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La toxicidad y las muertes por 3,4-metilendioximetanfetamina ("éxtasis")

J A Henry¹, K J Jeffreys, S Dawling

¹National Poisons Unit, Guy's Hospital, London, UK.

Lancet (London, England)

|August 15, 1992

Resumen

La toxicidad severa de la 3,4-metilendioximetanfetamina (MDMA), o éxtasis, está en aumento. Este medicamento puede causar hipertermia, insuficiencia orgánica y muerte, con casos crecientes de daño hepático y accidentes.

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Área de la Ciencia:

Toxicología Toxicología.
Medicina de emergencia Medicina de emergencia.
Farmacología Farmacología.

Sus antecedentes:

Se reconocen reacciones adversas a la 3,4-metilendioximetanfetamina (MDMA), comúnmente conocida como éxtasis, pero están presentes con patrones de enfermedad variados.
Las tendencias recientes indican un aumento en los casos de toxicidad severa vinculados al uso indebido de MDMA recreativo, incluso en pequeñas dosis.

Objetivo del estudio:

Informar sobre los patrones de toxicidad severa y reacciones adversas asociadas con el uso indebido de MDMA observados entre 1990 y 1991.
Para resaltar las complicaciones emergentes, como la hepatotoxicidad y los accidentes de tráfico relacionados con el MDMA.

Principales métodos:

Análisis retrospectivo de casos clínicos que experimentaron reacciones adversas a la MDMA.
Monitoreo de los patrones de toxicidad, incluidas las muertes, la hepatotoxicidad y las personas identificadas con drogas en accidentes de tráfico.

Principales resultados:

Siete muertes exhibieron toxicidad severa, incluyendo hipertermia, convulsiones, coagulación intravascular diseminada, rabdomiolisis y insuficiencia renal aguda.
Se documentaron siete casos de hepatotoxicidad, lo que sugiere una frecuencia creciente.
Cinco sujetos involucrados en accidentes de tránsito resultaron positivos para MDMA.

Conclusiones:

El uso indebido de MDMA puede conducir a efectos tóxicos agudos graves, incluida la hipertermia potencialmente fatal y la insuficiencia multiorgánica.
La hepatotoxicidad parece ser una complicación creciente del uso indebido de MDMA.
Se justifica una mayor supervisión de la morbilidad a largo plazo asociada con el uso de MDMA.