ABSTRACT
We present a case of acute, symptomatic hyponatremia in a young woman that developed
after use of 3,4-methylenedioxymethylamphetamine (MDMA), more commonly known as “ecstasy.”
The patient was treated with 5% saline and had complete recovery. The pathogenesis
of MDMA-associated hyponatremia involves excessive water intake and inappropriately
elevated antidiuretic hormone (ADH) levels. It seems that young, premenopausal women
are at particularly high risk for the development of severe, symptomatic hyponatremia
after use of this drug. Review of the literature revealed 4 fatal outcomes from MDMA-associated
hyponatremia. All were women and all died from cerebellar tonsillar herniation. We
suggest that acute hyponatremia that develops after MDMA use may be a life-threatening
condition. Recent recommendation that MDMA users should drink large volumes of water
may not be appropriate.
KEY INDEXING TERMS
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Article info
Publication history
Accepted:
February 26,
2003
Received:
January 9,
2003
Identification
Copyright
© 2003 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
