CHRONICLE OF AN ARTIFICIAL PARADISE, OR O NCE UPON A TIME, ADAM AND EVE

Ecstasy, or 3-4, methylene dioxymetamphetamine was first synthetized a t the beginning of the XXth century because of its appetite-suppressan t effects but was subsequently used mainly as a recreational drug. It produces a complex set of stimulating and relaxing effects that may be primarily due to serotoninergic system activation. It is widely belie ved to be safe, probably because it shows little potential for inducin g dependency, as compared with other compounds. Many adverse effects h ave, however, been reported over the last few years, some of which hav e been serious or fatal. Hyperthermia with rhabdomyolysis and, in most cases, renal failure, is among the best known serious adverse effects of Ecstasy. Disseminated intravascular coagulation and cardiocirculat ory collapse are sometime additional manifestations. Fluid and electro lyte imbalances, cardiac abnormalities, and toxic hepatitis have also been reported, as well as a number of harmful psychological effects, s ome of which were long-lasting. Available data do not allow an evaluat ion of the incidence of the adverse effects of Ecstasy, and causality can be difficult to demonstrate. Overdosage requires symptomatic treat ment of each complication. The role of dantrolene or other more or les s specific agents remains to be determined.