Methamphetamine and MDMA: ‘Safe’ drugs of abuse
Allana M. Krolikowski, A. Koyfman
March 1, 2014 DOI: 10.1016/j.afjem.2013.01.005 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review |
|---|---|
| Intervention | Benzodiazepines |
| Topics | MDMA |
| Key findings | The review contends that methamphetamine and MDMA intoxication commonly presents with restlessness, agitation, hypertension, tachycardia, and headache, while hyperthermia, hyponatraemia, and rhabdomyolysis are among the most serious complications; most deaths are attributed to hyperthermia complicated by multiple organ failure. It recommends benzodiazepines as first-line therapy for hyperthermia, agitation, critical hypertension, and seizures, and intensive care for serious complications. |
Abstract
Methamphetamine and MDMA have been called safe drugs of abuse. Worldwide there is an increased consumption of these drugs, which has become a focus of research in South Africa. As the number of methamphetamine users has increased in many African countries, it is essential that emergency care practitioners are able to diagnose and manage intoxication with methamphetamine, MDMA, and other derivatives. The most common presentations include restlessness, agitation, hypertension, tachycardia, and headache while hyperthermia, hyponatraemia, and rhabdomyolysis are among the most common serious complications. Most deaths are secondary to hyperthermia complicated by multiple organ failure. A number of laboratory analyses should be obtained if locally available. We provide a review of the current recommended general and specific management approaches. Benzodiazepines are the first line therapy for hyperthermia, agitation, critical hypertension, and seizures. Patients with serious complications are best managed in an intensive care unit if available. Emergency centres should create protocols and/or further train staff in the recognition and management of intoxication with these ‘not so safe' drugs.
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 2
- What Do Young Adults Expect from the Recreational Use of Ecstasy (3,4-Methylenedioxymethamphetamine/Molly)? A Latent Class Analysis of a Convenience Sample of Dutch Young Adults European Addiction Research 2023
- Ecstasy induced acute systolic heart failure and Non-Ischemic Cardiomyopathy in a young female: a rare case report and literature review Journal of Community Hospital Internal Medicine Perspectives September 6, 2019
Cites 18
- Human Pharmacology of MDMA Therapeutic Drug Monitoring March 19, 2004
- 3,4‐Methylenedioxymethamphetamine (MDMA, “Ecstasy”): pharmacology and toxicology in animals and humans Addiction May 1, 1994
- Mood and cognitive effects of ± 3,4‐methylenedioxymethamphetamine (MDMA, ‘ecstasy’): week‐end ‘high’ followed by mid‐week low Addiction July 1, 1997
- Multiple Severe Complications From Recreational Ingestion of MDMA ('Ecstasy') JAMA August 14, 1987
- MDMA (Ecstasy) and the Rave: A Review Pediatrics October 1, 1997
and 13 more in the library