Éxtasis (3,4-metilendioximetanfetamina, MDMA)aspectos farmacológicos, clínicos y criminológicos

Abstract

Objective: The consumption of designer drugs, whose major constituent is ecstasy (MDMA, 3,4-methylenedioxymethamphetamine), has been increased outstandingly at the last years. This event could be explained because the wrong idea from consumer about its low toxicity, together with the conviction that its use improves the capacity for interpersonal relationship. With this review we want to demythologize these aspects and alert too about the danger of its consume. Material and methods: Epidemiological, pharmacological (pharmacokinetic, neurochemical effects after acute and chronic administration), toxicological and criminological aspects are reviewed, as same as clinical sympthoms (physiological and subjective effects) and the treatment of disorders induced by MDMA. Results: The psychological effects caused by MDMA seem to be due to an increase of monoamines rate in the CNS. The principal mechanism of the euphoria induced by MDMA is the increase of serotonin and dopamine release at nucleus accumbens, property that shares with other abuse drugs. The MDMA's administration, in repetitive way, produces large and possibly permanent injury to serotonergic axons. The morbimortality by ecstasy is due to fulminant hyperthermia, cardiac arrhythmia, disseminated intravascular coagulation, rhabdomyolysis, acute renal failure and liver failure. Conclusions: The neurotoxicity described in the experimental animal and the human, together with the psychopathological symphtoms observed in ecstasy consumers, suggest that MDMA is not a suitable substance for its recreational use. For this reason, and due to increase to the traffic and taking of this drug, its consumption could being an true social-health problem.