Amphetamine toxicity
by
White SR.
Emergency Medicine and Pediatrics,
Wayne State University School of Medicine,
Detroit, Michigan,
and Children's Hospital of Michigan
Regional Poison Control Center,
Detroit, Michigan.
Semin Respir Crit Care Med. 2002;23(1):27-36.
ABSTRACT
Amphetamine abuse is widespread and associated with significant health risk. The most commonly encountered amphetamines are methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA, Ecstasy), and the ephedra alkaloids. Although each of these harbors unique toxicity, they similarly impact the cardiovascular and neurological systems in overdose. Other serious complications associated with amphetamine abuse include severe hyperpyrexia and hyponatremia. Secondary conditions such as rhabdomyolysis, disseminated intravascular coagulation (DIC), gastrointestinal (GI) bleeding, hepatic necrosis, and renal failure are common, especially in those with hyperthermia. Chronic abuse poses risk of vasculitis, neuropsychiatric abnormalities, and cardiomyopathy. In addition, there is a growing body of evidence that even recreational abuse of methamphetamine and MDMA may produce long-lasting damage to dopaminergic and serotonergic neurons. Management principles include adequate sedation, aggressive cooling, and the use of titratable agents in the management of cardiovascular abnormalities.
Club drugs
Abstinence
Parkinson's?
Liver failure
Brain damage?
Kidney damage
Malonate/toxicity
Deaths in New York
Long-term brain damage?
Toxic metabolites of MDMA?
MDMA and sympathetic activity
MDMA and the MAO-b deficient mouse
A distal axotomy of brain serotonin neurons?
A toxic intraneuronal metabolite of serotonin?
Electrophysiological evidence of 5-HT damage
Non-neurotoxic and neurotoxic serotonin-releasers
Ecstasy-induced toxicity and the dopamine transporter
5-HT, 5-HIAA,
norepinephrine, epinephrine and dopamine

Refs
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