The Complications of 'Ecstasy' (MDMA)

A nearly fatal toxic reaction to 3,4-methylenedioxymethamphetamine (MDMA) occurred after an estimated dose of 100 to 150 mg, with blood levels of 6500 and 7000 ng/mL measured one and two hours after hospital admission. Before MDMA became a Schedule 1 drug in July 1985, psychiatrists used similar doses (100 to 150 mg) as a psychotropic catalyst and sensory disinhibitor without reported toxic effects. This case was part of a controlled study of MDMA metabolism and disposition in a single subject, performed before the drug was scheduled.

Study at a glance

Abstract

To the Editor. —Drs Brown and Osterloh,1in a recent letter inTHE JOURNAL, reported a nearly fatal toxic reaction to 3,4-methylenedioxymethamphetamine (MDMA). The estimated dose of MDMA administered was 100 to 150 mg and the blood levels, measured at one and two hours after hospital admission, were 6500 and 7000 ng/mL, respectively. Before MDMA became a Schedule 1 drug on July 1, 1985,2it was used in doses of 100 to 150 mg by some psychiatrists who claimed that it was effective as a psychotropic catalyst and a sensory disinhibitor; at these doses, no toxic effects were reported. (The experiment was performed on March 12, 1985, before the scheduling of MDMA and was carried out by one of us [J.A.] in partial requirement for the degree of Doctor of Physiology.) At that time, we carried out a controlled study of MDMA metabolism and disposition in a single