Iversen, L, White, M, Treble, R. Designer psychostimulants: pharmacology and differences. Neuropharmacology 2014;87:59–65. https://doi.org/10.1016/j.neuropharm.2014.01.015CrossRefGoogle ScholarPubMed

Mounteney, J, Griffiths, P, Bo, A, Cunningham, A, Matias, J, Pirona A. Nine reasons why ecstasy is not quite what it used to be. Int J Drug Policy 2018;51:36–41.Google Scholar

Nichols, DE. Differences between the mechanism of action of MDMA, MBDB, and the classic hallucinogens. Identification of a new therapeutic class: entactogens. J Psychoactive Drugs 1986;18:305–313.Google Scholar

Sáez-Briones, P, Hernández, A. MDMA (3,4-methylenedioxymethamphetamine) analogues as tools to characterize MDMA-like effects: an approach to understand entactogen pharmacology. Curr Neuropharmacol 2013;11(5):521.Google Scholar

Hermle, L, Spitzer, M, Borchardt, D, Kovar, KA, Gouzoulis, E. Psychological effects of MDE in normal subjects. Are entactogens a new class of psychoactive agents?Neuropsychopharmacology 1993;8(2):171–176.Google Scholar

Bedi, GD. Is ecstasy an ‘empathogen’? Effects of MDMA on prosocial feelings and identification of emotional states in others. Biol Psychiatry 2010;68(12):1134–1140.Google Scholar

Iversen, LL. Speed, Ecstasy, Ritalin: The Science of Amphetamines. Oxford, Oxford University Press, 2006.Google Scholar

Bershad, AK, Miller, MA, Baggott, MJ, de Wit, H. The effects of MDMA on socioemotional processing: does MDMA differ from other stimulants? J Psychopharmacol 2016;30:1248–1258. https://doi.org/10.1177/0269881116663120CrossRefGoogle ScholarPubMed

Simmler, LD, Liechti, ME. Pharmacology of MDMA- and amphetamine-like new psychoactive substances. In: Maurer, H, Brandt, S (eds.), New Psychoactive Substances. Handbook of Experimental Pharmacology, vol. 252. Cham, Springer, 2018.Google Scholar

Parrott, AC. Is ecstasy MDMA? A review of the proportion of ecstasy tablets containing MDMA, their dosage levels, and the changing perceptions of purity. Psychopharmacology 2004;173:234–241.Google Scholar

Warrick, BJ, Wilson, J, Hedge, M, Freeman, S, Leonard, K, Aaron, C. Lethal serotonin syndrome after methylone and butylone ingestion. J Med Toxicol 2012;8(1):65–68. https://doi.org/10.1007/s13181-011-0199-6Google Scholar

Kalasinsky, KS, Hugel, J, Kish, SJ. Use of MDA (the ‘love drug’) and methamphetamine in Toronto by unsuspecting users of ecstasy (MDMA). J Forensic Sci 2004;49(5):1106–1112.CrossRefGoogle ScholarPubMed

European Monitoring Centre for Drugs and Drug Addiction. Recent changes in Europe’s MDMA/ecstasy market, EMCDDA Rapid Communication. Luxembourg, Publications Office of the European Union, 2016.Google Scholar

European Monitoring Centre for Drugs and Drug Addiction. Recent changes in Europe’s MDMA/ecstasy market, EMCDDA Rapid Communication. Luxembourg, Publications Office of the European Union, 2016.Google Scholar

Miliano, M, Serpelloni, G, Rimondo, C, Mereu, M, Marti, M, De Luca, MA. Neuropharmacology of new psychoactive substances (NPS): focus on the rewarding and reinforcing properties of cannabimimetics and amphetamine-like stimulants. Front Neurosci 2016 (online). https://doi.org/10.3389/fnins.2016.00153CrossRefGoogle Scholar

Zaitsu, K, Katagi, M, Tatsuno, M, Sato, T, Tsuchihashi, H, Suzuki, K. Recently abused β-keto derivatives of 3,4-methylenedioxyphenylalkylamines: a review of their metabolisms and toxicological analysis. Forensic Toxicol 2011;29(2):73–84.Google Scholar

Freudenmann, RW, Spitzer, M. The neuropsychopharmacology and toxicology of 3,4-methylenedioxy-N-ethyl-amphetamine (MDEA). CNS Drug Rev 2004;10(2):89–116.Google Scholar

King, LA. New phenethylamines in Europe. Drug Test Anal 2014;6:808–818.CrossRefGoogle ScholarPubMed

Winstock, AR, Wolff, K, Ramsey, J. 4-MTA: a new synthetic drug on the dance scene. Drug Alcohol Depend 2002;67(2):111–115.CrossRefGoogle ScholarPubMed

Cole, JC, Bailey, M, Sumnall, HR, Wagstaff, GF, King, LA. The content of ecstasy tablets: implications for the study of their long-term effects. Addiction 2002;97:1531–1536.Google Scholar

Cheng, WC, Poon, NL, Chan, MF. Chemical profiling of 3,4-methylenedioxymethamphetamine (MDMA) tablets seized in Hong Kong. J Forensic Sci 2003;48:1249–1259.CrossRefGoogle ScholarPubMed

Tanner-Smith, EE. Pharmacological content of tablets sold as ‘ecstasy’: results from an online testing service. Drug Alcohol Depend 2006;83(3):247–254.Google Scholar

European Monitoring Centre for Drugs and Drug Addiction. Recent changes in Europe’s MDMA/ecstasy market, EMCDDA Rapid Communication. Luxembourg, Publications Office of the European Union, 2016.Google Scholar

Boulanger-Gobeil, C, St-Onge, M, Laliberté, M, Auger, PL. Seizures and hyponatremia related to ethcathinone and methylone poisoning. J Med Toxicol 2012;8(1):59–61.Google Scholar

Elliott, S, Smith, C. Investigation of the first deaths in the United Kingdom involving the detection and quantitation of the piperazines BZP and 3-TFMPP. J Analytic Toxicol 2008;32(2):172–177.Google Scholar

Ling, LH, Marchant, C, Buckley, NA, Prior, M, Irvine, RJ. Poisoning with the recreational drug paramethoxyamphetamine (‘death’). Med J Australia 2001;174:453–455.Google Scholar

Togni, LR, Lanaro, R, Resende, RR, et al. The variability of ecstasy tablets composition in Brazil. J Forensic Sci 2015;60:147–151.Google Scholar

Palamara, JJ, Acosta, P, Ompad, DC, Cleland, CM. Self-reported ecstasy/MDMA/‘Molly’ use in a sample of nightclub and dance festival attendees in New York City. Subst Use Misuse 2017;52(1):82–91. https://doi.org/10.1080/10826084.2016.1219373Google Scholar

European Monitoring Centre for Drugs and Drug Addiction. Recent changes in Europe’s MDMA/ecstasy market, EMCDDA Rapid Communication. Luxembourg, Publications Office of the European Union, 2016.Google Scholar

Smith, ZK, Moore, K, Measham, F. MDMA powder, pills and crystal: the persistence of ecstasy and the poverty of policy. Drugs Alcohol Today 2009;9(1):13–19.Google Scholar

