Methylenedioxymethamphetamine (MDMA, "Ecstasy")

Ecstasy (MDMA) is an amphetamine derivative of growing popularity. The drug produces a range of toxicities when taken either in standard doses or overdose. In overdose it has major toxicity, producing several different life-threatening manifestations. Hepatotoxicity and hyponatremia are common but poorly understood consequences of MDMA overdose. The drug can produce long-term, if not permanent, neurologic sequelae by destruction of serotonergic neurons. Chronic Ecstasy use can result in psychosis, depression, and suicidal ideation. In the ED setting, it is essential for physicians to recognize and treat appropriately those who present with intoxication from this drug.