An "accidental"' acute psychosis with ecstasy use

Over the last 10 years, Europe has witnessed the development of the ecstasy phenomenon; this term is used to describe several products sharing more or less the same effects. The most widely used and hence the most well known is 3,4 MDMA, but MDA, MDEA, MBDB and even 2CB or nexus are available. The p sychopathological consequences of MDMA use in man are relatively poorly und erstood. The case reported here involves an acute psychotic episode with re sidual symptoms after six months, with a sudden onset at least 12 hours aft er taking alcohol and ecstasy without realising it, in an individual with n o previous psychopathology other than a moderate anxiety disorder. Twelve c ases of acute psychotic episodes after taking ecstasy have been reported in the literature; two after taking the drug on two occasions and one after a single use. No authors have examined the previous mental state or possible previous psychopathology with any precision. The present subject had not d isplayed any previous psychotic behavior when tested with a proven standard ized interview technique: this was confirmed by his peers and his family. H e did, however, show signs of social phobia. Although the personality of an individual is a factor in taking a drug, and probably in the quality of th e psychotropic effects experienced, a host of arguments favor the appearanc e of psychotic symptoms de novo, which were probably related to direct toxi city by MDMA and/or its metabolites on the serotoninergic neurons.