,4-methylenedioxymethamphetamine (MDMA, ecstasy) is one of the most commonly used psychoactive drugs, specifically among young adults and in nightlife and recreational party contexts. Often perceived as a safe drug, MDMA can display an array of toxic effects on multiple organs, with hyponatraemia (a low blood sodium concentration that can cause an altered mental state) being increasingly reported. Although hyponatraemia per se is among the most common electrolyte disorders encountered in clinical care, acute MDMA-induced hyponatraemia was first described in 1993 and constitutes a life-threatening condition if left untreated, particularly among women, who present higher incidence rates and increased odds of developing severe clinical effects. The present review outlines the main clinical manifestations and prevalence of MDMA-induced hyponatraemia, its pathophysiological mechanisms and the therapeutical approaches to correct this electrolyte imbalance.
Comparable studies
Other narrative reviews on MDMA, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Human Pharmacology of MDMA | 2004 | Review | |
| Human psychopharmacology of Ecstasy (MDMA): a review of 15 years of empirical research | 2001 | Review | |
| 3,4‐Methylenedioxymethamphetamine (MDMA, “Ecstasy”): pharmacology and toxicology in animals and humans | 1994 | Review | |
| (±)3,4-Methylenedioxymethamphetamine (‘Ecstasy’)-Induced Serotonin Neurotoxicity: Studies in Animals | 2000 | Review | |
| Amphetamine toxicities | 2010 | Review |
Citations in the library
Cites 25
- Hyponatraemic states following 3,4-methylenedioxymethamphetamine (MDMA, 'ecstasy') ingestion The Quarterly journal of medicine July 1, 2002
- Multiple MDMA (Ecstasy) Overdoses at a Rave Event Journal of Intensive Care Medicine May 28, 2012
- How MDMA's Pharmacology and Pharmacokinetics Drive Desired Effects and Harms The Journal of Clinical Pharmacology January 16, 2014
- SIADH and water intoxication related to ecstasy BMJ Case Reports August 29, 2018
- Oxytocin and the Role of Fluid Restriction in MDMA-Induced Hyponatremia: A Secondary Analysis of 4 Randomized Clinical Trials. JAMA Network Open November 4, 2024
and 20 more in the library