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Journal of Psychopharmacology, Vol. 17, No. 3, 342-345 (2003)
DOI: 10.1177/02698811030173018


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Neuropsychiatric Consequences (Atypical Psychosis and Complex-Partial Seizures) of Ecstasy Use: Possible Evidence for Toxicity-Vulnerability Predictors and Implications for Preventative and Clinical Care

Marco Vecellio

Psychiatric University Hospital Zurich, Zürich, Switzerland

Christian Schopper

Psychiatric University Hospital Zurich, Zürich, Switzerland

Jiri Modestin

Psychiatric University Hospital Zurich, Zürich, Switzerland, modestin{at}bli.unizh.ch

Two case reports of ecstasy abuse and its serious neuropsychiatric complications are presented. The first patient developed a florid paranoid psychosis resembling schizophrenia after repeated long-term recreational ecstasy abuse, and significant alterations with intermittent paroxysmal discharges were found in his electroencephalogram. The second patient showed an atypical paranoid psychosis with Fregoli syndrome and a series of complex-partial epileptic seizures with secondary generalization after a first single ecstasy dose. Both subjects presented considerable vulnerability; the first a minimal brain dysfunction after perinatal asphyxia and a persisting attention deficit/hyperactivity disorder, the second a long-lasting opioid addiction. In vulnerable individuals, dose-independent ecstasy abuse can lead to unpredictable and potentially dangerous neuropsychiatric sequelae which require proper initial assessment and adequate treatment.

Key Words: case report • complex-partial epilepsy • ecstasy • Fregoli syndrome • MDMA • 3,4-methylenedioxyamphetamine • paranoid psychosis • prevention • side-effects


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