Personal communication, John Ramsey.Google Scholar

European Monitoring Centre for Drugs and Drug Addiction. Recent changes in Europe’s MDMA/ecstasy market, EMCDDA Rapid Communication. Luxembourg, Publications Office of the European Union, 2016.Google Scholar

Palamara, JJ, Acosta, P, Ompad, DC, Cleland, CM. Self-reported ecstasy/MDMA/‘Molly’ use in a sample of nightclub and dance festival attendees in New York City. Subst Use Misuse 2017;52(1):82–91. https://doi.org/10.1080/10826084.2016.1219373CrossRefGoogle Scholar

European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2019: Trends and Developments. Luxembourg, Publications Office of the European Union, 2019.Google Scholar

European Monitoring Centre for Drugs and Drug Addiction. Recent changes in Europe’s MDMA/ecstasy market, EMCDDA Rapid Communication. Luxembourg, Publications Office of the European Union, 2016. Available at: www.emcdda.europa.eu/system/files/publications/2473/TD0116348ENN.pdf [last accessed 23 April 2022].Google Scholar

European Monitoring Centre for Drugs and Drug Addiction. Recent changes in Europe’s MDMA/ecstasy market, EMCDDA Rapid Communication. Luxembourg, Publications Office of the European Union, 2016.Google Scholar

European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2019: Trends and Developments. Luxembourg, Publications Office of the European Union, 2019.Google Scholar

World Drug Report 2019 (United Nations publication, Sales No. E.19.XI.9).Google Scholar

Home Office. Drug Misuse: Findings from the 2017/18 Crime Survey for England and Wales Statistical Bulletin 14/18 July 2018.Google Scholar

UK Focal Point on Drugs: United Kingdom Drug Situation 2017. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/713101/Focal_Point_Annual_Report.pdf [last accessed 10 March 2022].Google Scholar

National Advisory Committee on Drugs and Alcohol, & Department of Health Northern Ireland. Prevalence of Drug Use and Gambling in Ireland and Drug Use in Northern Ireland 2014/15. Published 2016.Google Scholar

Scottish Government. Scottish Crime and Justice Survey 2014/15: Drug Use. Published 2016.Google Scholar

Couchman, L, Frinculescu, A, Sobreira, C, et al. Variability in content and dissolution profiles of MDMA tablets collected in the UK between 2001 and 2018 – A potential risk to users? Drug Test Anal 2019;8: 1172–1182.Google Scholar

European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2019: Trends and Developments. Luxembourg, Publications Office of the European Union, 2019.Google Scholar

European Monitoring Centre for Drugs and Drug Addiction. Recent changes in Europe’s MDMA/ecstasy market, EMCDDA Rapid Communication. Luxembourg, Publications Office of the European Union, 2016.Google Scholar

European Monitoring Centre for Drugs and Drug Addiction. Recent changes in Europe’s MDMA/ecstasy market, EMCDDA Rapid Communication. Luxembourg, Publications Office of the European Union, 2016.Google Scholar

Brunt, TM, Koeter, MW, Niesink, RJ, van den Brink W. Linking the pharmacological content of ecstasy tablets to the subjective experiences of drug users. Psychopharmacology 2012;220(4):751–762. https://doi.org/10.1007/s00213-011-2529-4Google Scholar

Sherlock, K, Wolff, K, Hay, AW, Conner, M. Analysis of illicit ecstasy tablets: implications for clinical management in the accident and emergency department. J Accid Emerg Med 1999;16(3):194–197.Google Scholar

Morefield, KM. Pill content, dose and resulting plasma concentrations of 3,4-methylendioxymethamphetamine (MDMA) in recreational ‘ecstasy’ users. Addiction 2011;106(7):1293–1300.Google Scholar

Armenian, PT. Multiple MDMA (ecstasy) overdoses at a rave event: a case series. J Intensive Care Med 2013;28(4):252–258.Google Scholar

O’Connor, LC, Torrance, HJ, McKeown, DA, Simpson, K. Analysis of ‘ecstasy’ tablets from Police Scotland in the Glasgow area – November 2013 to July 2014.Google Scholar

Couchman, L, Frinculescu, A, Sobreira, C, et al. Variability in content and dissolution profiles of MDMA tablets collected in the UK between 2001 and 2018 – A potential risk to users? Drug Test Anal 2019;11(8):1172–1182.Google Scholar

Couchman, L, Frinculescu, A, Sobreira, C, et al. Variability in content and dissolution profiles of MDMA tablets collected in the UK between 2001 and 2018 – A potential risk to users? Drug Test Anal 2019;11(8):1172–1182.Google Scholar

Bombe, A, Dave-Momin, N, Shah, N, Sonavane, S, Desousa, A. MDMA dependence: a case report from urban India. History 2013;3(9):32–33.Google Scholar

Potash, MN. Persistent psychosis and medical complications after a single ingestion of MDMA ‘ecstasy’: a case report and review of the literature. Psychiatry 2009;6(7):40.Google Scholar

Rogers, G, Elston, J, Garside, R, et al. The harmful health effects of recreational ecstasy: a systematic review of observational evidence. Health Technol Assess 2009;13(6):iii–v. https://doi.org/10.3310/hta13050Google Scholar

Parrott, AC. Human psychobiology of MDMA or ‘ecstasy’: an overview of 25 years of empirical research. Hum Psychopharmacol 2013;28(4):289–307. https://doi.org/10.1002/hup.2318Google Scholar

Parrott, AC. MDMA, serotonergic neurotoxicity, and the diverse functional deficits of recreational ‘ecstasy’ users. Neurosci Biobehav Rev 2013;37(8):1466–1484. https://doi.org/10.1016/j. neubiorev.2013.04.016Google Scholar

Doblin, R, Greer, G, Holland, J, Jerome, L, Mithoefer, MC, Sessa, B. A reconsideration and response to Parrott AC (2013) ‘Human psychobiology of MDMA or “ecstasy”: an overview of 25 years of empirical research’. Hum Psychopharmacol Clin Exp 2014;29:105–108. https://doi.org/10.1002/hup.2389Google Scholar

Cole, JC. MDMA and the ‘ecstasy’ paradigm. J Psychoactive Drugs 2014;46(1):44–56.Google Scholar

See for example: Vizeli, P, Liechti ME. Safety pharmacology of acute MDMA administration in healthy subjects. J Psychopharmacol 2017;31(5):576–588. https://doi.org/10.1177/0269881117691569Google Scholar

De la Torre, RM. Human pharmacology of MDMA: pharmacokinetics, metabolism, and disposition. Ther Drug Monit 2004;26(2):137–144.Google Scholar

Docherty, JR, Green, AR. The role of monoamines in the changes in body temperature induced by 3,4-methylenedioxymethamphetamine (MDMA, ecstasy) and its derivatives. Br J Pharmacol 2010;160(5):1029–1044. https://doi.org/10.1111/j.1476-5381.2010.00722.xGoogle Scholar

Hysek, CM, Simmler, LD, Ineichen, M, et al. The norepinephrine transporter inhibitor reboxetine reduces stimulant effects of MDMA (‘ecstasy’) in humans. Clin Pharmacol Ther 2011;90(2):246–255. https://doi.org/10.1038/clpt.2011.78Google Scholar

