Substance-induced anxiety disorder after one dose of 3,4-methylenedioxymethamphetamine: a case report.
Kaeley Kaplan, Fiona Kurtz, Kelly Serafini
Journal of Medical Case Reports May 25, 2018 DOI: 10.1186/s13256-018-1670-7 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 35-year-old Hispanic man with no significant prior mental health history and no prior MDMA use |
| Interventions | 3 4-Methylenedioxymethamphetamine Behavioral therapy Buspirone Sertraline Primary Care Behavioral Health model |
| Dose | 50 mg daily sertraline; one dose of 3,4-methylenedioxymethamphetamine |
| Duration | Symptoms subsided approximately 2.5 months after MDMA ingestion; sertraline taper began six months after ingestion |
| Topics | MDMA Anxiety |
| Keywords | 3,4-methylenedioxymethamphetamine Mental health Primary care Substance-induced anxiety disorder |
| Key findings | The authors report that a single dose of MDMA preceded severe substance-induced anxiety and panic in a man with no prior psychiatric history, and that his symptoms resolved after combined behavioral health intervention and sertraline 50 mg daily, with no resurgence after tapering at six months. They argue the case supports the Primary Care Behavioral Health model for delivering timely mental health care in primary care. |
Abstract
In this report, we describe a case of a patient with substance-induced anxiety disorder occurring after a single dose of 3,4-methylenedioxymethamphetamine. Furthermore, we describe the use and efficacy of the Primary Care Behavioral Health model, a collaborative approach to integrative primary mental health care, in evaluating and treating this rare mental health disorder. Three days following ingestion of one dose of 3,4-methylenedioxymethamphetamine, a 35-year-old Hispanic man with no significant prior mental health history and no history of prior 3,4-methylenedioxymethamphetamine use presented to our hospital with severe, acute anxiety and panic symptoms. He was initially treated with a combination of behavioral therapy and the serotonin agonist buspirone. Buspirone ultimately proved ineffective, so it was discontinued in favor of the selective serotonin reuptake inhibitor sertraline. While awaiting the pharmacological onset of sertraline, the patient worked with a behavioral health consultant, who provided psychoeducation on the experience of panic, building relaxation skills, and modifying maladaptive thought patterns. Enhanced communication between the primary care provider and behavioral health consultant facilitated the planning and enactment of the patient's care plan. Approximately 2.5 months after his initial ingestion of 3,4-methylenedioxymethamphetamine, the patient's symptoms subsided. This improvement was attributed to the combination of the behavioral health intervention and sertraline at a dose of 50 mg daily. Six months after 3,4-methylenedioxymethamphetamine ingestion, the patient began to gradually taper sertraline and has had no resurgence of anxiety symptoms to date. Our patient's case not only demonstrates a rare presentation of 3,4-methylenedioxymethamphetamine-induced anxiety disorder but also provides support for the use of the Primary Care Behavioral Health model to deliver individualized, timely mental health care in a primary care setting.
Comparable studies
Other case reports and case series on MDMA for anxiety, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Anxiety-related Symptoms following the Sporadic Use of Ecstasy – A Case Study High-functioning 24-year-old student with a history of obsessive-compulsive disorder... | 2021 | Case study | n = 1 |
| The treatment of abandonment anxiety with MDMA and LSD Young woman in her mid-twenties with abandonment-related anxiety | 2023 | Retrospective case study | n = 1 |
| MDMA, Internal Family Systems therapy, and the Minnesota model in the resolution of C-PTSD-induced alcohol and diazepam addiction—A retrospective case study Man in his forties with alcohol and diazepam addiction and complex PTSD from childhood... | 2023 | Case study | n = 1 |
| Utilizing In Vivo and Imaginal Exposure in the Context of MDMA-Assisted Therapy for Social Anxiety Disorder: A Case Report Man in his late 30s with generalized social anxiety disorder | Case report | n = 1 | |
| MDMA ("ecstasy") and panic disorder: induction by a single dose. One individual with no prior psychiatric history who ingested a single typical dose of... | 1992 | Case study | n = 1 |
Citations in the library
Cites 7
- Recreational MDMA use in Sydney: a profile of ‘Ecstasy’ users and their experiences with the drug British Journal of Addiction August 1, 1992
- Acute, sub‐acute and long‐term subjective consequences of ‘ecstasy’ (MDMA) consumption in 430 regular users Human Psychopharmacology: Clinical and Experimental October 1, 2003
- The pharmacology and clinical pharmacology of 3,4-methylenedioxymethamphetamine (MDMA, "ecstasy"). Pharmacological Reviews September 2003
- An "accidental" acute psychosis with ecstasy use. Journal of Psychoactive Drugs 2001
- Ecstasy (MDMA): a review of its possible persistent psychological effects Psychopharmacology September 7, 2000
and 2 more in the library