In many of these cases the identity and dose of the substance taken is not known; however, in some cases only MDMA was identified on testing [3, 21] The acute adverse effects associated with MDMA use include cardiac arrhythmia, hyperthermia, cerebral haemorrhage, rhabdomyolysis, acute renal failure, hepatotoxicity and acute and chronic psychiatric symptoms and syndromes [34, 36, 37]. PSYCHIATRIC SYMPTOMS AND SYNDROMES AND SEROTONERGIC FUNCTION IN HUMANS Evidence from animal studies suggests that repeated MDMA administration brings about a lasting reduction in 5HT activity in the central nervous system. Neuropsychological testing has demonstated differences between MDMA users and controls on measures of impulsivity [33, 40]. It has also been shown that MDMA use alters sleep duration and pattern with reduced non-REM sleep, compared to age- and sex-matched controls.

A study has found that Garcinia kola extract (GKE) may have neuroprotective properties against MDMA-induced neurotoxicity in rat models. MDMA, also known as 'Ecstasy,' is a popular drug among teenagers, with stimulant, empathogenic, euphoric, and hallucinogenic properties that are thought to be caused by increases in dopamine, serotonin, and glutamate neurotransmission. The study involved 60 healthy adult male Wistar rats that were divided into six groups, with one serving as a control and the others receiving various doses of GKE and MDMA. The results showed that MDMA-induced psychostimulant animals had elevated levels of dopamine, serotonin, and glutamate, correlating with anxiolytic activity. However, histological and GFAP results revealed neuronal degeneration and astrogliosis/glia scar formation, demonstrating MDMA's neurotoxic damage to neurons in the prefrontal cortex and behavioural deficits. The administration of GKE was found to slow down MDMA's neurotoxic damage and behavioural deficits. The study highlights the potential for GKE to be developed as a neuroprotective agent against MDMA-induced neurotoxicity.

These seizures were likely to be convulsive seizures, but CABG patients may also have non-convulsive seizures. Fever commonly leads to seizures in young children, but may also contribute to seizure risk in systemically ill adults, particularly if other risk factors for seizures are present.

The use of recreational drugs has been associated with neurological complications, particularly stroke. The majority of cases occur within minutes to an hour after administration, but delayed onset has also been reported. Possible underlying mechanisms include acute elevation of blood pressure, cardiac dysrhythmias, cerebral vasospasm, vasculitis, embolization due to infective endocarditis or dilated cardiomyopathy, embolization due to foreign material injected with the diluents under non-sterile conditions and contaminants in street drugs which have cardiovascular effects. Aneurysms and arteriovenous malformations have been detected in up to half of the patients with haemorrhagic stroke due to cocaine abuse. In addition to stroke, cocaine can cause vascular headaches, seizures, movement disorders, and cerebral atrophy correlating with the duration of abuse. Snorting of organic solvents may cause encephalopathy, while heroin addicts have reported cases of spongiform leukoencephalopathy. Peripheral neuropathy is occasionally precipitated by drug poisoning after intravenous administration. The impurities of the drug, risky administration techniques, and the use of mixtures of various drugs, often with simultaneous alcohol drinking, should be considered when assessing the background of the adverse event, as well as the overall lifestyle of the addicted subjects.

Subarachnoid haemorrhage is likely to be more severe and to have a worse outcome when cocaine is implicated [21 ]. Spongiform leukoencephalopathy is an unusual complication of illicit drug misuse with severe, often fatal, neurological deterioration and lesions of the white matter of the cerebrum, cerebellum, and basal ganglia, most often precipitated by inhalation of vaporised heroin [22 ]. Hyperthermic complications Excessive cocaine use can result in hallucinations, agitation, and hyperthermia, and management is urgent. Alcohol causes hepatic metabolism of cocaine to an ethyl homologue cocaethylene that has a plasma half-life three to five times longer than that of cocaine [1 ]. Despite being a central nervous system depressant, alcohol is taken with cocaine to increase the desired effects of the latter, but it also increases cocaine's potential for toxicity.

The Australian Federal Police (AFP) may be able to prioritize drug profiling techniques, making the entire process less costly and time-consuming, according to the findings of a study published in the Forensic Science International journal. Led by Andrea Migliano, the report says gas chromatography--mass spectrometry (GC-MS) was well-suited to detecting links between drug seizure cases and could therefore be prioritized for policing intelligence purposes. The report suggests that by prioritizing one method, testing fewer samples of drugs found in seizures could allow greater numbers of associated case files to be opened, as well as quicker and more efficient intelligence-led policing. The findings highlight the significance of the study and the potential of optimizing analytical procedures and prioritizing techniques to ensure the police have more time and valuable results that can be used to supplement their intelligence operations. This, in turn, could have major implications for law enforcement agencies worldwide looking to tweak and improve methods for analyzing drug seizures.

There have been recent case reports of deaths associated with BZP in combination with other sympathomimetics though no deaths attributed to BZP alone. Symptoms of BZP ingestion noted in 80 admissions of 61 patients attending Christchurch Hospital's Emergency Department in mid-2005 BZP Adverse Reactions sweating hyperventilation palpitations chest pain urinary retention vomiting insomnia anxiety dizzy headache dystonia tremor agitation collapse confusion Seizure* 0 10 20 30 40 Percentage Figure 4.

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EEG nature of seizures caused by cocaine and methamphetamine Because cocaine and methamphetamine are the two stimulants most likely to be abused and to cause problems related to seizures, the nature of the convulsions elicited by these two drugs was examined further. Seizure induction for methamphetamine was also rapid but, in contrast to cocaine, seizures persisted for over 3 min suggesting that methamphetamine was not inactivated nearly as quickly as cocaine.

The combination of methylone and ethcatinone might have contributed to neurologic manifestations compatible with serotonin toxicity, although our patient never had autonomic instability. The patient's initial laboratory evaluation showed a compensated metabolic acidosis with an anion gap of 15, an elevation of creatine kinase, a hypokalemia with hypochloremia, hypomagnesemia, hypophosphoremia, a total calcium of 2.20 mmol/L, a blood glucose of 6.7 mmol/L, a normal renal function and negative cardiac enzymes.