Download PDF
NOTARZT 2004; 20(3): 94-99
DOI: 10.1055/s-2003-814969
Originalia
© Georg Thieme Verlag KG Stuttgart · New York

„Ecstasy” (MDMA): Pharmakologie, Toxikologie und Behandlung der akuten Intoxikation

„Ecstasy” (MDMA): Pharmacology, Toxicology, and Manangement of IntoxicationM.  E.  Liechti1
  • 1Medizinische Klinik A (Chefarzt: Prof. Dr. F. Follath), Department für Innere Medizin, Universitätsspital Zürich
Nachdruck aus: Dtsch Med Wochenschr 2003; 128: 1361 - 1366 © Georg Thieme Verlag Stuttgart · New York · ISSN 0012-0472
Further Information

Publication History

Publication Date:
17 May 2004 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

„Ecstasy” (3,4-Methylendioxymethamphetamin, MDMA) ist eine in der Technoszene verbreitete Droge. Die vorliegende Übersicht konzentriert sich nach einer Zusammenfassung der Pharmakologie und Toxikologie von MDMA auf das Management einer Intoxikation mit MDMA oder andere Substanzen, die unter dem Namen Ecstasy verkauft werden.

Abstract

„Ecstasy” (3,4-methylene dioxymethamphetamine = MDMA) is a drug widely used among „techno” fans. The following survey after summarising the pharmacology and toxicology of MDMA, focusses on the management of an intoxication with MDMA or with other substances marketed under the „Exstasy” label.

Schlüsselwörter

„Ecstasy” - MDMA - andere „Ecstasy”-Substanzen - Intoxikation - Management

Key words

„Ecstasy” - MDMA - other „Ecstasy” drugs - toxicology - intoxication - management

