MDMA Toxicity Differential Diagnoses

Updated: Jan 25, 2023
  • Author: In-Hei Hahn, MD, FACEP, FACMT; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Diagnostic Considerations

In the United States, adulteration of MDMA tablets decreased markedly from 2009 to 2016, with MDMA being the only psychoactive component in almost half of “ecstasy” tablets tested in 2016, versus only 8.7% in 2009). In particular, many fewer tablets are adulterated with stimulants. Additionally, by 2019 the forms of MDMA had expanded to include readily available high-purity powder and crystalline forms of the drug.  [23]

Mephedrone (4-methylmethcathinone) is a novel psychoactive substance that produces effects similar to those of MDMA (3,4-methylenedioxymethamphetamine, ecstasy). Use of mephedrone has been associated with adverse effects and fatal intoxications. A study in 12 male volunteers found that mephedrone produced a significant increase in systolic and diastolic blood pressure, heart rate, and pupillary diameter, along with stimulant-like effects, euphoria, and well-being similar the effects of MDMA. However, the effects of mephedrone peaked earlier and were shorter in duration. [27]

Differential Diagnoses