MDMA (ecstasy) use is associated with which adverse effects?

MDMA (ecstasy) use is associated with which adverse effects?

• A. Respiratory depression and pinpoint pupils
• B. Hypertension and bradycardia only
• C. Serotonin toxicity and hyponatremia
• D. Muscle rigidity with hyperkalemia

Answer: (C)

MDMA's effects are driven by strong increases in serotonin in the brain, which can lead to serotonergic toxicity (serotonin syndrome) when levels are high. This syndrome brings autonomic instability and neuromuscular symptoms together—rapid heart rate, high blood pressure, sweating, agitation, and features like tremor or clonus. Hyponatremia is another key risk with MDMA, often from drinking excessive water in hot environments or altered water balance due to ADH effects, which can dilute sodium levels and lead to confusion, seizures, or swelling. These two adverse effects—serotonin toxicity and hyponatremia—are characteristic of MDMA use. Other options don’t fit as well. Respiratory depression and pinpoint pupils are typical of opioid overdoses, not MDMA. Hypertension with bradycardia isn’t the usual pattern, since MDMA commonly causes tachycardia and hypertension. Muscle rigidity with hyperkalemia points more toward malignant hyperthermia or neuroleptic malignant syndrome, not MDMA.

MDMA's effects are driven by strong increases in serotonin in the brain, which can lead to serotonergic toxicity (serotonin syndrome) when levels are high. This syndrome brings autonomic instability and neuromuscular symptoms together—rapid heart rate, high blood pressure, sweating, agitation, and features like tremor or clonus. Hyponatremia is another key risk with MDMA, often from drinking excessive water in hot environments or altered water balance due to ADH effects, which can dilute sodium levels and lead to confusion, seizures, or swelling. These two adverse effects—serotonin toxicity and hyponatremia—are characteristic of MDMA use.

Other options don’t fit as well. Respiratory depression and pinpoint pupils are typical of opioid overdoses, not MDMA. Hypertension with bradycardia isn’t the usual pattern, since MDMA commonly causes tachycardia and hypertension. Muscle rigidity with hyperkalemia points more toward malignant hyperthermia or neuroleptic malignant syndrome, not MDMA.