Presentation
The present case shows that only one Ecstasy tablet can have a fatal outcome. In fact, this case is one of a series of 14 Ecstasy-related deaths in a three-year time span in Ontario; all of the cases are being reviewed. [ncbi.nlm.nih.gov]
Entire Body System
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Unconsciousness
The Abbotsford woman, whose name has not been released, is in critical condition after paramedics responded to a call about 6 a.m. and found her unconscious at a home in the 33700-block of George Ferguson Way. [vancouversun.com]
An ambulance was eventually called just before 4am after she suffered a fit and started foaming at the mouth but by the time paramedics arrived she was unconscious. [telegraph.co.uk]
Covered in mud, she finally crumpled unconscious in the road. Her friends, unable to rouse her, made frightened calls to Leah’s family. [dailymail.co.uk]
The girl arrived unconscious (Glasgow Coma Scale was 3), and was intubated, ventilated and started on a dopamine infusion. She was pronounced brain dead two days later in the intensive care unit. [ncbi.nlm.nih.gov]
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Swelling
Combined with the loss of body salts through heavy sweating, excessive amounts of water can cause a severe imbalance of electrolytes, leading to brain swelling, seizures or organ failure. Agitation. [eu.northjersey.com]
Leah Betts had been found slumped in a bathroom by her stepmother, Janet, on the night of her 18th birthday party and died from water intoxication, having drunk three litres of water in a very short space of time, causing her brain to swell. [dailymail.co.uk]
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Collapse
Wigan schoolgirl Leah Robinson, who collapsed after taking Ecstasy on Christmas Day 2016 -two days after her 16th birthday - miraculously survived after taking Ecstasy The second, Wigan schoolgirl Leah Robinson, who collapsed after taking Ecstasy on Christmas [dailymail.co.uk]
The teenager collapsed in a shaking fit and began foaming at the mouth after she swallowed two of the tablets. [telegraph.co.uk]
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Hyperthermia
Ecstasy overdose can cause hyperthermia, leading to organ damage and even death. [mentalhelp.net]
[…] emergency department physicians and general practitioners, should be familiar with the morbidity of Ecstasy, which ranges from an increase in sympathetic tone (tachycardia, hypertension, sweating, mydriasis) to more severe symptoms such as hyponatremia, hyperthermia [ncbi.nlm.nih.gov]
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Physician
Julian Marsden, an emergency room physician at St. Paul’s Hospital for the past 19 years, said he has seen the drug become more mainstream and in recent years an average of three ecstasy overdoses are treated at his hospital every week. [vancouversun.com]
Physicians, especially emergency department physicians and general practitioners, should be familiar with the morbidity of Ecstasy, which ranges from an increase in sympathetic tone (tachycardia, hypertension, sweating, mydriasis) to more severe symptoms [ncbi.nlm.nih.gov]
Gastrointestinal
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Nausea
Anti-nausea medication is often provided along with sedatives to reduce withdrawal symptoms. Treatment of physical symptoms precedes psychosocial treatment, which is offered once the individual is stable. [mentalhelp.net]
Cardiovascular
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Hypertension
Physicians, especially emergency department physicians and general practitioners, should be familiar with the morbidity of Ecstasy, which ranges from an increase in sympathetic tone (tachycardia, hypertension, sweating, mydriasis) to more severe symptoms [ncbi.nlm.nih.gov]
Jaw & Teeth
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Foaming at the Mouth
The teenager collapsed in a shaking fit and began foaming at the mouth after she swallowed two of the tablets. [telegraph.co.uk]
Skin
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Sweating
He is sweating profusely. A police officer shines his light against the wall and tells Lowery there’s nobody there. [eu.northjersey.com]
Hyperthermia (overheating) is a primary outcome of ecstasy overdose because of the extreme physicality of typical users, the inability to sweat, and the fact that ecstasy usage increases body temperature. [mentalhelp.net]
Hyponatremia is associated with Ecstasy use either because of an inappropriate secretion of antidiuretic hormone or because of sodium loss through excessive sweating during dancing combined with electrolyte-free water intake. [ncbi.nlm.nih.gov]
Her head was swollen, she was covered in cold sweat and her temperature had dropped to 26c [normal body temperature is about 37c]. ‘Doctors had put her in a coma while they tried to warm her up and flush out the Ecstasy. [dailymail.co.uk]
[…] usually felt about 20 minutes to an hour after it’s taken and last for around 6 hours. 1 You may experience: euphoria feeling energetic and confident large pupils jaw clenching and teeth grinding heightened senses (sight, hearing and touch) excessive sweating [adf.org.au]
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Flushing
They had to flush me out and kept me warm because I had hypothermia. But fortunately there were no long-lasting effects. I’m very grateful to the medical staff.’ [dailymail.co.uk]
Psychiatrical
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Delusion
Paranoid delusions. Users can see and hear things that aren’t there. The typical Emergency Department drug test does not detect ecstasy, Calello said, but a post-mortem analysis would. [eu.northjersey.com]
Neurologic
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Seizure
Combined with the loss of body salts through heavy sweating, excessive amounts of water can cause a severe imbalance of electrolytes, leading to brain swelling, seizures or organ failure. Agitation. [eu.northjersey.com]
People who suffer an adverse reaction to ecstasy can have psychotic breakdowns, hallucinations and agitation as well as seizures, kidney failure and, in rare cases, heart attacks, he said. [vancouversun.com]
Seizures. While the risk of overdosing on ecstasy is not as high as with drugs such as cocaine or heroin, the risk exists. [mentalhelp.net]
Finally, looking at the patient’s sodium level on admission, she could have had a fatal hyponatremic seizure. [ncbi.nlm.nih.gov]
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Agitation
Agitation. “Your system gets really revved up — your heart beats very fast,” said Calello. A user feels like they’re running a race or running for their life, she said. [eu.northjersey.com]
People who suffer an adverse reaction to ecstasy can have psychotic breakdowns, hallucinations and agitation as well as seizures, kidney failure and, in rare cases, heart attacks, he said. [vancouversun.com]
Symptoms include: cravings for MDMA aches and pains exhaustion restless sleep agitation trouble concentrating anxiety and depression. 7 [adf.org.au]
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Stroke
Enormous strain on the heart and other parts of the body, which can lead to stroke. 5 MDMA antidepressants: Drowsiness, clumsiness, restlessness and feeling drunk and dizzy. 6 Withdrawal Giving up MDMA after using it for a long time is challenging because [adf.org.au]
I just stroked her hair and told her, “I’m here Leah, please stay with us.” I just prayed she could hear me. I was terrified I was going to lose her.’ [dailymail.co.uk]
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Neglect
The neglect of social and professional relationships and responsibilities. The development of tolerance, resulting in a need for higher quantities to achieve the same results (obtain the same "high"). [mentalhelp.net]
Urogenital
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Kidney Failure
People who suffer an adverse reaction to ecstasy can have psychotic breakdowns, hallucinations and agitation as well as seizures, kidney failure and, in rare cases, heart attacks, he said. [vancouversun.com]
Treatment
Treatment of physical symptoms precedes psychosocial treatment, which is offered once the individual is stable. [mentalhelp.net]
The initial treatment should concentrate on these symptoms. The general opinion of Ecstasy’s reputed safety should be corrected. Among adolescents and the lay public, Ecstasy is still considered to be a safe drug. [ncbi.nlm.nih.gov]
Prevention
Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report (MMWR). June 11, 2010 / 59(22);677-681 Johnston L. et al (2014). Key Findings on Adolescent Drug Use. Monitoring the Future: National Survey Results on Drug Use. [mentalhelp.net]