Bruxismo secundario al consumo recreacional de éxtasis: revisión de la literatura / Secondary bruxism after recreational ecstasy consumption: a review

El Metilendioximetanfetamina (MDMA) o éxtasis, es una droga sintética que fue accidentalmente aislada en 1914, sin encontrarse en ella una utilidad médica. La OMS la considera una droga psicotrópica y es ilegal en diversos países, incluyendo a Chile. De acuerdo al Estudio Global de Drogas Sintéticas, el consumo de éxtasis ha aumentado considerablemente en Latinoamérica entre el 2008 y 2014, estudios en Chile la muestran con una "nueva droga" cuyo consumo está aumentando en personas de 19­25 años de edad. El concepto de bruxismo en odontología ha cambiado con el paso del tiempo. Actualmente se reconoce su naturaleza multifactorial, en dónde los factores centrales (patofisiología) juegan un rol principal. Diversos autores han reportado bruxismo como un efecto secundario al consumo recreacional de éxtasis, con frecuencias que van entre el 50 a 89%. Esto puede explicarse debido al efecto de desbalance a nivel de las vías serotoninérgicas y/o domaminérgicas que produce el MDMA, tal como parece ocurrir en el bruxismo. Debido a que la Oficina de las Naciones Unidas contra la Droga y el Delito (UNODOC) advierte del aumento progresivo y significativo del consumo de éxtasis en la población joven chilena, es importante conocer las implicancias orales con la finalidad de lograr un mejor manejo odontológico, siendo necesarios mayores estudios para determinar la real asociación entre el consumo de éxtasis recreacional y bruxismo secundario.

Methylenedioxymethamphetamine (MDMA) or Ecstasy is a synthetic drug accidentally isolated in 1914, finding in it no specific medical use. The WHO considers it as a psychotropic drug and it is illegal in several countries, including Chile. According to the Global Synthetic Drugs Assessment, the use of ecstasy has increased steadily in Latin-America between the years 2008 and 2012, and studies in Chile show ecstasy as a "new drug", with an increased consumption in the 19-25 year-old age group. The concept of bruxism in dentistry has changed over time, moving to a multifactorial etiology where central factors, such as pathophysiology have a major role. Several authors report bruxism as a side effect of ecstasy consumption, at a rate of between 50 and 89%. This can be explained by the fact that MDMA acts centrally inducing imbalance at the level of serotonergic and/or dopaminergic pathways, as it occurs in bruxism. Since the United Nations Office on Drugs and Crime warns of a significant and progressive increase in the consumption of recreational ecstasy in young Chilean adult population, it is important to know there are oral implications in order to have better dental management, and further studies are necessary in order to determine an actual association between ecstasy consumption and secondary bruxism.

role of the A2A receptor in cell apoptosis caused by MDMA

Ecstasy, also known as 3, 4-methylenedioxymethamphetamine [MDMA], is a psychoactive recreational hallucinogenic substance and a major worldwide recreational drug. There are neurotoxic effects observed in laboratory animals and humans following MDMA use. MDMA causes apoptosis in neurons of the central nervous system [CNS]. Withdrawal signs are attenuated by treatment with the adenosine receptor [A2A receptor]. This study reports the effects of glutamyl cysteine synthetase [GCS], as an A2A receptor agonist, and succinylcholine [SCH], as an A2A receptor antagonist, on Sprague Dawley rats, both in the presence and absence of MDMA. In this experimental study, we used seven groups of Sprague Dawley rats [200-250 g each]. Each group was treated with daily intraperitoneal [IP] injections for a period of one week, as follows: i. MDMA [10 mg/kg]; ii. GCS [0.3 mg/kg]; iii. SCH [0.3 mg/kg]; iv. GCS + SCH [0.3 mg/kg each]; v. MDMA [10 mg/kg] + GCS [0.3 mg/kg]; vi. MDMA [10 mg/kg] + SCH [0.3 mg/kg]; and vi. normal saline [1 cc/kg] as the sham group. Bax [apoptotic protein] and Bcl-2 [anti-apoptotic protein] expressions were evaluated by striatum using RT-PCR and Western blot analysis. There was a significant increase in Bax protein expression in the MDMA+SCH group and a significant decrease in Bcl-2 protein expression in the MDMA+SCH group [p<0.05]. A2A receptors have a role in the apoptotic effects of MDMA via the Bax and Bcl-2 pathways. An agonist of this receptor [GCS] decreases the cytotoxcity of MDMA, while the antagonist of this receptor [SCH] increases its cytotoxcity

Club drugs: review of the ‘rave’ with a note of concern for the Indian scenario.

