The pharmacology and toxicology of "ecstasy" (MDMA) and related drugs

"ECSTASY" (MDMA) AND RELATED DRUGS ARE AMPHETAMINE DERIVATIVES that also ha ve some of the pharmacological properties of mescaline. They have become po pular with participants in "raves," because they enhance energy, endurance, sociability and sexual arousal. This vogue among teenagers and young adult s, together with the widespread belief that "ecstasy" is a safe drug, has l ed to a thriving illicit traffic in it. But these drugs also have serious t oxic effects, both acute and chronic, that resemble those previously seen w ith other amphetamines and are caused by an excess of the same sympathomime tic actions for which the drugs are valued by the users. Neurotoxicity to t he serotonergic system in the brain can also cause permanent physical and p sychiatric problems. A detailed review of the literature has revealed over 87 "ecstasy"-related fatalities, caused by hyperpyrexia, rhabdomyolysis, in travascular coagulopathy, hepatic necrosis, cardiac arrhythmias, cerebrovas cular accidents, and drug-related accidents or suicide. The toxic or even f atal dose range overlaps the range of recreational dosage. The available ev idence does not yet permit an accurate assessment of the size of the proble m presented by the use of these drugs.