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Toxicity and deaths from 3,4-methylenedioxymethamphetamine ("ecstasy").

J A Henry, K J Jeffreys, S Dawling

Lancet (London, England) August 15, 1992 DOI: 10.1016/0140-6736(92)91469-o (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Case series Case report Peer reviewed
Sample size 19
Population People presenting with MDMA-related toxicity, including fatalities, hepatotoxicity cases, and road traffic accident subjects
Topics MDMA
Key findings Recreational misuse of small amounts of MDMA was associated with severe acute toxicity, including 7 fatalities with fulminant hyperthermia, convulsions, disseminated intravascular coagulation, rhabdomyolysis, and acute renal failure. The authors also report 7 cases of hepatotoxicity, which they suspect is increasing, and 5 road traffic accident subjects in whom MDMA was identified, and they argue that long-term morbidity from MDMA deserves close monitoring.

Abstract

The risk of adverse reactions to 3,4-methylenedioxymethamphetamine (MDMA), more commonly known as "ecstasy", is now widely known in both the USA and UK, but the patterns of illness remain varied. We report our experience during 1990 and 1991. There has been a recent increase in cases of severe toxicity following recreational misuse of small amounts of MDMA. Among 7 fatalities, the pattern of toxicity included fulminant hyperthermia, convulsions, disseminated intravascular coagulation, rhabdomyolysis, and acute renal failure. Until now, there have been few reports of this type of toxicity from MDMA, which may be related both to the potential of the drug to alter thermoregulation and to the circumstances of misuse. In addition, we have monitored 7 cases of hepatotoxicity and suspect that the frequency of this complication is increasing; a history of MDMA misuse should be sought in young people presenting with unexplained jaundice or hepatomegaly. We also describe 5 subjects involved in road traffic accidents in whom MDMA was identified. Misuse of MDMA can have severe acute toxic effects; few data are available concerning long-term morbidity, and this deserves close monitoring in future.