Navigating Treatment Challenges: A Case Study on Refractory Psychosis in a Chronic MDMA (3,4-Methylenedioxymethamphetamine) User.
Cureus May 1, 2024 Melissa N Litenski, Aoife B O'Reardon, Nicole Pabon et al. 1 citation
A 23-year-old woman with chronic MDMA use disorder and childhood trauma developed severe psychosis and catatonia. Although initially suspected to be drug-induced psychosis, her history and symptoms led to a diagnosis of bipolar I disorder with psychotic features, worsened by MDMA use. Standard antipsychotics failed and worsened catatonia, requiring electroconvulsive therapy (ECT) for improvement. Socioeconomic barriers disrupted follow-up care, resulting in an emergency department visit shortly after discharge. The case illustrates the complex interaction of substance use, psychiatric illness, and trauma, highlights ECT's effectiveness in severe psychosis, and underscores the need for comprehensive mental health services for vulnerable populations and further research on MDMA's psychiatric effects.