Henry J A, Jeffreys K J, Dawling S
National Poisons Unit, Guy's Hospital, London, UK.
Lancet. 1992 Aug 15;340(8816):384-7. doi: 10.1016/0140-6736(92)91469-o.
The risk of adverse reactions to 3,4-methylenedioxymethamphetamine (MDMA), more commonly known as "ecstasy", is now widely known in both the USA and UK, but the patterns of illness remain varied. We report our experience during 1990 and 1991. There has been a recent increase in cases of severe toxicity following recreational misuse of small amounts of MDMA. Among 7 fatalities, the pattern of toxicity included fulminant hyperthermia, convulsions, disseminated intravascular coagulation, rhabdomyolysis, and acute renal failure. Until now, there have been few reports of this type of toxicity from MDMA, which may be related both to the potential of the drug to alter thermoregulation and to the circumstances of misuse. In addition, we have monitored 7 cases of hepatotoxicity and suspect that the frequency of this complication is increasing; a history of MDMA misuse should be sought in young people presenting with unexplained jaundice or hepatomegaly. We also describe 5 subjects involved in road traffic accidents in whom MDMA was identified. Misuse of MDMA can have severe acute toxic effects; few data are available concerning long-term morbidity, and this deserves close monitoring in future.
3,4－亚甲基二氧甲基苯丙胺（MDMA），更常见的名称是“摇头丸”，在美国和英国，其不良反应风险如今已广为人知，但发病模式依然多样。我们报告1990年至1991年期间的经验。近期，少量MDMA被用于娱乐性滥用后出现严重中毒病例有所增加。在7例死亡病例中，中毒模式包括暴发性高热、惊厥、弥散性血管内凝血、横纹肌溶解和急性肾衰竭。到目前为止，关于MDMA导致此类中毒的报告很少，这可能与该药物改变体温调节的潜力以及滥用情况有关。此外，我们监测了7例肝毒性病例，并怀疑这种并发症的发生率正在上升；对于出现不明原因黄疸或肝肿大的年轻人，应询问其摇头丸滥用史。我们还描述了5例涉及交通事故且检测出MDMA的受试者。摇头丸滥用会产生严重的急性毒性作用；关于长期发病率的数据很少，这在未来值得密切监测。
