MDMA-Associated Liver Toxicity: Pathophysiology, Management, and Current State of Knowledge.
Ruff Joseph Macale Cajanding
AACN advanced critical care 2019 DOI: 10.4037/aacnacc2019852 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | MDMA |
| Keywords | 4-methylenedioxyamphetamine N-methyl-3 Ecstasy drug Liver failure Nursing care Pharmacology Toxicology Transplants |
| Key findings | MDMA use is associated with a wide spectrum of organ toxicities, with the liver particularly affected. The authors outline proposed mechanisms of MDMA-induced liver damage and argue that patient-related factors explain individual differences in susceptibility, and they discuss nursing management of acute liver failure due to MDMA overuse. |
Abstract
3,4-Methylenedioxymethamphetamine (MDMA, ecstasy) has become a popular recreational drug of abuse among young adults, partly because of the belief that it is relatively safe compared with other drugs with the same stimulant and hallucinogenic effects. However, MDMA use has been associated with a wide spectrum of organ toxicities, with the liver being severely affected by its deleterious effects. This article discusses the essential pharmacology of MDMA and describes the effects MDMA has on various organ systems of the body, with particular focus on the liver. The putative mechanisms by which MDMA can cause liver damage are explored, with emphasis on patient-related factors that explain why some individuals are more susceptible than others to damage from MDMA. The incidence of hepatotoxicity related to MDMA use is presented, and the nursing management of patients who develop acute liver failure due to MDMA overuse is explored in light of current evidence.
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
Cited by 5
- Pharmacologic Similarities and Differences Among Hallucinogens The Journal of Clinical Pharmacology August 1, 2021
- The Effects of Folic Acid on Testicular Histology, Sperm Quality, and Spermatogenesis Indices Following 3,4-Methylenedioxymethamphetamine Exposure in Adult Male Rats Addiction and Health September 4, 2023
- Acute 3,4-Methylenedioxymethamphetamine (MDMA) Toxicity Leading to Fulminant Hepatic Failure and Emergency Liver Transplantation Cureus December 20, 2025
- Successful treatment of intractable MDMA adverse reactions using acupuncture and traditional Chinese medicine Journal of Psychedelic Studies April 2, 2025
- A Case of Ecstasy-Induced Acute Hepatic Injury. Cureus October 2022
Cites 38
- Differences Between the Mechanism of Action of MDMA, MBDB, and the Classic Hallucinogens. Identification of a New Therapeutic Class: Entactogens Journal of Psychoactive Drugs October 1, 1986
- Human Pharmacology of MDMA Therapeutic Drug Monitoring March 19, 2004
- Subjective Reports of the Effects of MDMA in a Clinical Setting Journal of Psychoactive Drugs October 1, 1986
- Cardiovascular and neuroendocrine effects and pharmacokinetics of 3, 4-methylenedioxymethamphetamine in humans. Journal of Pharmacology and Experimental Therapeutics July 1, 1999
- Pathology of deaths associated with "ecstasy" and "eve" misuse. Journal of Clinical Pathology February 1, 1996
and 33 more in the library