Drug‐induced hyperthermia

Nimmo, Susan; Kennedy, B. W.; Tullett, W.M.; Blyth, A.; Dougall, J.

doi:10.1111/j.1365-2044.1993.tb07423.x

Cited by 57 publications

(33 citation statements)

References 31 publications

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“…Severe reported complications from MDMA ingestion include rhabdomyolysis, acute renal failure, cardiac collapse, malignant hyperthermia, disseminated intravascular coagulation, hepatic failure, hyponatremia, urinary retention, cerebral infarct, and cerebral hemorrhage (Table 1). [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] In addition, cases of profound psychosis and depression (once thought to be seen only in chronic users of MDMA) have been reported after minimal use. 3S -42 It is not yet known exactly what pathophysiologic role MDMA plays in the variety of adverse events that have been observed.…”

Section: Case Reports Of Adverse Reactionsmentioning

confidence: 99%

Ecstasy (3,4-Methylenedioxymethamphetamine): History, Neurochemistry, and Toxicology

Rochester

Kirchner

1999

The Journal of the American Board of Family Medicine

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Background: 3,4-Methylenedioxymethamphetamine (MDMA; ecstasy), a compound chemically related to stimulant and hallucinogenic drugs, has been found to induce a state of euphoria and increased selfawareness. MDMA has been increasingly used for recreational purposes, especially among college students and other young adults, and has been associated with multiple toxic effects.Methods: Using MEDLINE, the medical literature was searched from 1986 using the key words "ecstasy," "MDMA," and "designer drugs." Articles dating before 1986 were accessed from cross-reference of the more recent articles. A case report is described.Results: MDMA was developed in 1912 as an appetite suppressant but never became commercially successful. It resurfaced in the 1950s as a psychotherapeutic agent. In 1985 MDMA was classified as a schedule 1 drug by the Food and Drug Administration after reports of neurotoxicity in laboratory animals. It again resurfaced in the mid 1980s as a recreational drug used primarily among college students and other young adults. There are a number of case reports describing toxic effects from MDMA, including hyperthermia, rhabdomyolysis, coagulopathy, and acute renal failure. Little information is available regarding acute management or treatment of toxic ingestions.Conclusions: MDMA ingestion has been associated with severe toxic effects. Although the literature describes numerous cases of toxic ingestion, there are no published recommendations or suggestions to guide physicians in the evaluation and treatment of such cases. By reviewing the history, neurochemistry, and tOxicology of MDMA, as well as providing some guidance regarding management of toxic ingestion, we can arm the provider with valuable information for use in the acute setting. In addition, this information will assist providers in counseling young adults regarding the possible consequences of using this substance.

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Section: Case Reports Of Adverse Reactionsmentioning

confidence: 99%

Ecstasy (3,4-Methylenedioxymethamphetamine): History, Neurochemistry, and Toxicology

Rochester

Kirchner

1999

The Journal of the American Board of Family Medicine

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“…Robertson e col. 16 , constataram que o aumento da atividade serotoninérgica no sistema nervoso central, causa hiperatividade motora, por eles correlacionada com atividade vagarosa rítmica hipocampal e a atividade rápida de baixa voltagem neocortical, sugerindo que os bloqueios metergolínicos dos receptores de serotonina, mediam comportamentos estereotipados. Quanto à hipertemia, sabe-se que a dopamina e a serotonina são importantes mediadores da regulação da temperatura 17 . É comprovada a hiperatividade dos receptores 5-HT na ST causada pelo "ecstasy"(por dano dos terminais dos axônios de 5-HT, por anfetaminas substitutas) 18 .…”

Section: Discussionunclassified

Síndrome serotoninérgica associada ao uso de paroxetina: relato de caso

Cavallazzi

Grezesiuk

1999

Arq. Neuro-Psiquiatr.

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RESUMO-Relatamos um caso de síndrome serotoninérgica pelo uso de inibidor da recaptação da serotonina, a paroxetina. Tal síndrome por esta droga, sem combinações, ainda não tinha sido descrita na literatura.PALAVRAS-CHAVE: síndrome serotoninérgica, paroxetina, mioclonia.Serotonin syndrome associated to the use of paroxetine: case report ABSTRACT-We report on a case of serotonin syndrome associated to the use of the paroxetine, a serotonin reuptake inhibitor drug. Serotonin syndrome related to this drug not combined with other drugs had not yet been described in literature.KEY-WORDS: serotonin syndrome, paroxetine, myoclonus.O uso de antidepressivos do tipo inibidor da recaptação da serotonina tem aumentado nos últimos anos em neurologia e psiquiatria. Como são drogas de introdução recente, pouco se sabe de seus efeitos secundários precoces e tardios. Relatamos um efeito colateral imediato dessas drogas, a síndrome serotoninérgica (ST). RELATO DO CASOMRA, 19 anos, sexo feminino, procurou auxílio médico com sintomas compatíveis com cefaléia tipo tensão episódica e quadro depressivo, com duração de aproximadamente um ano. O exame neurológico era normal. A tomografia computadorizada de crânio, foi normal. Iniciou-se o uso de paroxetina (Aropax) na dose diária de 10 mg , reajustada para 20 mg, 5 dias após o início do tratamento. A partir deste dia, a paciente apresentou quadro abrupto de sudorese fria, hipertemia (38ºC), hipotensão arterial, diaforese, palidez, sensações parestésicas pelo corpo, agitação psicomotora. Este quadro se acompanhava de contrações musculares mioclônicas abruptas e generalizadas nos membros superiores e inferiores, axiais e da face, com predomínio do hemicorpo direito. A paciente permaneceu internada por 48 horas, tendo sido suspensa a paroxetina e iniciado o uso de diazepan, 10 mg diárias, com melhoria das mioclonias generalizadas. Após três dias a paciente foi avaliada por nós e observamos persistência de episódios de mioclonias focais na hemiface direita e por vezes no membro inferior direito, levando-a a cair. A paciente relatava não estar fazendo uso de alimentos contendo triptofano. Os episódios de mioclonias chegavam a durar 10 minutos. Administramos clonazepan (Rivotril), 0, 75 mg por dia, com melhora gradual dos episódios mioclônicos ao longo de 45 dias seguintes. Um eletrencefalograma (EEG) realizado neste período foi normal.Residência de Neurologia do Hospital Governador Celso Ramos, Florianópolis, SC: *Preceptor; **Residente. Aceite: 25-junho-1999.Dr. Luís Otávio Cavallazzi -Rua Barão de Batovi 546 -88015-340 Florianópolis SC -Brasil.

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“…44 The mechanism of hyperthermia is likely central serotonergic overload in the hypothalamus 45-47 but sustained muscular activity from dancing and a disregard of normal body signals such as thirst, compound any central effects. 48,49 Whether MDMA can trigger malignant hyperthermia is unknown.…”

Section: Adverse Effectsmentioning

confidence: 99%