Literatur

  • 1 Baggott M, Stuart R, Jerome L. Medical emergencies and adverse events in ecstasy users. In: Baggott M, Jerome L, Stuart R (eds) 3,4-Methylenedioxymethamphetamine (MDMA): A review of the English-language scientific and medical literature. Multidisciplinary Association for Psychodelic Studies http://www.maps.org
    Google Scholar
  • 2 Balmelli C, Kupferschmidt H, Rentsch K, Schneemann M. Tödliches Hirnödem nach Einnahme von Ecstasy und Benzylpiperazin.  Dtsch Med Wochenschr. 2001;  126 809-811
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Benz R, Iten P X, Schmid M, Vogt M. Ein fremdes weißes Pulver.  Schweiz Med Forum. 2002;  2 475-476
    PubMedGoogle Scholar
  • 4 Boot B P, McGregor I S, Hall W. MDMA (Ecstasy) neurotoxicity: assessing and communicating the risks.  Lancet. 2000;  355 1818-1821
    CrossrefPubMedGoogle Scholar
  • 5 Cole J C, Bailey M, Sumnall H R, Wagstaff G F, King L A. The content of ecstasy tablets: implications for the study of their long-term effects.  Addiction. 2002;  97 1531-1536
    CrossrefPubMedGoogle Scholar
  • 6 Torre R de la, Farré M, Roset P N. et al . Pharmacology of MDMA in humans.  Ann N Y Acad Sci. 2000;  914 225-237
    PubMedGoogle Scholar
  • 7 Dughiero G, Schifano F, Forza G. Personality dimensions and psychopathological profiles of Ecstasy users.  Human Psychopharmacol Clin Exp. 2001;  16 635-639
    PubMedGoogle Scholar
  • 8 Gamma A, Liechti M E. The psychophysiology of substance-related disorders. In: D'haenen H, Boer JA Den, Willner P (eds) Biological Psychiatry. London; Wiley 2002: 467-493
    Google Scholar
  • 9 Giroud C, Augsburger M, Sadeghipour F, Varesio E, Veuthey J-L, Rivier L. Ecstasy - la situation en Suisse romande. Composition des saisies, analyse des échantillons biologiques et brève revue de son action pharmacologique et de sa toxicité.  Schweiz Rundsch Med Prax. 1997;  86 510-523
    PubMedGoogle Scholar
  • 10 Gledhill J A, Moore D F, Bell D, Henry J A. Subarachnoidal haemorrhage associated with MDMA abuse.  J Neurol Neurosurg Psychiat. 1993;  56 1036-1037
    PubMedGoogle Scholar
  • 11 Gouzoulis-Mayfrank E, Daumann J, Sass H. Neurotoxische Langzeitschäden bei Ecstasy(MDMA)-Konsumenten: Überblick über den aktuellen Wissensstand.  Nervenarzt. 2002;  73 405-421
    CrossrefPubMedGoogle Scholar
  • 12 Gouzoulis-Mayfrank E, Hermle L, Kovar K-A, Sass H. Die entaktogene „Ecstasy” (MDMA), „Eve” (MDE) und andere ringsubstituierte Methamphetaminderivate.  Nervenarzt. 1996;  67 369-380
    PubMedGoogle Scholar
  • 13 Gouzoulis-Mayfrank E, Thelen B, Habermeyer E. et al . Psychopathological, neuroendocrine and autonomic effects of 3,4-methylenedioxyethylamphetamine (MDE), psilocybin and d-methamphetamine in healthy volunteers.  Psychopharmacology. 1999;  142 41-50
    CrossrefPubMedGoogle Scholar
  • 14 Harris D S, Baggott M, Mendelson J H, Mendelson J E, Jones R T. Subjective and hormonal effects of 3,4-methylenedioxymethamphetamine (MDMA) in humans.  Psychopharmacology. 2002;  162 396-405
    CrossrefPubMedGoogle Scholar
  • 15 Hartung T K, Schofield E, Short A I, Parr M JA, Henry J A. Hyponatriaemic states following 3,4-methylenedioxymethamphetamine (MDMA, „ecstasy”) ingestion.  Q J Med. 2002;  95 431-437
    PubMedGoogle Scholar
  • 16 Henry J A. Ecstasy and the dance of death.  Br Med J. 1992;  305 5-6
    PubMedGoogle Scholar
  • 17 Henry J A, Fallon J K, Kicman A T, Hutt A J, Cowan D A, Forsling M. Low-dose MDMA („Ecstacy”) induces vasopressin secretion.  Lancet. 1998;  351 1784
    CrossrefPubMedGoogle Scholar
  • 18 Henry J A, Hill I R. Fatal interaction between ritonavir and MDMA.  Lancet. 1998;  352 1751-1752
    PubMedGoogle Scholar
  • 19 Henry J A, Jeffreys K J, Dawling S. Toxicity and deaths from 3,4-methylenedioxymethamphetamine („ecstasy”).  Lancet. 1992;  340 384-387
    CrossrefPubMedGoogle Scholar
  • 20 Henry J A, Rella J G. Medical risks associated with MDMA use. In: Holland J (ed) Ecstasy: the complete guide - A comprehensive look at the risks and benefits of MDMA. Rochester, Vermont; Park Street Press 2001: 71-86
    Google Scholar
  • 21 Hernández Lopez C, Farré M, Roset P N. et al . 3,4-Methylenedioxymethamphetamine (Ecstasy) and alcohol interactions in humans: psychomotor performance, subjective effects, and pharmacokinetics.  J Pharmacol Exp Ther. 2002;  300 236-244
    CrossrefPubMedGoogle Scholar
  • 22 Johnston L D, O'Malley P M, Bachman J G. Monitoring the Future national survey results on drug use, 1975 - 2001. Volume I: Secondary school students. Bethesda, MD; National Institute on Drug Abuse 2002 NIH Publication No. 02-5106
    Google Scholar
  • 23 Kupferschmidt H, Wyss P A, Fattinger K, Meier-Abt P J. Medizinische Probleme beim Konsum illegaler Drogen. In: Grundlagen der Arzneimitteltherapie. Basel; Documed 2001
    Google Scholar
  • 24 Lange-Brock N, Berg T, Müller A R. et al . Akutes Leberversagen nach Konsum von Ecstasy (MDMA).  Z Gastroenterol. 2002;  40 581-586
    Article in Thieme ConnectPubMedGoogle Scholar
