0
ARTICLE |

Ecstasy, the Serotonin Syndrome, and Neuroleptic Malignant Syndrome—A Possible Link?

Donna Ames, MD; William C. Wirshing, MD
JAMA. 1993;269(7):869. doi:10.1001/jama.1993.03500070049022.
Text Size: A A A
Published online

To the Editor.  —We read with interest the report on 3,4-methylenedioxymethamphetamine (ecstasy).1 The toxic effects of this drug—hyperthermia, autonomic instability, increased motor restlessness, and death by renal failure—appear to be similar to certain features of both the "serotonin (5-HT) syndrome"2 and neuroleptic malignant syndrome (NMS).The serotonin syndrome has been reported in depressed patients who are taking a combination of medications that enhance central nervous system serotonin function such as tryptophan, monoamine oxidase inhibitors, and other antidepressant medications. The most frequently reported symptoms that comprise the syndrome are changes in mental status, restlessness, myoclonus, hyperreflexia, diaphoresis, shivering, and tremor. The precise etiology of the syndrome is unclear, although some evidence supports the theory that it is caused by hyperstimulation of the 5-HT1A receptor in the brainstem and spinal cord. This is based on animal research in which 5-HT2 antagonism with specific 5-HT2 antagonists, mianserin hydrochloride

Topics

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

Figures

Tables

References

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();