Acute toxic effects of ‘Ecstasy’ (MDMA) and related compounds: overview of pathophysiology and clinical management
Since the late 1980s ‘Ecstasy’ (3,4-methylenedioxymethamphetamine, MDMA) has become established as a popular recreational drug in western Europe. The UK National Criminal Intelligence Service estimates that 0.5–2 million tablets are consumed weekly in Britain. It has been reported that 4.5% of young...
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| Veröffentlicht in: | British journal of anaesthesia : BJA 2006-06, Vol.96 (6), p.678-685 |
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| container_title | British journal of anaesthesia : BJA |
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| creator | Hall, A.P. Henry, J.A. |
| description | Since the late 1980s ‘Ecstasy’ (3,4-methylenedioxymethamphetamine, MDMA) has become established as a popular recreational drug in western Europe. The UK National Criminal Intelligence Service estimates that 0.5–2 million tablets are consumed weekly in Britain. It has been reported that 4.5% of young adults (15–34 yr) in the UK have used MDMA in the previous 12 months. Clinically important toxic effects have been reported, including fatalities. While the phenomenon of hyperpyrexia and multi-organ failure is now relatively well known, other serious effects have become apparent more recently. Patients with acute MDMA toxicity may present to doctors working in Anaesthesia, Intensive Care and Emergency Medicine. A broad knowledge of these pathologies and their treatment is necessary for anyone working in an acute medical speciality. An overview of MDMA pharmacology and acute toxicity will be given followed by a plan for clinical management. |
| doi_str_mv | 10.1093/bja/ael078 |
| format | Article |
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The UK National Criminal Intelligence Service estimates that 0.5–2 million tablets are consumed weekly in Britain. It has been reported that 4.5% of young adults (15–34 yr) in the UK have used MDMA in the previous 12 months. Clinically important toxic effects have been reported, including fatalities. While the phenomenon of hyperpyrexia and multi-organ failure is now relatively well known, other serious effects have become apparent more recently. Patients with acute MDMA toxicity may present to doctors working in Anaesthesia, Intensive Care and Emergency Medicine. A broad knowledge of these pathologies and their treatment is necessary for anyone working in an acute medical speciality. An overview of MDMA pharmacology and acute toxicity will be given followed by a plan for clinical management.</description><identifier>ISSN: 0007-0912</identifier><identifier>EISSN: 1471-6771</identifier><identifier>DOI: 10.1093/bja/ael078</identifier><identifier>PMID: 16595612</identifier><identifier>CODEN: BJANAD</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject>4-methylenedioxymethamphetamine ; Adolescent ; Adult ; Anesthesia ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; complications ; complications, convulsions ; complications, death ; complications, hepatotoxicity ; complications, hyperthermia ; complications, hyponatraemia ; convulsions ; death ; Death, Sudden - etiology ; Fever - chemically induced ; Hallucinogens - toxicity ; hepatotoxicity ; Humans ; hyperthermia ; hyponatraemia ; Hyponatremia - chemically induced ; MDMA (Ecstasy) ; Medical sciences ; Multiple Organ Failure - chemically induced ; N-Methyl-3,4-methylenedioxyamphetamine - toxicity ; Rhabdomyolysis - chemically induced ; toxicity ; toxicity, 3,4-methylenedioxymethamphetamine, MDMA (Ecstasy)</subject><ispartof>British journal of anaesthesia : BJA, 2006-06, Vol.96 (6), p.678-685</ispartof><rights>2006 British Journal of Anaesthesia</rights><rights>The Board of Management and Trustees of the British Journal of Anaesthesia 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org 2006</rights><rights>2006 INIST-CNRS</rights><rights>Copyright Oxford University Press(England) Jun 2006</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c588t-e4dec1d072f3d326328d58a7e713a9c18fbfc0aa354d9c94525e7038290fb3693</citedby><cites>FETCH-LOGICAL-c588t-e4dec1d072f3d326328d58a7e713a9c18fbfc0aa354d9c94525e7038290fb3693</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17859149$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16595612$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hall, A.P.