Roiser, JP. Association of a functional polymorphism in the serotonin transporter gene with abnormal emotional processing in ecstasy users. Am J Psychiatry 2005;162(3):609–612.Google Scholar

Pardo-Lozano, R, Farré, M, Yubero-Lahoz, S, et al. Clinical pharmacology of 3,4-methylenedioxymethamphetamine (MDMA, ‘ecstasy’): the influence of gender and genetics (CYP2D6, COMT, 5-HTT). PLoS ONE 2012;7(10):e47599.Google Scholar

Baylen, CA. A review of the acute subjective effects of MDMA/ecstasy. Addiction 2006;101(7):933–947.Google Scholar

Gouzoulis-Mayfrank, E. Differential actions of an entactogen compared to a stimulant and a hallucinogen in healthy humans. Heffter Rev Psychedelic Res 2001;2:64–72.Google Scholar

Shulgin, AT. History of MDMA. In: SJ Peroutka, ed., Ecstasy: The Clinical, Pharmacological and Neurotoxicological Effects of the Drug MDMA, pp. 1–20. Norwell, MA, Kluwer Academic, 1990.Google Scholar

Greer, GR, Tolbert, R. The therapeutic use of MDMA. In: Peroutka, SJ, ed., Ecstasy: The Clinical, Pharmacological and Neurotoxicological Effects of the Drug MDMA, pp. 21–36. Norwell, MA, Kluwer Academic, 1990.Google Scholar

Sessa, B. Is there a case for MDMA-assisted psychotherapy in the UK? J Psychopharmacol 2007;21(2):220–224.Google Scholar

Harris, DS, Baggott, M, Mendelson, JH, Mendelson, JE, Jones, RT. Subjective and hormonal effects of 3,4-methylenedioxymethamphetamine (MDMA) in humans. Psychopharmacology 2002;162(4):396–405.Google Scholar

Bershad, AK, Mayo, LM, Van Hedger, K, et al. Effects of MDMA on attention to positive social cues and pleasantness of affective touch. Neuropsychopharmacol 2019;44:1698–1705. https://doi.org/10.1038/s41386-019-0402-zGoogle Scholar

Dumont, GJ. Increased oxytocin concentrations and prosocial feelings in humans after ecstasy (3,4-methylenedioxymethamphetamine) administration. Social Neurosci 2009;4(4):359–366.Google Scholar

Bershada, AK, Weafer, JJ, Kirkpatrick, MG, Wardle, MC, Miller, MA, de Wita Soc, H. Oxytocin receptor gene variation predicts subjective responses to MDMA. Neuroscience 2016;11(6):592–599. https://doi.org/10.1080/17470919.2016.1143026Google Scholar

Bershada, AK, Weafer, JJ, Kirkpatrick, MG, Wardle, MC, Miller, MA, de Wita Soc, H. Oxytocin receptor gene variation predicts subjective responses to MDMA. Neuroscience 2016;11(6):592–599. https://doi.org/10.1080/17470919.2016.1143026Google Scholar

Peiró, AM. Human pharmacology of 3,4-methylenedioxymethamphetamine (MDMA, ecstasy) after repeated doses taken 2 h apart. Psychopharmacology 2013;225(4):883–893.Google Scholar

Yubero-Lahoz, SRM. Sex differences in 3,4-methylenedioxymethamphetamine (MDMA; ecstasy)-induced cytochrome P450 2D6 inhibition in humans. Clin Pharmacokinet 2011;50(5):319–329.Google Scholar

Green, AR, Mechan, AO, Elliott, JM, O’Shea, E, Colado, MI. The pharmacology and clinical pharmacology of 3,4-methylenedioxymethamphetamine (MDMA, ‘ecstasy’). Pharmacol Rev 2003;55(3):463–508.Google Scholar

Parrott, AC, Lock, J, Adnum, L, Thome, J. MDMA can increase cortisol levels by 800% in dance clubbers. J Psychopharmacology 2013;27(1):113–114.Google Scholar

Vevelstad, M, Oiestad, EL, Middelkoop, G, et al. The PMMA epidemic in Norway: comparison of fatal and non-fatal intoxications. Forensic Sci Int 2012;219:151–157.Google Scholar

Lurie, Y, Gopher, A, Lavon, O, Almog, S, Sulimani, L, Bentur, Y. Severe paramethoxymethamphetamine (PMMA) and paramethoxyamphetamine (PMA) outbreak in Israel. Clin Toxicol 2012;50:39–43.Google Scholar

Hill, SL, Thomas, SHL. Clinical toxicology of newer recreational drugs. Clin Toxicol 2011;49:705–719.Google Scholar

Ling, LH, Marchant, C, Buckley, NA, Prior, M, Irvine, RJ. Poisoning with the recreational drug paramethoxyamphetamine (‘death’). Med J Australia 2001;174:453–455.Google Scholar

De Letter, EA, Coopman, VAE, Cordonnier, JACM, Piette, MHA. One fatal and seven non-fatal cases of 4-methylthioamphetamine (4-MTA) intoxication: clinico-pathological findings. Int J Legal Med 2001;114:352–356.Google Scholar

Elliot, SP. Fatal poisoning with a new phenethylamine: 4-methylthioamphetamine (4-MTA). J Anal Toxicol 2000;24:85–89.Google Scholar

Felgate, HE, Felgate, PD, James, RA, Sims, DN, Vozzo, DC. Recent paramethoxyamphetamine deaths. J Anal Toxicol 1998;22:169–172.Google Scholar

Lamberth, PG, Ding, GK, Nurmi, LA. Fatal paramethoxy-amphetamine (PMA) poisoning in the Australian Capital Territory. Med J Australia 2008;188:426.Google Scholar

Daws, LC, Irvine, RJ, Callaghan, PD, Toop, NP, White, JM, Bochner, F. Differential behavioural and neurochemical effects of para-methoxyamphetamine and 3,4-methylenedioxymethamphetamine in the rat. Prog Neuropsychopharmacol Biol Psychiatry 2000;24:955–977.Google Scholar

Silins, E, Copeland, J, Dillon, P. Qualitative review of serotonin syndrome, ecstasy (MDMA) and the use of other serotonergic substances: hierarchy of risk. Aust NZ J Psychiatry 2007;41(8):649–655.Google Scholar

Corkery, JM, Elliott, S, Schifano, F, Corazza, O, Ghodse, AH. MDAI (5,6-methylenedioxy-2-aminoindane; 6,7-dihydro-5Hcyclopenta[f][1,3]benzodioxol-6-amine; ‘sparkle’; ‘mindy’) toxicity: a brief overview and update. Hum Psychopharmacol Clin Exp 2013;28:345–355.Google Scholar

Brandt, SD, Sumnall, HR, Measham, F, Cole, J. Analyses of second generation ‘legal highs’ in the UK: initial findings. Drug Test Anal 2010;2(8):377–382.Google Scholar

Greer, GR, Tolbert, R. A method of conducting therapeutic sessions with MDMA. J Psychoactive Drugs 1998;30(4):371–379.Google Scholar

