A Comprehensive Review of MDMA and GHB: Two Common Club Drugs

Club drugs like MDMA (Ecstasy) and GHB have become alarmingly popular, with use increasing dramatically from 1997 to 1999. MDMA is an amphetamine analog with sympathomimetic properties, while GHB is a GABA analog with sedative properties. MDMA toxic reactions include tachycardia, sweating, and hyperthermia, with severe cases leading to disseminated intravascular coagulation, rhabdomyolysis, and acute renal failure. Treatment involves lowering body temperature and maintaining hydration. GHB intoxication causes coma, respiratory depression, confusion, amnesia, and vomiting, requiring cardiac and respiratory support. The nonlinear pharmacokinetics of both drugs make dose-response estimation difficult. Health care professionals need familiarity with these substances and treatment options.

Study at a glance

Abstract

“Club drugs” have become alarmingly popular. The use of 3,4‐methylenedioxymethamphetamine (MDMA, Ecstasy) and γ‐hydroxybutyrate (GHB), in particular, has increased dramatically from 1997–1999. The pharmacokinetics of MDMA and GHB appear to be nonlinear, making it difficult to estimate a dose‐response relationship. The drug MDMA is an amphetamine analog with sympathomimetic properties, whereas GHB is a γ‐aminobutyric acid analog with sedative properties. Symptoms of an MDMA toxic reaction include tachycardia, sweating, and hyperthermia. Occasional severe sequelae include disseminated intravascular coagulation, rhabdomyolysis, and acute renal failure. Treatment includes lowering the body temperature and maintaining adequate hydration. Symptoms of GHB intoxication include coma, respiratory depression, unusual movements, confusion, amnesia, and vomiting. Treatment includes cardiac and respiratory support. Because of the popularity of these agents and their potentially dangerous effects, health care professionals must be familiar with these substances and the treatment options for patients who present with symptoms of a toxic reaction.