</creatorcontrib><creatorcontrib>Henry, J.A.</creatorcontrib><title>Acute toxic effects of ‘Ecstasy’ (MDMA) and related compounds: overview of pathophysiology and clinical management</title><title>British journal of anaesthesia : BJA</title><addtitle>Br J Anaesth</addtitle><description>Since the late 1980s ‘Ecstasy’ (3,4-methylenedioxymethamphetamine, MDMA) has become established as a popular recreational drug in western Europe. The UK National Criminal Intelligence Service estimates that 0.5–2 million tablets are consumed weekly in Britain. It has been reported that 4.5% of young adults (15–34 yr) in the UK have used MDMA in the previous 12 months. Clinically important toxic effects have been reported, including fatalities. While the phenomenon of hyperpyrexia and multi-organ failure is now relatively well known, other serious effects have become apparent more recently. Patients with acute MDMA toxicity may present to doctors working in Anaesthesia, Intensive Care and Emergency Medicine. A broad knowledge of these pathologies and their treatment is necessary for anyone working in an acute medical speciality. An overview of MDMA pharmacology and acute toxicity will be given followed by a plan for clinical management.</description><subject>4-methylenedioxymethamphetamine</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Anesthesia</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>complications</subject><subject>complications, convulsions</subject><subject>complications, death</subject><subject>complications, hepatotoxicity</subject><subject>complications, hyperthermia</subject><subject>complications, hyponatraemia</subject><subject>convulsions</subject><subject>death</subject><subject>Death, Sudden - etiology</subject><subject>Fever - chemically induced</subject><subject>Hallucinogens - toxicity</subject><subject>hepatotoxicity</subject><subject>Humans</subject><subject>hyperthermia</subject><subject>hyponatraemia</subject><subject>Hyponatremia - chemically induced</subject><subject>MDMA (Ecstasy)</subject><subject>Medical sciences</subject><subject>Multiple Organ Failure - chemically induced</subject><subject>N-Methyl-3,4-methylenedioxyamphetamine - toxicity</subject><subject>Rhabdomyolysis - chemically induced</subject><subject>toxicity</subject><subject>toxicity, 3,4-methylenedioxymethamphetamine, MDMA (Ecstasy)</subject><issn>0007-0912</issn><issn>1471-6771</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90s1u1DAQB3ALgehSuPAAKEICAVKoP-I45ra0hSJthYRAIC6W15603iZxsJOle-tjwOv1SXDJipUQ4uTLb2as-Q9CDwl-SbBkB8uVPtDQYFHdQjNSCJKXQpDbaIYxFjmWhO6hezGuMCaCSn4X7ZGSS14SOkPruRkHyAZ_6UwGdQ1miJmvs-urH8cmDjpurq9-Zs9Oj07nzzPd2SxAowewmfFt78fOxleZX0NYO_h-U9fr4dz355vofOPPNr9LTOM6Z3STtbrTZ9BCN9xHd2rdRHiwfffRpzfHHw9P8sX7t-8O54vc8KoacigsGGKxoDWzjJaMVpZXWoAgTEtDqnpZG6w144WVRhacchCYVVTieslKyfbR06lvH_y3EeKgWhcNNI3uwI9RpYUUTFCc4OO_4MqPoUt_U0QKwaXgVUIvJmSCjzFArfrgWh02imB1E4VKUagpioQfbTuOyxbsjm53n8CTLdAxbacOujMu7pyouCSF3Dk_9v8fmE_OxQEu_0gdLlQpmODq5MtXtVjwz6_pB6aOki8mDymAlF9Q0TjoDFgX0hko692_xvwCcZTB6w</recordid><startdate>20060601</startdate><enddate>20060601</enddate><creator>Hall, A.P.</creator><creator>Henry, J.A.</creator><general>Elsevier Ltd</general><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>6I.