Mithoefer, MC, Wagner, MT, Mithoefer, AT, et al. Durability of improvement in post-traumatic stress disorder symptoms and absence of harmful effects or drug dependency after 3,4-methylenedioxymethamphetamine-assisted psychotherapy: a prospective long-term follow-up study. J Psychopharmacol 2013;27(1):28–39. https://doi.org/10.1177/0269881112456611Google Scholar

Johansen, PØ, Krebs, TS. How could MDMA (ecstasy) help anxiety disorders? A neurobiological rationale. J Psychopharmacol 2009;23(4):389–391. https://doi.org/10.1177/0269881109102787Google Scholar

Parrott, AC. The potential dangers of using MDMA for psychotherapy. J Psychoactive Drugs 2014;46(1):37–43.Google Scholar

Capela, JP. Molecular and cellular mechanisms of ecstasy-induced neurotoxicity: an overview. Mol Neurobiol 2009;39(3):210–271.Google Scholar

Sessa, B, Higbed, L, Nutt, D. A review of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy. Front Psychiatry 2019 (online). https://doi.org/10.3389/fpsyt.2019.00138Google Scholar

Feduccia, AA, Holland, J, Mithoefer, MC. Progress and promise for the MDMA drug development program. Psychopharmacology 2018;235(2):561–571. https://doi.org/10.1007/s00213-017-4779-2Google Scholar

Mithoefer, MC, Mithoefe, AT, Feduccia, AA, et al.3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for post-traumatic stress disorder in military veterans, firefighters, and police officers: a randomised, double-blind, dose-response, phase 2 clinical trial. Lancet Psychiatry 2018;5(6):486–497.Google Scholar

Sessa, B. MDMA and PTSD treatment: ‘PTSD: from novel pathophysiology to innovative therapeutics’. Neurosci Lett 2017;649:176–180.Google Scholar

Ot’alora, MG, Grigsby, J, Poulter, B, et al.3,4-Methylenedioxymethamphetamine-assisted psychotherapy for treatment of chronic post-traumatic stress disorder: a randomized phase 2 controlled trial. J Psychopharmacol 2018;32(12):1295–1307.Google Scholar

Bouso, JC, Doblin, R, Farre, M, et al. MDMA-assisted psychotherapy using low doses in a small sample of women with chronic post-traumatic stress disorder. J Psychoactive Drugs 2008;40:225–236.Google Scholar

Greer, GR, Tolbert, R. A method of conducting therapeutic sessions with MDMA. J Psychoactive Drugs 1998;30:371–379.Google Scholar

Thal, SB, Lommen, MJJ. Current perspective on MDMA-assisted psychotherapy for posttraumatic stress disorder. J Contemp Psychother 2018;48:99–108. https://doi.org/10.1007/s10879-017-9379-2Google Scholar

Oehen, PR. A randomized, controlled pilot study of MDMA (±3,4-methylenedioxymethamphetamine)-assisted psychotherapy for treatment of resistant, chronic post-traumatic stress disorder (PTSD). J Psychopharmacol 2013;27(1):40–52.Google Scholar

Barone, W, Beck, J, Mitsunaga-Whitten, M, Perl, P. Perceived benefits of MDMA-assisted psychotherapy beyond symptom reduction: qualitative follow-up study of a clinical trial for individuals with treatment-resistant PTSD. J Psychoactive Drugs 2019;51(2):199–208. https://doi.org/10.1080/02791072.2019.1580805Google Scholar

Bahji, A, , Forsyth, A, Groll, D, Hawken, ER. Efficacy of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for post-traumatic stress disorder: a systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2020;96:109735.Google Scholar

Schenk, S, Newcombe, D. Methylenedioxymethamphetamine (MDMA) in psychiatry: pros, cons, and suggestions. J Clin Psychopharmacol 2018;38(6):632–638. https://doi.org/10.1097/JCP.0000000000000962Google Scholar

Danforth, AL, Grob, CS, Struble, C, et al. Reduction in social anxiety after MDMA-assisted psychotherapy with autistic adults: a randomized, double-blind, placebo-controlled pilot study Psychopharmacology 2018;235(11):3137–3148. https://doi.org/10.1007/s00213-018-5010-9Google Scholar

Sessa, B. Why MDMA therapy for alcohol use disorder? Neuropharmacology 2018;142:83–88. https://doi.org/10.1016/j.neuropharm.2017.11.004Google Scholar

Concar, D. Ecstasy has dramatic effect on Parkinson’s symptoms. New Scientist 2002;17(2368):14.Google Scholar

Johnston, TH, Millar, Z, Huot, P, et al. A novel MDMA analogue, UWA-101, that lacks psychoactivity and cytotoxicity, enhances l-DOPA benefit in parkinsonian primates. FASEB J 2012;26(5):2154–2163. https://doi.org/10.1096/fj.11-195016Google Scholar

Moonzwe, LS, Schensul, JJ, Kostick, KM. The role of MDMA (ecstasy) in coping with negative life situations among urban young adults. J Psychoactive Drugs 2011;43(3):199–210.Google Scholar

Jansen, KLR. Ecstasy (MDMA) dependence. Drug Alcohol Depend 1999;53(2):121–124.Google Scholar

Sessa, B. Can psychedelics have a role in psychiatry once again? Br J Psychiatry 2005;186(6):457–458.Google Scholar

McElrath, K, Van Hout, MC. A preference for mephedrone: drug markets, drugs of choice, and the emerging ‘legal high’ scene. J Drug Issues 2011;41(4):487–507.Google Scholar

European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). European Drug Report. Trends and Developments 2015. Luxembourg, Publications Office of the European Union, 2015. Available at: www.emcdda.europa.eu/system/files/publications/2637/TDAT16001ENN.pdf [last accessed 10 March 2022].Google Scholar

European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Recent changes in Europe’s MDMA/ecstasy market. Results from an EMCDDA trendspotter study. Luxembourg, Publications Office of the European Union, 2016b. Available at: www.emcdda.europa.eu/system/files/publications/2473/TD0116348ENN.pdf [last accessed 10 March 2022].Google Scholar

Edland-Gryta M, , Sandberg S, , Pedersen W. From ecstasy to MDMA: recreational drug use, symbolic boundaries, and drug trends. Int J Drug Policy 2017;50:1–8.Google Scholar

Home Office. Drugs Misuse: Findings from the 2018/19 Crime Survey for England and Wales Statistical Bulletin. Published September 2019.Google Scholar

European Monitoring Centre for Drugs and Drug Addiction. Recent changes in Europe’s MDMA/ecstasy market, EMCDDA Rapid Communication. Luxembourg, Publications Office of the European Union, 2016.Google Scholar

European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2019: Trends and Developments. Luxembourg, Publications Office of the European Union, 2019.Google Scholar

European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2019: Trends and Developments. Luxembourg, Publications Office of the European Union, 2019.Google Scholar

European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2019: Trends and Developments. Luxembourg, Publications Office of the European Union, 2019.Google Scholar

European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2019: Trends and Developments. Luxembourg, Publications Office of the European Union, 2019.Google Scholar

Palamar, JJ, Acosta, P, Omp, DC, Cleland, CM. Self-reported ecstasy/MDMA/‘Molly’ use in a sample of nightclub and dance festival attendees in New York City. Subst Use Misuse 2017;52(1):82–91. https://doi.org/10.1080/10826084.2016.1219373Google Scholar

