One Night of Fun, One Lifetime of Effects: MDMA and Sympathomimetic Syndrome

Abstract

Sympathomimetic syndromes are rare medical conditions involving complex clinical pictures caused by substances that have a stimulatory effect on the sympathetic nervous system or have similar effects to the sympathetic nervous system. In this case report, the clinical manifestations of sympathomimetic syndromes, the diagnostic process, treatment strategies and the difficulties encountered especially in emergency medicine will be reviewed.

Keywords

• Critical care
• Emergency department
• Sympathomimetic syndrome

References

1. Kalant H. The pharmacology and toxicology of “ecstasy” (MDMA) and related drugs. CMAJ. 2001 Oct 2;165(7):917- 28. PMID: 11599334; PMCID: PMC81503.
2. Steinkellner T, Freissmuth M, Sitte HH, Montgomery T. The ugly side of amphetamines: short- and long-term toxicity of 3,4-methylenedioxymethamphetamine (MDMA, ‘Ecstasy’), methamphetamine and D-amphetamine. Biol Chem. 2011 Jan;392(1-2):103-15. doi: 10.1515/BC.2011.016. PMID: 21194370; PMCID: PMC4497800.
3. Jansen KL, Theron L. Ecstasy (MDMA), methamphetamine, and date rape (drug-facilitated sexual assault): a consideration of the issues. J Psychoactive Drugs. 2006 Mar;38(1):1-12. doi: 10.1080/02791072.2006.10399822. PMID: 16681170.
4. King A, Dimovska M, Bisoski L. Sympathomimetic Toxidromes and Other Pharmacological Causes of Acute Hypertension. Curr Hypertens Rep. 2018 Feb 24;20(1):8. doi: 10.1007/s11906-018-0807-9. PMID: 29478133.
5. Chan TC, Evans SD, Clark RF. Drug-induced hyperthermia. Crit Care Clin. 1997 Oct;13(4):785-808. doi: 10.1016/s0749- 0704(05)70369-9. PMID: 9330841.
6. Brown H, Pollard KA. Drugs of Abuse: Sympathomimetics. Crit Care Clin. 2021 Jul;37(3):487-499. doi: 10.1016/j. ccc.2021.03.002. PMID: 34053702.
7. Shannon M. Methylenedioxymethamphetamine (MDMA, “Ecstasy”). Pediatr Emerg Care. 2000 Oct;16(5):377-80. doi: 10.1097/00006565-200010000-00022. PMID: 11063374.