MDMA
- Mechanism of action
- ↑ Release and ↓ reuptake of serotonin, dopamine, and norepinephrine
- Serotonin stimulation is more prominent
- MDMA increases secretion of antidiuretic hormone (ADH) → thirst → increased water intake without electrolyte repletion → hyponatremia
- ↑ Release and ↓ reuptake of serotonin, dopamine, and norepinephrine
- Clinical features
- Clinical features of stimulant intoxication, e.g., sympathetic toxidrome, euphoria, agitation
- Entactogen: social empathy (feeling of “oneness”), loss of anxiety, promotion of introspection and personal reflection
- Hyponatremia: can manifest with seizures, cerebral and/or pulmonary edema
- Features of serotonin syndrome (especially with concomitant use of an SSRI)
- Other: grinding teeth (bruxism), trismus, distorted perceptions of sensation and time
Mnemonic
MDMA has street names like ecstasy, E, X, XTC. Remember X to bruxism.