Hansen, DB. ‘Weddings, parties, anything…’: a qualitative analysis of ecstasy use in Perth, Western Australia. Int J Drug Policy 2001;12(2):181–199.Google Scholar

Halpern, P, Moskovich, J, Avrahami, B, Bentur, Y, Soffer, D, Peleg, K. Morbidity associated with MDMA (ecstasy) abuse – a survey of emergency department admissions. Hum Exp Toxicol 2011;30(4):259–266. https://doi.org/10.1177/0960327110370984Google Scholar

Horyniak, D, Degenhardt, L, Smit de, V, et al. Pattern and characteristics of ecstasy and related drug (ERD) presentations at two hospital emergency departments, Melbourne, Australia, 2008–2010. Emerg Med J 2014;31(4):317–322. https://doi.org/10.1136/emermed2012-202174Google Scholar

European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2019: Trends and Developments. Luxembourg, Publications Office of the European Union, 2019.Google Scholar

Mounteney, J, Griffiths, P, Bo, A, Cunningham, A, Matias, J, Pirona, A. Nine reasons why ecstasy is not quite what it used to be. Int J Drug Policy 2018;51:36–41.Google Scholar

Pearson, G. Normal drug use: ethnographic fieldwork among an adult network of recreational drug users in inner London. Subst Use Misuse 2001;36(1–2):167–200.Google Scholar

Winstock, A. The Global Drug Survey 2014 Findings. Global Drug Survey, April 2014. Available at: www.globaldrugsurvey.com/facts-figures/the-global-drug-survey-2014-findings [last accessed 10 March 2022].Google Scholar

Jansen, KLR. Ecstasy (MDMA) dependence. Drug Alcohol Depend 1999;53(2):121–124.Google Scholar

Topp, L, Hando, J, Dillon, P, Roche, A, Solowij, N. Ecstasy use in Australia: patterns of use and associated harm. Drug Alcohol Depend 1999;55:105–115.Google Scholar

Carhart-Harris, RL, Murphy, K, Leech, R, et al. The effects of acutely administered 3,4-methylenedioxymethamphetamine on spontaneous brain function in healthy volunteers measured with arterial spin labeling and blood oxygen level-dependent resting state functional connectivity. Biol Psychiatry 2014;2014:S0006-3223(14) 00005-5. https://doi.org/10.1016/j. biopsych.2013.12.015Google Scholar

Scholey, AB, Parrott, AC, Buchanan, T, Heffernan, TM, Ling, J, Rodgers, J. Increased intensity of ecstasy and polydrug usage in the more experienced recreational ecstasy/MDMA users: a WWW study. Addict Behav 2004;29(4):743–752.Google Scholar

Wu, L-TA. The variety of ecstasy/MDMA users: results from the National Epidemiologic Survey on alcohol and related conditions. Am J Addictions 2009;18(6):452–461.Google Scholar

Palamar, JJ, Acosta, P, Omp, DC, Cleland, CM. Self-reported ecstasy/MDMA/‘Molly’ use in a sample of nightclub and dance festival attendees in New York City. Subst Use Misuse 2017;52(1):82–91. https://doi.org/10.1080/10826084.2016.1219373Google Scholar

Kinner, SA, George, J, Johnston, J, Dunn, M, Degenhardt, L. Pills and pints: risky drinking and alcohol-related harms among regular ecstasy users in Australia. Drug Alcohol Rev 2012;31:273–280.Google Scholar

Hopper, JW. Incidence and patterns of polydrug use and craving for ecstasy in regular ecstasy users: an ecological momentary assessment study. Drug Alcohol Depend 2006;85(3):221–235.Google Scholar

Hall, AP, Henry, JA. Acute toxic effects of ‘ecstasy’ (MDMA) and related compounds: overview of pathophysiology and clinical management. Br J Anaesthesia 2006;96(6):678–685.Google Scholar

Benschop, A, Urbán, R, Kapitány-Fövény, M, et al. Why do people use new psychoactive substances? Development of a new measurement tool in six European countries. J Psychopharmacol 2020;34(6):600–611. https://doi.org/10.1177/0269881120904951Google Scholar

Winstock, A. Drug Pleasure Ratings. Global Drug Survey, April 2014. Available at: www.globaldrugsurvey.com/facts-figures/the-net-pleasure-index-results [last accessed 10 March 2022].Google Scholar

ter Bogt, TF, Engels, RC. ‘Partying’ hard: party style, motives for and effects of MDMA use at rave parties. Subst Use Misuse 2005;40(9–10):1479–1502.Google Scholar

Kamilar-Britt, P, Bedi, G. The prosocial effects of 3,4-methylenedioxymethamphetamine (MDMA): controlled studies in humans and laboratory animals. Neurosci Biobehav Rev 2015;57:433–446.Google Scholar

Bershad, AK, Miller, MA, Baggott, MJ, de Wit, H. The effects of MDMA on socio-emotional processing: does MDMA differ from other stimulants? J Psychopharmacol 2016;30(12):1–11. https://doi.org/10.1177/0269881116663120Google Scholar

Dolder, PC, Müller, F, Schmid, Y, Borgwardt, SJ, Liecht ME. Direct comparison of the acute subjective, emotional, autonomic, and endocrine effects of MDMA, methylphenidate, and modafinil in healthy subjects. Psychopharmacology 2018;235:467–479. https://dooi.org/10.1007/s00213-017-4650-5Google Scholar

Zemishlany, ZD. Subjective effects of MDMA (‘ecstasy’) on human sexual function. Eur Psychiatry 2001;16(2):127–130.Google Scholar

Kennedy, KE. Ecstasy and sex among young heterosexual women: a qualitative analysis of sensuality, sexual effects, and sexual risk taking. Int J Sex Health 2010;22(3):155–166.Google Scholar

Passie, T, Hartmann, U, Schneider, U, Emrich, HM, Krüger, TH. Ecstasy (MDMA) mimics the postorgasmic state: impairment of sexual drive and function during acute MDMA-effects may be due to increased prolactin secretion. Med Hypotheses 2005;64(5):899–903.Google Scholar

Bourne, ARD. The chemsex study: drug use in sexual settings among gay and bisexual men in Lambeth, Southwark and Lewisham, London. Sigma Research, London School of Hygiene and Tropical Medicine, 2014.Google Scholar

Vizeli, P, Liechti, M E. Safety pharmacology of acute MDMA administration in healthy subjects. J Psychopharmacol 2017;31(5):576–588. https://doi.org/10.1177/0269881117691569Google Scholar

Papaseit, E, Torrens, M, Pérez-Mañá, C, Muga, R, Farré, M. Key interindividual determinants in MDMA pharmacodynamics. Exp Opin Drug Metab Toxicol 2018;14(2):183–195. https://doi.org/10.1080/17425255.2018.1424832Google Scholar

Coppola, M, Mondola, R. Is the 5-iodo-2-aminoindan (5-IAI) the new MDMA? J Addict Res Ther 2012;3:134.Google Scholar