'Club drugs’ which include Ecstasy, gamma-hydroxybutyrate (GHB), ketamine, and Rohypnol (flunitrazepam) have become popular with participants in ‘raves’, because they are perceived to enhance energy, endurance, sociability and sexual arousal. These drugs vary in their pharmacologic properties, physiological and psychological effects, and potential consequences. The use of club drugs by young people has increased in the last decade, and continue to get modified and evolve, making them very difficult to monitor. Further, these drugs are not picked up by routine drugs screening procedures, thereby making these popular with the criminals. India, which is in a phase of social transition, also faces this rising menace. Despite the nature and extent of this problem, this area has been under-researched. Data from India are sparse barring a few newspaper and police reports. Keeping abreast of current trends in club drug use prepares the clinician to recognize the clinical effects of club drug use, to manage club drug related emergencies, and to generate social awareness.

Knowledge, attitude, and practice of Iranian adolescent girls towards 3-4-methylenedioxymethamphetamine

To investigate knowledge, attitude, and practice [KAP] of Iranian adolescent girls towards 3-4-methylenedioxymethamphetamine [MDMA [Ecstasy]]. A cross-sectional design study was conducted on female adolescents in Tehran high schools. The study took place in Tehran University of Medical Sciences, Tehran, Iran in October to December 2008. A randomized cluster sample of adolescent girls from 14-18 years old, and enrolled in 57 public high schools of Tehran were selected. A written informed consent was obtained from all study participants. In order to assess the participants' demographic characteristics, and KAP towards Ecstasy, a 61-item, researcher-made, valid, and reliable questionnaire was completed anonymously by all participants at schools. The questionnaire included 4 main domains assessing adolescents': 1. Demographic characteristics [14 items], 2. Knowledge [10 items] 3. Attitude [24 items], and 4. Practice [13 items] toward Ecstasy. Results were considered significant at p

Protective effects of N-Acetyl-L-cystein on 3,4-Methylene Dioxymethamphetamie-induced Neurotoxicity in Cerebellum of male rats

3-4, methylenedioxymethamphetamine [MDMA] causes apoptosis in nervous system and several studies suggest that oxidative stress contributes to MDMA-induced neurotoxicity. The aim of this study is to examine the effects of N-acetyl-L-Cystein [NAC] as an antioxidant on MDMA-induced apoptosis. 21 Sprague dawley male rats [200-250mg] were treated with MDMA [2x0,5mg/kg] or MDMA plus NAC [100mg/kg IP for 7 day]. After last administration of MDMA, rats were killed, cerebellum was removed and Bax and Bcl-2 expression was assessed by western blotting method. The results of this study showed that MDMA causes up-regulation of Bax and down-regulation of Bcl-2 and NAC administration attenuated MDMA-induced apoptosis. The present study suggests that NAC treatment may improve MDMA-induced neurotoxicity.

Recognition of special form of amphetamine acquaintance in iran and presentation of 4 cases with neurovascular complication

Ecstasy and crystal are recently new most widely abused illegal drugs in Iran. Ecstasy/MDMA abuse may cause acute complications that have fatal consequences. Pt 1: A 26 year old who referred to emergency room due to acute paraplegia and finally died with cardiac arrest. Pt 2: A 45 year old woman who came with seizure disorder and unconsciousness. Finally she died due to cardiac arrest. Pt 3: A 32 year old man was admitted due to acute flaccid paraplegia. He had diffused skin rash due to vasculitis. The patient died despite of supportive cares. Pt 4: A 23 year old man who referred to neurological ward because of generalized tonic-clonic seizures following Crystal and Ecstasy abuse. The patient was discharged after 4 days with good general conditions. Unfortunately recently, the rate of Ecstasy and Crystal drugs abusers in Iran have increased. This paper notify about the neurological side effects of these drugs

[Effects of MDMA [ecstasy] on oocyte quality and fertilization rate in mice]

Ecstasy drug abuse is relatively common among the youth undergoing psychosocial stresses. Categorized as a stimulant drug, ecstasy has nervous, cardiac and immunological side-effects. The endocrine system is not spared from the harmful effects of the drug and it could influence ovulation by exerting its effects on the hypothalamic-hypophyseal-gonadal axis. The aim of this study was to evaluate the effects of ecstasy on the quality of oocytes and on fertilization rate in mice. Thirty female NMRI mice were divided into three groups, after checking for their estrous cycles. At the beginning of each cycle, ecstasy was administered intraperitoneally to the animals in groups A [a minimum dose of 5 mg/kg/day] and B [a maximum dose of 20 mg/kg/day]. At the end of the second day, 10 IU PMSG, and at the end of the 4th day, 10 IU HCG were administered intra-peritoneally. The mice in group C underwent the same procedures except receiving ecstasy. All the mice were sacrificed on the fifth day to aspirate their oocytes for further evaluation. In-vitro fertilization was done using mature or MII oocytes and fertilization was checked after 5 hours. The results were later statistically analyzed. The number of retrieved oocytes was similar between the experimental and control groups. However, the rate of mature oocytes [MII] was significantly higher [p=0.0001] in the controls [31.2%] than the mice in groups A [15.2%] and B [12.8%]. Moreover, fertilization rate was significantly higher in the controls than the experi-mental groups. Administration of Ecstasy in mice can affect both oocyte maturity and the fertilization potential of oocytes. The overall effects of ecstasy on embryo development and implantation needs further studies to reach a definitive conclusion

survey of youth knowledge attitude and behavior toward ecstasy use in Northestern districts of Tehran

