Can Ecstasy Cause Hyperthermia?
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The consumption of ecstasy (MDMA) can indeed cause hyperthermia, particularly in environments with high ambient temperatures. The risk is further amplified in individuals with pre-existing conditions such as hyperthyroidism. These findings highlight the importance of understanding the environmental and physiological factors that contribute to MDMA-induced hyperthermia to mitigate the risks associated with its recreational use.
Ecstasy, scientifically known as 3,4-methylenedioxymethamphetamine (MDMA), is a psychoactive drug commonly used for recreational purposes. While it is known for its euphoric effects, MDMA consumption has been associated with severe adverse reactions, including hyperthermia. This article explores the relationship between ecstasy use and hyperthermia, drawing on findings from recent research studies.
Mechanism of Hyperthermia Induced by MDMA
MDMA induces hyperthermia through a complex mechanism that involves both environmental and physiological factors. The drug’s thermogenic response is significantly influenced by the ambient temperature (AT) in which it is consumed. Research has shown that higher ATs can exacerbate the hyperthermic effects of MDMA, making environments like “rave” parties particularly dangerous for users1.
Influence of Ambient Temperature
A study conducted on Charles River mice demonstrated that the hyperthermic response to MDMA is dose-dependent and significantly potentiated by high AT. Mice administered with MDMA and placed in an environment with an AT of 30±2°C exhibited a more pronounced increase in body temperature compared to those in a cooler environment of 20±2°C. This suggests that the risk of hyperthermia is heightened in warmer settings, which are common during recreational use of ecstasy1.
Case Study: Hyperthyroidism and MDMA-Induced Hyperthermia
A case report highlighted the fatal consequences of MDMA-induced hyperthermia in a 24-year-old woman with underlying hyperthyroidism (Graves’ disease). The subject developed severe hyperthermia and multi-organ complications following MDMA use. The presence of diffuse thyroid hyperplasia suggested that pre-existing hyperthyroidism might have predisposed the individual to a fatal hyperthermic reaction. This case underscores the potential role of pre-existing medical conditions in exacerbating the hyperthermic effects of MDMA2.
Can ecstasy cause hyperthermia?
James Docherty has answered Near Certain
An expert from Royal College of Surgeons in Ireland in Cardiology, Physiology, Pharmacology
The answer is yes. I enclose summary of a review article published by myself and my colleague, Richard Green. The key sentences from this summary are:
The hyperthermia occurring in recreational users of MDMA can be fatal, but (data reviewed here indicate that) it is unlikely that any single pharmaceutical agent will be effective in reversing the hyperthermia, so careful body cooling remains the principal clinical approach. Crucially, educating recreational users about the potential dangers of hyperthermia and the control of ambient temperature should remain key approaches to prevent this potentially fatal problem.
Technical summary of our research:
Hyperthermia is probably the most widely known acute adverse event that can follow ingestion of 3,4-methylenedioxymethamphetamine (MDMA, ecstasy) by recreational users. The effect of MDMA on body temperature is complex because the drug has actions on all three major monoamine neurotransmitters [5-hydroxytryptamine (5-HT), dopamine and noradrenaline], both by amine release and by direct receptor activation. Hyperthermia and hypothermia can be induced in laboratory animals by MDMA, depending on the ambient temperature, and involve both central thermoregulation and peripheral changes in blood flow and thermogenesis. Acute 5-HT release is not directly responsible for hyperthermia, but 5-HT receptors are involved in modulating the hyperthermic response. Impairing 5-HT function with a neurotoxic dose of MDMA or p-chlorophenylalanine alters the subsequent MDMA-induced hyperthermic response. MDMA also releases dopamine, and evidence suggests that this transmitter is involved in both the hyperthermic and hypothermic effects of MDMA in rats. The noradrenergic system is also involved in the hyperthermic response to MDMA. MDMA activates central alpha(2A)-adrenoceptors and peripheral alpha(1)-adrenoceptors to produce cutaneous vasoconstriction to restrict heat loss, and beta(3)-adrenoceptors in brown adipose tissue to increase heat generation. The hyperthermia occurring in recreational users of MDMA can be fatal, but data reviewed here indicate that it is unlikely that any single pharmaceutical agent will be effective in reversing the hyperthermia, so careful body cooling remains the principal clinical approach. Crucially, educating recreational users about the potential dangers of hyperthermia and the control of ambient temperature should remain key approaches to prevent this potentially fatal problem.
Can ecstasy cause hyperthermia?
A R Green has answered Near Certain
An expert from The University of Nottingham in Pharmacology
In the early days of recreational ecstasy use there were several well documented cases of severe hyperthermia, looking just like heat stroke. It is generally accepted that this only occurs in a high room temperature environment. Subsequently most dance clubs etc made sure the rooms were kept cooler, so the incidence of severe hyperthermia decreased substantially
Can ecstasy cause hyperthermia?
Jennifer L Cornish has answered Near Certain
An expert from Macquarie University in Neuroscience, Pharmacology
It is well documented in the preclinical literature that MDMA increases body and brain temperature, particularly in warm-high ambient temperatures. The administration of MDMA increases both metabolism and body temperature in a dose dependent manner, which means that the more you take the bigger the effect. Some of our work using a related chemical, methamphetamine, has shown that the increase in temperature is more pronounced in brown adipose tissue, when compared to core body temperature, contributing to increased non-shivering thermogenesis. This increase in temperature in brown adipose tissue has also been reported following MDMA administration and would be one of the contributors to the hyperthermic effect of taking this drug.
Can ecstasy cause hyperthermia?
João Paulo Capela has answered Near Certain
An expert from Universidade Fernando Pessoa in Pharmacology, Toxicology, Neuroscience
Data from human studies and experimental animals, including non-human primates have documented the hyperthermic effects of ecstasy. The temperature increase in humans is dependent on several factors, some of them have to with the place where ecstasy is being intake. If ecstasy is taken in dance events, then the crowded environment, closed places and the ambient temperature are important factors.
Unfortunately, some users under certain conditions attain hyperthermic temperatures that can lead to death. In intoxicated users temperatures of 40, 41 or even 42ºC have been recorded. Hyperthermia is very difficult to control in intensive care units, and sustained high temperature levels can lead to rhabdomyolysis, multiple organ failure and death.
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