Nichols, DE, Oberlender, R. Structure-activity relationships of MDMA and related compounds: a new class of psychoactive drugs? Ann NY Acad Sci 1990;600(1):613–623.Google Scholar

Simmler, LD, Liechti, ME. Pharmacology of MDMA- and amphetamine-like new psychoactive substances. In: Maurer, H, Brandt, S, (eds.), New Psychoactive Substances. Handbook of Experimental Pharmacology, vol. 252. Cham, Springer, 2018.Google Scholar

Raznahan, M, Hassanzadeh, E, Houshmand, A, Kashani, L, Tabrizi, M, Akhondzadeh, S. Change in frequency of acute and subacute effects of ecstasy in a group of novice users after 6 months of regular use. Psychiatr Danub 2013;25(2):175–178.Google Scholar

Parrott, AC. Recreational ecstasy/MDMA, the serotonin syndrome, and serotonergic neurotoxicity. Pharmacol Biochem Behav 2002;71(4):837–844.Google Scholar

Fuit, S, Brookhuis, A, Karel, C et al. Physical, affective and somatic effects of ecstasy (MDMA): an observational study of recreational users. Curr Psychopharmacol 2017;6(1):51–58.Google Scholar

O’Sullivan, A, Parrott, AC. Deteriorating cost–benefit ratios for ecstasy/MDMA with repeated usage. Open Addiction J 2011;4:38–39.Google Scholar

Young, SN, Regoli, M, Leyton, M, Pihl, RO, Benkelfat, C. The effect of acute tryptophan depletion on mood and impulsivity in polydrug ecstasy users. Psychopharmacology 2014;231(4):707–716. https://doi.org/10.1007/s00213-013-3287-2Google Scholar

Travers, KR, Lyvers, M. Mood and impulsivity of recreational ecstasy users in the week following a ‘rave’. Addict Res Theory 2005;13(1):43–52.Google Scholar

European Monitoring Centre for Drugs and Drug Addiction. Recent changes in Europe’s MDMA/ecstasy market, EMCDDA Rapid Communication. Luxembourg, Publications Office of the European Union, 2016.Google Scholar

Al-Samarraie, MS, Vevelstad, M, Nygaard, IL, Bachs, L, Mørland, J. Intoxation with paramethoxymethamphetamine. [Article in Norwegian.] Tidsskr Nor Laegeforen 2013;133(9):966–999. https://doi.org/10.4045/tidsskr.12.0417Google Scholar

Shulgin, AT, Shulgin, A. 4-MA; PMA; 4-methoxyamphetamine. In: PIHKAL: A Chemical Love Story (Monograph 97), pp. 707–709. Liverpool, Transform Press, 1991.Google Scholar

Shulgin, AT, Shulgin, A. 4-MA; PMA; 4-methoxyamphetamine. In: PIHKAL: A Chemical Love Story (Monograph 97), pp. 707–709. Liverpool, Transform Press, 1991.Google Scholar

Figurasin R, Maguire NJ. 3,4-Methylenedioxy-Methamphetamine (MDMA, Ecstasy, Molly) Toxicity. [Updated 2019 May 11]. In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 2019. Available at: www.ncbi.nlm.nih.gov/books/NBK538482/ [last accessed 10 March 2022].Google Scholar

Rigg, KK, Sharp, A. Deaths related to MDMA (ecstasy/molly): prevalence, root causes, and harm reduction interventions. J Subst Use 2018;23(4):345–352. https://doi.org/10.1080/14659891.2018.1436607Google Scholar

Roxburgh, A, Lappin, J. MDMA-related deaths in Australia 2000 to 2018. Int J Drug Policy 2020;76:102630.Google Scholar

Drugscope. Business as Usual? A Status Report on New Psychoactive Substances (NPS) and Club Drugs in the UK. Published 2014.Google Scholar

Cimbura, G. PMA deaths in Ontario. Can Med Assoc J 1974;110(11):1263.Google Scholar

Office for National Statistics. Deaths Related to Drug Poisoning in England and Wales, 2013. Published 2014. Available at: www.ons.gov.uk/ons/dcp171778_375498.pdf [last accessed 10 March 2022].Google Scholar

European Monitoring Centre for Drugs and Drug Addiction. Recent changes in Europe’s MDMA/ecstasy market, EMCDDA Rapid Communication. Luxembourg, Publications Office of the European Union, 2016.Google Scholar

See for example: Darracq, MA, Thornton, SL, Minns, AB, Gerona, RR. A case of 3,4-dimethoxyamphetamine (3,4-DMA) and 3,4-methylenedioxymethamphetamine (MDMA) toxicity with possible metabolic interaction. J Psychoactive Drugs 2016;48(5):351–354. https://doi.org/10.1080/02791072.2016.1225324Google Scholar

Rosenson, J, Smollin, C, Sporer, KA, Blanc, P, Olson, KR. Patterns of ecstasy-associated hyponatremia in California. Ann Emerg Med 2007;49(2):164–171.Google Scholar

Williams, H, Dratcu, L, Taylor, R, Roberts, M, Oyefeso, A. ‘Saturday night fever’: ecstasy-related problems in a London accident and emergency department. J Accid Emerg Med 1998;15(5):322–326.Google Scholar

Liechti, ME, Kunz, I, Kupferschmidt, H. Acute medical problems due to ecstasy use. Swiss Med Wkly 2005;135(43–44):652–657.Google Scholar

Simmler, LD, Liechti, ME. Pharmacology of MDMA- and amphetamine-like new psychoactive substances. In: Maurer, H, Brandt, S (eds.), New Psychoactive Substances. Handbook of Experimental Pharmacology, vol. 252. Cham, Springer, 2018.Google Scholar

Degenhardt, L, Hall, W. The Health and Psychological Effects of ‘Ecstasy’ (MDMA) Use. National Drug and Alcohol Research Centre, University of New South Wales, 2010.Google Scholar

Cajanding, RJM. MDMA-associated liver toxicity: pathophysiology, management, and current state of knowledge. AACN Adv Crit Care 2019;30(3):232–248. https://doi.org/10.4037/aacnacc2019852Google Scholar

Refstad, S. Paramethoxyamphetamine (PMA) poisoning: a ‘party drug’ with lethal effects. Acta Anaesthesiologica Scand 2003;47:1298–1299. https://doi.org/10.1046/j.1399-6576.2003.00245.xGoogle Scholar

Giannikopoulos, G, Stamoulis, I, Panagi, G, et al. P0494 severe hypoglycaemia, acute renal failure and rhabdomyolysis associated with the use of 3,4-methylenedioxymethamphetamine (‘ecstasy’). Eur J Intern Med 2009;20:S164.Google Scholar

Raviña, P, Quiroga, JM, Raviña, T. Hyperkalemia in fatal MDMA (‘ecstasy’) toxicity. Int J Cardiol 2004;93(2):307–308.Google Scholar

Greene, SL, Dargan, PI, O’Connor, N, Jones, AL, Kerins, M. Multiple toxicity from 3,4-methylenedioxymethamphetamine (‘ecstasy’). Am J Emerg Med 2003;21(2):121–124.Google Scholar

Moore, K, Wells, H, Feilding, A. Roadmaps to regulation: MDMA. Br J Sociol 2002;53(1):89–105.Google Scholar