This study evaluated the knowledge and attitude of Tehran northwestern young population toward ecstasy use and its consequences. In this descriptive, analytical-crossectional study, 400 young [247males, 153 females] persons residing in northwestern districts of Tehran were assessed by a demographic and knowledge, attitude and behavior questionnaire. They were selected via the multi-stage random sampling. The data were analyzed through the descriptive statistic methods and x [2]. 41% of samples had good knowledge, 50%had moderate knowledge and 9% had low knowledge. 32%saples had good attitude, 44% had moderate attitude and 24% had bad attitude 26%of respondents have reported that they have used the ecstasy tablets. One important finding is that 31%of ecstasy user are also addicted to other kinds of narcotics. 44.9%of males and 35.3%of females were moderately aware of the dangerous outcomes of the ecstasy use.25.9%of males and 20.3%femles regarded the ecstasy use a bad and dangerous act. In this study there was a significant relationship between attitude and gender [p=0.035].also there was a significant relationship between ecstasy use and gender [p<0.001] and a notable relationship between ecstasy use and education [p=0.008] A considerable percent of respondents was not aware of the dangerous outcomes of the ecstasy and not show the expected negative attitude toward this drug and a vast percentage of them had used the drug

Ecstasy (MDMA) ingestion related with severe hyponatremia in patients with mild head injury.

The occurrence of severe hyponatremia is an unusual complication in patients with a mild head injury. Between December 2001 and January 2003, 1147 patients with a mild head injury were reviewed Only patients who presented with deterioration of consciousness or seizure due to hyponatremia, confirmed by serum investigation, were further evaluated, presenting features and clinical courses. The results revealed only 3 patients developed severe hyponatremia following a mild head injury. Surprisingly, all of them had a recent history of ecstasy (MDMA) use, as well as hyponatremia which didn't develop until the episode of a mild head injury. In the present report, the associated mechanisms of both conditions of severe hyponatremia are discussed and the literature is reviewed.

"Extase": revisäo farmacológica / \"Ecstasy\": a pharmacological review

Neste estudo, fez-se uma revisäo bibliográfica sobre a 3,4-metilenodioximetan-fetamina (MDMA), mais conhecida como "êxtase", uma droga em expansäo de abuso entre os jovens. Descreve-se o histórico, desde sua síntese até seu uso inicial como auxiliar em psicoterapia e, mais recentemente, como droga de abuso. Apresenta-se o perfil de uso em outros países, tentando prever o possível padräo de uso no Brasil, onde já se iniciou o abuso. O detalhamento sobre a farmacocinética da MDMA visa a justificar as conseqüências sobre a atividade farmacológica e toxicológica. Resumen-se as manifestaçöes clínicas de toxicidade a curto e a médio prazo, descrevendo-se os efeitos na intoxicaçäo grave com o "êxtase". Säo apresentados os estudos dos mecanismos de açäo no sentido de justificar seus efeitos tóxicos psíquicos e físicos, detalhar os mecanismos pelos quais a droga é auto-administrada e as possibilidades terapêuticas para reverter os efeitos

"Extase" (3,4 metilenodioximetanfetamina, MDMA): uma droga velha e um problema novo? / \"Ecstasy\" (3,4 methylenedioxymethamphetamine, MDMA): an old drug and a new problem?

O uso recreacional da MDMA ou, como tem sido popularmente chamado, êxtase, tem sido identificado em vários dos pacientes que buscam tratamento para dependências de drogas nas clínicas de Säo paulo. Embora a MDMA näo seja uma nova droga, pois foi sintetizada no começo do século, a maioria dos profissionais de saúde näo tem conhecimento de seus efeitos físicos e psíquicos e das possíveis complicaçöes que podem ocorrer com seu uso. O objetivo desta revisäo é: 1) traçar um histórico da MDMA desde a sua síntese até seu uso recente como droga de abuso em vários países; 2) discutir seus principais efeitos químicos e toxicológicos; 3) apresentar os possíveis efeitos adversos da MDMA em humanos; 4) discutir o perfil de uso em outros países e seus possíveis padröes em nosso meio. Foi feita revisäo de literatura baseada no MEDLINE no período de 1985 a 1995