'Eve' and 'Ecstasy'

MDMA (Ecstasy) and its legal replacement MDEA (Eve) are thought to be safe by recreational users and psychotherapists, but five deaths associated with their use are reported. In three cases, the drugs may have contributed to death by triggering arrhythmias in people with underlying heart disease. In one case, MDMA use led to bizarre, risky behavior resulting in accidental death. In another, MDMA was considered the immediate cause. Death from these drugs appears rare but does occur, and may be more common in individuals with pre-existing cardiac disease.

Study at a glance

Abstract

3,4-Methylenedioxymethamphetamine (MDMA, "Ecstasy"), a synthetic analogue of 3,4-methylenedioxyamphetamine, has been the center of recent debate over its potential for abuse vs its use as a psychotherapeutic agent. Following its emergency classification in Schedule 1 by the Drug Enforcement Administration in 1985, 3,4-methylenedioxyethamphetamine (MDEA,"Eve") has appeared as MDMA's legal replacement. MDMA is thought to be safe by recreational users and by psychotherapists who support its use. The details of five deaths associated with the use of MDMA and MDEA are reported. In three patients, MDMA or MDEA may have contributed to death by the induction of arrhythmias in individuals with underlying natural disease. In another patient, use of MDMA preceded an episode of bizarre and risky behavior that resulted in accidental death. In another patient, MDMA was thought to be the immediate cause of death. Death as a consequence of the use of these drugs appears to be rare, but it does occur; this outcome may be more common in individuals with underlying cardiac disease. (JAMA1987;257:1615-1617)