Fineschi, V, Masti, A. Fatal poisoning by MDMA (ecstasy) and MDEA: a case report. Int J Legal Med 1996;108(5):272–275.Google Scholar

Liechti, ME, Gamma, A, Vollenweider, FX. Gender differences in the subjective effects of MDMA. Psychopharmacology 2001;154(2):161–168.Google Scholar

Feio-Azevedo, R, Costa, VM, Barbosa, DJ, et al. Aged rats are more vulnerable than adolescents to ‘ecstasy’-induced toxicity. Arch Toxicol 2018;92:2275–2295. https://doi.org/10.1007/s00204-018-2226-8Google Scholar

Gouzoulis-Mayfrank, E. The confounding problem of polydrug use in recreational ecstasy/MDMA users: a brief overview. J Psychopharmacol 2006;20(2):188–193.Google Scholar

Milroy, CM. ‘Ecstasy’-associated deaths: what is a fatal concentration? Analysis of a case series. Forensic Sci Med Pathol 2011;7(3):248–252.Google Scholar

Vecellio, M, Schopper, C, Modestin, J. Neuropsychiatric consequences (atypical psychosis and complex-partial seizures) of ecstasy use: possible evidence for toxicity-vulnerability predictors and implications for preventative and clinical care. J Psychopharmacol 2003;17(3):342–345.Google Scholar

Kamour, A, James, D, Lupton, DJ, et al. Patterns of presentation and clinical features of toxicity after reported use of ([2-aminopropyl]-2,3-dihydrobenzofurans), the ‘benzofuran’ compounds. A report from the United Kingdom National Poisons Information Service. Clin Toxicol 2014;52(10):1025–1031. https://doi.org/10.3109/15563650.2014.973115Google Scholar

Lin, DL, Liu, HC, Yin HL. Recent paramethoxymethamphetamine (PMMA) deaths in Taiwan. J Anal Toxicol 2007;31(2):109–113.Google Scholar

Gimeno Clemente, C, Chiappini, S, Claridge, H, et al. The unregulated psychoactive compound: ‘benzo fury’. Curr Drug Abuse Rev 2013;6(4):285.Google Scholar

Chan, WL, Wood, DM, Hudson, S, Dargan, PI. Acute psychosis associated with recreational use of benzofuran 6-(2-aminopropyl) benzofuran (6-APB) and cannabis. J Med Toxicol 2013;9(3):278–281. https://doi.org/10.1007/s13181-013-0306-yGoogle Scholar

Weinmann, W, Bohnert, M. Lethal monointoxication by overdosage of MDEA. Forensic Sci Int 1998;91(2):91–101.Google Scholar

Chen, WH, Chui, C, Yin, HL. The antemortem neurobehavior in fatal paramethoxymethamphetamine usage. Subst Abus 2012;33(4):366–372.Google Scholar

Spatt, J, Glawar, B, Mamoli, B. A pure amnestic syndrome after MDMA (‘ecstasy’) ingestion. J Neurol Neurosurg Psychiatry 1997;62(4):418.Google Scholar

Meehan, TJ, Bryant, SM, Aks, SE. Drugs of abuse: the highs and lows of altered mental states in the emergency department. Emerg Med Clin North Am 2010;28(3):663–682. https://doi.org/10.1016/j. emc.2010.03.012Google Scholar

TOXBASE®. MDMA. www.toxbase.orgGoogle Scholar

Drake, WM, Broadhurst, PA. QT-interval prolongation with ecstasy. South African Med J 1996;86(2):180–181.Google Scholar

Hartung, TK, Schofield, E, Short, AI, Parr, MJA, Henry, JA. Hyponatraemic states following 3,4-methylenedioxymethamphetamine (MDMA, ‘ecstasy’) ingestion. Q J Med 2002;95:431–437.Google Scholar

Dowling, GP, McDonough, ET, Bost, RO. ‘Eve’ and ‘ecstasy’: a report of five deaths associated with the use of MDEA and MDMA. JAMA 1987;257(12):1615–1617.Google Scholar

Madhok, A, Boxer, R, Chowdhury, D. Atrial fibrillation in an adolescent – the agony of ecstasy. Pediatr Emerg Care 2003;19(5):348–349.Google Scholar

Qasim, A, Townend, J, Davies, MK. Ecstasy-induced acute myocardial infarction. Heart 2001;85(6):e10.Google Scholar

Mutlu, H, Silit, E, Pekkafali, Z, Incedayi, M, Basekim, C, Kizilkaya, E. ‘Ecstasy’ (MDMA)-induced pneumomediastinum and epidural pneumatosis. Diagn Interv Radiol 2005;11(3):150–151.Google Scholar

Gungadeen, A, Moor, J. Extensive subcutaneous emphysema and pneumomediastinum after ecstasy ingestion. Case Rep Otolaryngol 2013;2013:795867. https://doi.org/10.1155/2013/795867Google Scholar

Clause, AL, Coche, E, Hantson, P, Jacquet, LM. Spontaneous pneumomediastinum and epidural pneumatosis after oral ecstasy consumption. Acta Clinica Belgica 2014;69(2):146–148.Google Scholar

James, RA, Dinan, A. Hyperpyrexia associated with fatal paramethoxyamphetamine (PMA) abuse. Med Sci Law 1998;38(1):83–88.Google Scholar

Els, A, Coopman, VAE, Cordonnier, JACM, Piette, MHA, Chemiphar, NV. One fatal and seven nonfatal cases of 4-methylthioamphetamine (4-MTA) intoxication: clinico-pathological findings. In: A Els, Investigation of Fatalities Related to the Use of 3,4-Methylenedioxymethamphetamine (MDMA, ‘Ecstasy’) and Analogues: Anatomo-Pathological and Thanato-Toxicological Approach. PhD thesis, University of Ghent, 2002. Available at: http://lib.ugent.be/fulltxt/RUG01/000/745/574/RUG01-000745574_2010_0001_AC.pdf [last accessed 11 March 2022].Google Scholar

Pearson, JM, Hargraves, TL, Hair, LS, et al. Three fatal intoxications due to methylone. J Anal Toxicol 2012;36(6):444–451. https://doi.org/10.1093/jat/bks043Google Scholar

Campbell, GA, Rosner, MH. The agony of ecstasy: MDMA (3,4-methylenedioxymethamphetamine) and the kidney. Clin J Am Soc Nephrol 2008;3(6):1852–1860. https://doi.org/10.2215/CJN.02080508Google Scholar

Watson, JD. Exertional heat stroke induced by amphetamine analogues. Anaesthesia 1993;48(12):1057–1060.Google Scholar

Parrott, AC. MDMA (3,4-methylenedioxymethamphetamine) or ecstasy: the neuropsychobiological implications of taking it at dances and raves. Neuropsychobiology 2004;50(4):329–335.Google Scholar

Kiyatkin, EA. Critical role of peripheral vasoconstriction in fatal brain hyperthermia induced by MDMA (ecstasy) under conditions that mimic human drug use. J Neurosci 2014;34(23):7754–7762.Google Scholar

