Acute hyponatraemia and ‘ecstasy’: insights from a quantitative and integrative analysis

A 20‐year‐old woman attended a ‘rave party’ where she took the drug 3,4‐methylenedioxymethamphetamine (MDMA, ‘ecstasy’). She had used this drug previously without serious adverse effects. On this occasion, while both she and her friends drank a large quantity of water, only she became seriously ill....

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Bibliographic Details
Published in:QJM : An International Journal of Medicine 2002-07, Vol.95 (7), p.475-483
Main Authors: Cherney, D.Z.I., Davids, M.R., Halperin, M.L.
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Digestive System Physiological Phenomena
Drinking
Drug toxicity and drugs side effects treatment
Female
Hallucinogens - adverse effects
Humans
Hyponatremia - chemically induced
Hyponatremia - diagnosis
Medical sciences
Miscellaneous (drug allergy, mutagens, teratogens...)
N-Methyl-3,4-methylenedioxyamphetamine - adverse effects
Pharmacology. Drug treatments
Sex Factors
Sodium - metabolism
Sweat - chemistry
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Summary:A 20‐year‐old woman attended a ‘rave party’ where she took the drug 3,4‐methylenedioxymethamphetamine (MDMA, ‘ecstasy’). She had used this drug previously without serious adverse effects. On this occasion, while both she and her friends drank a large quantity of water, only she became seriously ill. The initial manifestation was an altered sensorium; several hours later she had a grand mal seizure. In the Emergency Department, the most striking features were the severe degree of hyponatraemia (112 mmol/l) and cerebral oedema. To explain the basis for this life‐threatening clinical presentation, an imaginary consultation was sought with Professor McCance. Using both a deductive and a quantitative analysis that involved several medical subspecialties, he illustrated that a simple story of water ingestion and vasopressin release was not sufficient to explain her hyponatraemia. It was only after events in her gastrointestinal tract were analysed that a plausible hypothesis could be constructed.
ISSN:1460-2725
1460-2393
1460-2393
DOI:10.1093/qjmed/95.7.475