Life-Threatening 3,4‐Methylenedioxyamphetamine (MDMA) Usage
Handbook of Substance Misuse and Addictions January 1, 2022 DOI: 10.1007/978-3-030-67928-6_118-1 via Springer Nature
Summary
MDMA (ecstasy, Molly) is a synthetic stimulant and hallucinogen commonly used at electronic dance music parties, especially by young people in Hong Kong and globally. While recreational use is widespread, serious illness and death can occur, linked to serotonin toxicity. Cyproheptadine, an antihistamine with serotonin-blocking properties, is reported as an effective treatment for moderate serotonin syndrome. This chapter reviews the life-threatening risks of MDMA use, the serotonin syndrome associated with it at EDM events, diagnosis and management, and the benefits of cyproheptadine as an antidote.
Study at a glance
| Characteristics | Review Peer reviewed |
|---|---|
| Topics | MDMA |
| Keywords | 3,4-methylenedioxymethamphetamine Serotonin syndrome Cyproheptadine |
| Key finding | Cyproheptadine is reported to be an effective agent for managing moderate serotonin syndrome associated with MDMA abuse. |
Abstract
MDMA (3,4-methylenedioxymethamphetamine), popularly known as “ecstasy,” “E,” “Adam,” “XTC,” “M&M,” or “Molly,” is a synthetic compound of phenethylamine with stimulant and hallucinogenic properties. It is a common recreational street drug affecting young people particularly at urban dance parties in Hong Kong. MDMA abuse is widely reported in electronic dance music (EDM) festivals all over the world. Although uncommon, mortality and serious morbidity occur with recreational use, which is believed to be related to serotonin toxicity. Cyproheptadine has antihistamine and 5-HT antagonist property, which is reported to be an effective agent in managing serotonin syndrome of moderate severity. This chapter reviewed the life-threatening usage of MDMA, serotonin syndrome associated with MDMA abuse in EDM, diagnosis and management and the benefits of cyproheptadine as an antidote.