Management of poisoning by amphetamine or ecstasy

While amphetamine and especially methamphetamine (speed) is being misused by all social classes in order to increase stamina, intellectual expansion, endurance, and euphoria, the drug 3,4-methylenedioxy-N-methylamphetamine (MDMA) (ecstasy) is preferentially abused by the younger generation for the feeling of empathy, the touching within, and enhancement of the senses. Acute intoxication differs in regard to their effects on the person. The predominant sympathetic overstimulation after methamphetamine results in cardiovascular and CNS hyperactivity accompanied by agitation and seizures, while tachycardia is a prodrome of fibrillation. The excess hypertonia often leads into myocardial infarction and may even induce cerebral haemorrhage. MDMA intoxication often seen in the emergency department is predominantly characterized by hyperthermia, the most important condition to treat, followed by rhabdomyolysis and acute renal failure. Since there is no specific antidote available, in both cases therapy consists of treatment until the acute effects are gone.