Saturday night fever: ecstasy (MDMA) and medical emergencies

Background To assess the extent and nature of acute MDMA (ecstasy)-related problems presenting to a large London hospital's Accident and Emergency (A&E) Department. Method The computerized attendance records for all patients seen at the A&E Dept. over a 15-month period were retrospectively screened and the notes of potential cases systematically reviewed. Results. Patterns of MDMA use: 48 consecutive MDMA (ecstasy)-related cases were identified. All were in the 15 to 30 year age group with most presenting in the early hours at weekends and having consumed MDMA at a night club. About 40% had taken MDMA before and the mean number of tablets consumed was two. Poly-drug use was common, with half of the sample having concurrently taken another illicit drug, most commonly other stimulants (amphetamines and cocaine). Clinical presentation of MDMA users: Many patients had collapsed or passed out and the most common signs were related to sympathetic overactivity, agitation/disturbed behaviour and increased temperature. Conclusions. For young adults presenting late at night at weekends and exhibiting symptoms of sympathetic overactivity, disturbed behaviour and increased temperature ("Saturday night fever") the use of MDMA and/or other stimulant dance drugs should be suspected.