Products
Ecstasy is not legally available in many countries. It is one of the prohibited substances under the Federal Narcotics Act (schedule d). However, ecstasy is known to be manufactured and trafficked illegally.
Structure and properties
Ecstasy or 3,4-methylenedioxy–methamphetamine (MDMA, C11H15NO2, Mr = 193.2 g/mol) is a derivative of methamphetamine and is usually administered as a racemate. The substance was synthesized in the early 20th century. It became popular in the late 1980s and 1990s in connection with rave and techno parties.
Effects
Ecstasy has stimulant, psychoactive, disinhibitory, and anxiety-relieving properties. It can be characterized by the following three E’s: Energy, Empathy, and Euphoria. The effects are due in part to the release of the neurotransmitters serotonin, dopamine, and norepinephrine in the central nervous system and interaction with neurotransmitter transporters and receptors. They begin about one hour after ingestion and last four to six hours. The half-life is between six to eight hours.
Indications for use
Medical applications are discussed, particularly post-traumatic stress disorder (PTSD). Ecstasy is primarily abused as a stimulant intoxicant, for example as a party and club drug.
Dosage
The tablets, if pure, usually contain between about 80 to 150 mg of MDMA.
Contraindications
Abusive use is strongly discouraged. In particular, use is not indicated in cases of hypersensitivity, mental illness, urinary retention, cardiovascular disease such as arrhythmia, coronary artery disease, angina, arterial occlusive disease, epilepsy, other acute or chronic illnesses, during pregnancy and lactation, in children and the elderly, and when other intoxicants or medications (e.g., sympathomimetics, antidepressants, SSRIs, MAO inhibitors, migraine medications, cardiac medications) are taken at the same time.
Interactions
Ecstasy is metabolized by catechol- methyltransferase and CYP2D6. It has a high potential for pharmacodynamic and pharmacokinetic drug-drug interactions.
Adverse effects
Ecstasy has numerous potential adverse effects, and its use may be life-threatening. Side effects include:
- Rapid pulse, high blood pressure, sweating.
- Increase in body temperature
- Confusion, aggression, depression
- Dilated pupils, nystagmus
- Dry mouth
- Gait disturbances
- Teeth grinding
- Withdrawal symptoms, depressed mood
- Injuries, accidents
- Dependence, long-term effects
Serious side effects include sudden death, overheating of the body (hyperthermia), life-threatening dissolution of the muscles, multi-organ failure, liver failure, myocardial infarction, serotonin syndrome, psychosis and cerebral edema. Finally, the illegally trafficked tablets may contain impurities or other psychoactive substances.