  • 25 Lester S J, Baggott M, Welm S. et al . Cardiovascular effects of 3,4-methylenedioxymethamphetamine. A double-blind placebo-controlled trial.  Ann Int Med. 2000;  133 969-973
    PubMedGoogle Scholar
  • 26 Liechti M E, Achermann E. Das Pneumomediastinum.  Dtsch Med Wochenschr. 2002;  127 2273-2276
    Article in Thieme ConnectPubMedGoogle Scholar
  • 27 Liechti M E, Baumann C, Gamma A, Vollenweider F X. Acute psychological effects of 3,4-methylenedioxymethamphetamine (MDMA, „Ecstasy”) are attenuated by the serotonin uptake inhibitor citalopram.  Neuropsychopharmacology. 2000;  22 513-521
    CrossrefPubMedGoogle Scholar
  • 28 Liechti M E, Gamma A, Vollenweider F X. Gender differences in the subjective effects of MDMA.  Psychopharmacology. 2001;  154 161-168
    CrossrefPubMedGoogle Scholar
  • 29 Liechti M E, Mathys J. Komatöses Zustandsbild bei einem 21-jährigen Partygänger.  Internist. 2003;  44 215-218
    PubMedGoogle Scholar
  • 30 Liechti M E, Saur M, Gamma A, Hell D, Vollenweider F X. Psychological and physiological effects of MDMA („Ecstasy”) after pretreatment with the 5-HT2 antagonist ketanserin in healthy humans.  Neuropsychopharmacology. 2000;  23 396-404
    CrossrefPubMedGoogle Scholar
  • 31 Liechti M E, Vollenweider F X. Acute psychological and physiological effects of MDMA („Ecstasy”) after haloperidol pretreatment in healthy humans.  Eur Neuropsychopharmacol. 2000;  10 289-295
    PubMedGoogle Scholar
  • 32 Liechti M E, Vollenweider F X. The serotonin uptake inhibitor citalopram reduces acute cardiovascular and vegetative effects of 3,4-methylenedioxymethamphetamine („Ecstasy”) in healthy volunteers.  J Psychopharmacol. 2000;  14 269-274
    CrossrefPubMedGoogle Scholar
  • 33 Liechti M E, Vollenweider F X. Which neuroreceptors mediate the subjective effects of MDMA in humans? A summary of mechanistic studies.  Hum Psychopharmacol Clin Exp. 2001;  16 589-598
    CrossrefPubMedGoogle Scholar
  • 34 Ling L H, Marchant C, Buckley N A, Prior M, Irvine R J. Poisoning with the recreational drug paramethoxyamphetamine.  Med J Aust. 2001;  174 453-455
    PubMedGoogle Scholar
  • 35 McCann U D, Szabo Z, Scheffel U, Dannals R F, Ficaurte G A. Positron emission tomographic evidence of toxic effect of MDMA („Ecstasy”) on brain serotonin neurons in human beings.  Lancet. 1998;  352 1433-1437
    CrossrefPubMedGoogle Scholar
  • 36 Meyer L V. Suchtmittelnachweis.  Internist. 1999;  40 601-604
    CrossrefPubMedGoogle Scholar
  • 37 Milroy C M, Clark J C, Forrest A RW. Pathology of deaths associated with ecstasy and eve misuse.  J Clin Pathol. 1996;  49 149-153
    PubMedGoogle Scholar
  • 38 Morgan M J. Ecstasy (MDMA): a review of its possible persistent psychological effects.  Psychopharmacology. 2000;  152 230-248
    CrossrefPubMedGoogle Scholar
  • 39 Nichols D E. Differences between the mechanism of action of MDMA, MBDB, and the classical hallucinogens. Identification of a new therapeutic class: Entactogens.  J Psychoactive Drugs. 1986;  18 305-313
    PubMedGoogle Scholar
  • 40 Reneman L, Booij J, Reitsma J B. et al . Effects of dose, sex, and long-term abstention from use of toxic effects of MDMA (ecstasy) on brain serotonin neurons.  Lancet. 2001;  358 1864-1869
    CrossrefPubMedGoogle Scholar
  • 41 Ricaurte G A, Yuan J, Hatzidimitriou G, Cord B J, McCann U D. Severe dopaminergic neurotoxicity in primates after a common recreational dose regimen of MDMA („Ecstasy”).  Science. 2002;  297 2260-2263
    CrossrefPubMedGoogle Scholar
  • 42 SFA/ISPA .Ecstasy in der Schweiz, die erste repräsentative Studie zur Modedroge. Lausanne; SFA (Schweizerische Fachstelle für Alkohol- und andere Drogenprobleme) 1996
    Google Scholar
  • 43 Soar K, Turner J JD, Parrott A C. Psychiatric disorders in Ecstasy (MDMA) users: a literature review focusing on personal predisposition and drug history.  Hum Psychopharmacol Clin Exp. 2001;  16 641-645
    CrossrefPubMedGoogle Scholar
  • 44 Vastag B. Ecstasy experts want realistic messages.  J Am Med Assoc. 2001;  286 777
    CrossrefPubMedGoogle Scholar
  • 45 Verheyden S L, Hadfield J, Calin T, Curran H V. Subacute effects of MDMA (plusmn 3,4-methylenedioxymethamphetamine, „ecstasy”) on mood: evidence of gender differences.  Psychopharmacology. 2002;  161 23-31
    CrossrefPubMedGoogle Scholar
  • 46 Sydow K von, Lieb R, Pfister H, Höfler M, Wittchen H-U. Use, abuse and dependence of ecstasy and related drugs in adolescents and young adults - a transient phenomenon? Results of a longitudinal community study.  Drug Alcohol Depend. 2002;  66 147-159
    PubMedGoogle Scholar
  • 47 Williams H, Dratcu L, Taylor R, Roberts M, Oyefeso A. „Saturday night fever”: ecstasy related problems in a London accident and emergency department.  J Accid Emerg Med. 1998;  15 322-367
    PubMedGoogle Scholar

Dr. med. Matthias E. Liechti

Medizinische Klinik A · Department für Innere Medizin · Universitätsspital Zürich

Rämistraße 100

8091 Zürich · Schweiz

Phone: 0041/1/255-1111

Fax: 0041/1/255-4445

Email: matthias.liechti@usz.ch