Ecstasy toxicity]

The substance, 3,4-methylenedioxymethamphetamine (MDMA) or ecstasy, is an amphetamine derivate. A mistaken belief that it is a safe drug of low toxicity and a long duration of action has led to its widespread popularity among teenagers and young adults in recent years. Unfortunately, ecstasy use has increased to epidemic proportions. In this review article pharmacokinetics and pathophysiology of MDMA, general medical adverse effects, cardiovascular effects, serotonin syndrome, hyponatremia, neurologic effects, hepatotoxicity, and long-term neuropsychiatric effects, clinical features of toxicity, prehospital and emergency department care problems, and mortality/morbidity, prophylactic advices are discussed.