ABSTRACT
The consumption of the jet set drug Ecstasy (3,4-methylenedioxymetamphetamine, abbreviated to MDMA) by young people is increasing markedly. Parallel to this development, there is a large number of reports on severe neurological, psychiatric and medical complications following the use of Ecstasy. Seizures are among the most common clinical complications of the CNS following the ingestion of Ecstasy. Our report presents the case of a 21-year-old patient, who had a series of grand mal seizures after taking 12 tablets of Ecstasy. 36 hours after ingestion the substance MDMA was demonstrated at a level of 300 ng/ml in the serum and CSF. Following treatment with Clonazepam and under an adequate level of carbamazepine, no further seizures occurred. The diagnosis was difficult because the patient initially denied the consumption of drugs and the routine toxicological screening does not contain the substance MDMA.
Subject(s)
Epilepsy, Tonic-Clonic/chemically induced , N-Methyl-3,4-methylenedioxyamphetamine/adverse effects , Adult , Chromatography, Gas , Dose-Response Relationship, Drug , Electroencephalography/drug effects , Epilepsy, Tonic-Clonic/diagnosis , Humans , Male , Metabolic Clearance Rate , N-Methyl-3,4-methylenedioxyamphetamine/pharmacokineticsABSTRACT
A method is described which permits the simultaneous detection of methaqualone, phenothiazines, opiates and benzodiazepines in urine. Its diagnostic application is discussed. After cleavage of conjugates with hydrochloric acid, the substances are extracted and identified by thin-layer chromatography. In most cases analysis can be carried out using 2 solvent systems, phenothiazines, methaqualone and opiates being visualised using a three stage spray sequence. Since phenothiazines can interfere with the detection of methaqualone, a specific eluant is used to ensure reliable detection of the latter. Methaqualone can be positively identified by its characteristic metabolite pattern, whereas phenothiazines can only be detected as a group.
