Dr. Andy

Reflections on medicine and biology among other things

Thursday, May 04, 2006

That's a lot of ecstacy!

From the February issue of the journal Psychosomatics
Mr. A, 37 years old, used ecstasy between the ages of 21 and 30. . . . An estimate of lifetime consumption yielded a total intake of more than 40,000 tablets. At the time of his presentation, Mr. A reported current cannabis consumption, together with a previous history of polydrug misuse (i.e., solvents, benzodiazepines, amphetamines, LSD, cocaine, heroin). After three episodes of "collapsing" at parties, Mr. A finally stopped his ecstasy use. . . . He eventually developed severe panic attacks, recurrent anxiety, depression, muscle rigidity (particularly at the neck and jaw levels), functional hallucinations, and paranoid ideation. The Mini-Mental State Exam revealed disorientation to time, poor concentration, and short-term memory difficulties. Decrease in level of cannabis intake led both to disappearance of his paranoid ideas and hallucinations and reduction of his panic attacks, but remaining symptomatology persisted. Administration of the Wechsler Memory Scale (3rd Edition)3 suggested the existence of global memory-function impairment, with no subtest score being above the 10th percentile. Assessment of daily functioning skills identified major behavioral consequences of his memory loss (i.e., repeating activities several times). Although Mr. A was able to fully understand the instructions given, his concentration and attention were so impaired that he was unable to follow the sequence of the tasks required. A structural MRI brain scan revealed no focal cerebral lesions;
Curiously, a recent commentary in the Lancet (which is where I heard about this individual) suggests that this case demonstrates the adverse effects of ecstacy may be LESS than previously thought:
But the case of a man who emerged from a decade-long period of intensive MDMA use—during which he is estimated to have taken 40 000 pills—with no signs of the profound neurotoxicity that has long been feared to result from even limited consumption of ecstasy, has re-energised calls for more research into the real side-effects, and therapeutic potential, of psychedelic drugs.
One shudders at the thought of the shape this guy would be in if he'd had more bad sequalae.

But there are apparently people who've developed persistent psychosis after a single use of ecstacy. From that case report, here is a description of the various bad things that can happen after using ecstacy:
There is a widely held belief that MDMA is a "safe" drug, but a growing body of literature has documented both medical and psychiatric adverse reactions to MDMA. Medical consequences include renal failure, rhabdomyolysis, disseminated intravascular coagulation, hepatitis, cerebral infarction, seizures, delirium, and coma. In terms of psychiatric sequelae, MDMA use has been associated with depression, anxiety, panic attacks, flashbacks, perceptual changes, depersonalization, and derealization
Other than that it sounds perfectly safe (more here)

10 Comments:

At 12:43 PM, Blogger ollie said...

Bout time you posted again! :-)

I swear, being a blogger and having a life doesn't mix. ;-)

 
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