Recreational drug use among holidaymakers in Ibiza often involves multiple substances, both traditional and novel, leading to acute psychiatric emergencies. The pattern of poly-substance use is linked to a range of psychopathological consequences. Better understanding of the specific effects of individual drugs, clearer diagnostic signs and symptoms, and long-term follow-up studies are needed.
MDMA (ecstasy) neurotoxicity may involve nitrosative stress driven by the enzyme iNOS rather than by NOX enzymes that produce reactive oxygen species. In rats given MDMA, iNOS expression increased, and cells positive for 3-nitrotyrosine (a marker of nitrosative damage) rose in the frontal cortex. No changes occurred in NOX2, NOX1, or NOX4 immunoreactivity or in the oxidative stress marker 8OHdG. MDMA and nitrosative markers colocalized with dopamine-transporter-positive cells, which were neurons, not microglia or astrocytes. The findings indicate that iNOS-derived nitrosative stress, not NOX enzymes, likely contributes to MDMA-induced neurotoxicity.