</scope><scope>AAFTH</scope><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7U7</scope><scope>C1K</scope></search><sort><creationdate>20060601</creationdate><title>Acute toxic effects of ‘Ecstasy’ (MDMA) and related compounds: overview of pathophysiology and clinical management</title><author>Hall, A.P. ; Henry, J.A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c588t-e4dec1d072f3d326328d58a7e713a9c18fbfc0aa354d9c94525e7038290fb3693</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>4-methylenedioxymethamphetamine</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Anesthesia</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>complications</topic><topic>complications, convulsions</topic><topic>complications, death</topic><topic>complications, hepatotoxicity</topic><topic>complications, hyperthermia</topic><topic>complications, hyponatraemia</topic><topic>convulsions</topic><topic>death</topic><topic>Death, Sudden - etiology</topic><topic>Fever - chemically induced</topic><topic>Hallucinogens - toxicity</topic><topic>hepatotoxicity</topic><topic>Humans</topic><topic>hyperthermia</topic><topic>hyponatraemia</topic><topic>Hyponatremia - chemically induced</topic><topic>MDMA (Ecstasy)</topic><topic>Medical sciences</topic><topic>Multiple Organ Failure - chemically induced</topic><topic>N-Methyl-3,4-methylenedioxyamphetamine - toxicity</topic><topic>Rhabdomyolysis - chemically induced</topic><topic>toxicity</topic><topic>toxicity, 3,4-methylenedioxymethamphetamine, MDMA (Ecstasy)</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hall, A.P.</creatorcontrib><creatorcontrib>Henry, J.A.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>British journal of anaesthesia : BJA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hall, A.P.</au><au>Henry, J.A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Acute toxic effects of ‘Ecstasy’ (MDMA) and related compounds: overview of pathophysiology and clinical management</atitle><jtitle>British journal of anaesthesia : BJA</jtitle><addtitle>Br J Anaesth</addtitle><date>2006-06-01</date><risdate>2006</risdate><volume>96</volume><issue>6</issue><spage>678</spage><epage>685</epage><pages>678-685</pages><issn>0007-0912</issn><eissn>1471-6771</eissn><coden>BJANAD</coden><abstract>Since the late 1980s ‘Ecstasy’ (3,4-methylenedioxymethamphetamine, MDMA) has become established as a popular recreational drug in western Europe. The UK National Criminal Intelligence Service estimates that 0.5–2 million tablets are consumed weekly in Britain. It has been reported that 4.5% of young adults (15–34 yr) in the UK have used MDMA in the previous 12 months. Clinically important toxic effects have been reported, including fatalities. While the phenomenon of hyperpyrexia and multi-organ failure is now relatively well known, other serious effects have become apparent more recently. Patients with acute MDMA toxicity may present to doctors working in Anaesthesia, Intensive Care and Emergency Medicine. A broad knowledge of these pathologies and their treatment is necessary for anyone working in an acute medical speciality. An overview of MDMA pharmacology and acute toxicity will be given followed by a plan for clinical management.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><pmid>16595612</pmid><doi>10.1093/bja/ael078</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | 4-methylenedioxymethamphetamine Adolescent Adult Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences complications complications, convulsions complications, death complications, hepatotoxicity complications, hyperthermia complications, hyponatraemia convulsions death Death, Sudden - etiology Fever - chemically induced Hallucinogens - toxicity hepatotoxicity Humans hyperthermia hyponatraemia Hyponatremia - chemically induced MDMA (Ecstasy) Medical sciences Multiple Organ Failure - chemically induced N-Methyl-3,4-methylenedioxyamphetamine - toxicity Rhabdomyolysis - chemically induced toxicity toxicity, 3,4-methylenedioxymethamphetamine, MDMA (Ecstasy) |
| title | Acute toxic effects of ‘Ecstasy’ (MDMA) and related compounds: overview of pathophysiology and clinical management |
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