Chen, Y, Tran, HTN, Saber, YH, Hall, FS. High ambient temperature increases the toxicity and lethality of 3,4-methylenedioxymethamphetamine and methcathinone. Pharmacol Biochem Behav 2020;192:172912. https://doi.org/10.1016/j.pbb.2020.172912Google Scholar

Green, AR. A review of the mechanisms involved in the acute MDMA (ecstasy)-induced hyperthermic response. Eur J Pharmacol 2004;500(1):3–13.Google Scholar

Hunt, PA. Heat illness. J R Army Med Corps 2005;151(4):234–242.Google Scholar

Schütte, JK, Schäfer, U, Becker, S, et al. 3,4-methylenedioxymethamphetamine induces a hyperthermic and hypermetabolic crisis in pigs with and without a genetic disposition for malignant hyperthermia. Eur J Anaesthesiol 2013;30(1):29–37. https://doi.org/10.1097/EJA.0b013e32835a1127Google Scholar

Fritz-Patrick, J, Pineau Mitchell, A, Auzinger, G. Too hot to handle: a case report of extreme pyrexia after MDMA ingestion. Ther Hypothermia Temp Manag 2018;8(3):173–175. https://doi.org/10.1089/ther.2018.0002Google Scholar

Pilgrim, JL. Deaths involving MDMA and the concomitant use of pharmaceutical drugs. J Analytic Toxicol 2011;35(4):219–226.Google Scholar

Copeland, JP. Ecstasy and the concomitant use of pharmaceuticals. Addict Behav 2006;31(2):367–370.Google Scholar

Pilgrim, JL. Serotonin toxicity involving MDMA (ecstasy) and moclobemide. Forensic Sci Int 2012;215(1):184–188.Google Scholar

Advisory Council on the Misuse of Drugs (ACMD). Benzofurans: A Review of the Evidence of Use and Harm. Published 2013. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/261783/Benzofuran_compounds_report.pdf [last accessed 23 April 2022].Google Scholar

Kraner, JC, McCoy, DJ, Evans, MA, Evans, LE, Sweeney, BJ. Fatalities caused by the MDMA-related drug paramethoxyamphetamine (PMA). J Anal Toxicol 2001;25(7):645–648.Google Scholar

Baggott, MJ, Garrison, KJ, Coyle, JR, et al. MDMA impairs response to water intake in healthy volunteers. Adv Pharmacol Sci 2016;2016:2175896. https://doi.org/10.1155/2016/2175896Google Scholar

Simmler, LD, Hysek, CM, Liechti, ME. Sex differences in the effects of MDMA (ecstasy) on plasma copeptin in healthy subjects. J Clin Endocrinol Metab 2011;96(9):2844–2850. https://doi.org/10.1210/ jc.2011-1143Google Scholar

Finch, EL. Cerebral oedema after MDMA (‘ecstasy’) and unrestricted water intake. Drug workers emphasise that water is not an antidote to drug.Br Med J 1996;313(7058):690.Google Scholar

Chang, JCYC. Late diagnosis of MDMA-related severe hyponatremia. Case Rep Intern Med 2014;1(2):153.Google Scholar

Virani, S, Daya, GN, Brainch, N, et al. Persistent psychosis due to single dose of ecstasy. Cureus 2018;10(7):e3058. https://doi.org/10.7759/cureus.3058Google Scholar

Van Kampen, J. Persistent psychosis after a single ingestion of ‘ecstasy’. Psychosomatics 2001;42(6):525–527.Google Scholar

McGuire, P, Fahy, T. Chronic paranoid psychosis after misuse of MDMA (‘ecstasy’). Br Med J 1991;302(6778):697.Google Scholar

Bramness, JGM. Amphetamine-induced psychosis – a separate diagnostic entity or primary psychosis triggered in the vulnerable? BMC Psychiatry 2012;12(1):221.Google Scholar

Vaiva, GV. An ‘accidental’ acute psychosis with ecstasy use. J Psychoactive Drugs 2001;33(1):95–98.Google Scholar

Rugani, FS. Symptomatological features of patients with and without ecstasy use during their first psychotic episode. Int J Environ Res Public Health 2012;9(7):2283–2292.Google Scholar

Kim, J, Fan, B, Liu, X, Kerner, N, Wu, P. Ecstasy use and suicidal behavior among adolescents: findings from a national survey. Suicide Life Threat Behav 2011;41:435–444.Google Scholar

Hinkelbein, J, Gabel, A, Volz, M, Ellinger, K. Suicide attempt with high-dose ecstasy. [Article in German.] Der Anaesthesist 2003;52(1):51–54.Google Scholar

Karlovšek, MZ, Alibegovic, A, Balažic, J. Our experiences with fatal ecstasy abuse (two case reports). Forensic Sci Int 2005;147:S77–80.Google Scholar

Fernando, T, Gilbert, JD, Carroll, CM, Byard, RW. Ecstasy and suicide. J Forensic Sci 2012;57:1137–1139.Google Scholar

Rojek, S, Małgorzata, K, Strona, M, Maciów, M, Kula, K. ‘Legal highs’ – toxicity in the clinical and medico-legal aspect as exemplified by suicide with bk-MBDB administration. Forensic Sci Int 2012;222(1):e1–e6.Google Scholar

Bonsignore, A, Barranco, R, Morando, A, et al. MDMA-induced cardio-toxicity and pathological myocardial effects: a systematic review of experimental data and autopsy findings. Cardiovasc Toxicol 2019;19:493–499. https://doi.org/10.1007/s12012-019-09526-9Google Scholar

Hoggett, KD. Ecstasy-induced acute coronary syndrome: something to rave about. Emerg Med Australasia 2012;24(3):339–342.Google Scholar

Mizia-Stec, K, Gasior, Z, Wojnicz, R, et al. Severe dilated cardiomyopathy as a consequence of ecstasy intake. Cardiovasc Pathol 2008;17(4):250–253. https://doi.org/10.1016/j.carpath.2007.07.006Google Scholar

Rehman, S, Khalid, F, Kowsika, S, Ghobrial, I. As molly takes the party toll: MDMA toxicity presenting with pulmonary hemorrhage. Am J Resp Crit Care Med 2020;201:A1616.Google Scholar

Stull, BW. Spontaneous pneumomediastinum following ecstasy ingestion and sexual intercourse. Emerg Med J 2008;25(2):113–114.Google Scholar

Marasco, SF. Ecstasy-associated pneumomediastinum. Ann R Coll Surg Engl 2007;89(4):389.Google Scholar

Kahn, DE. 3 cases of primary intracranial hemorrhage associated with ‘Molly’, a purified form of 3,4-methylenedioxymethamphetamine (MDMA). J Neurol Sci 2012;323(1):257–260.Google Scholar

Wong, S, Afshani, M. Intracranial vascular complications of ‘molly’ usage: case report and review of the literature. Conn Med 2016;80(8):467–469.Google Scholar

Garbino, JJ. Ecstasy ingestion and fulminant hepatic failure: liver transplantation to be considered as a last therapeutic option. Vet Hum Toxicol 2001;43(2):99–102.Google Scholar

Seymour, HG. Severe ketoacidosis complicated by ‘ecstasy’ ingestion and prolonged exercise. Diabet Med 1996;13:908–909.Google Scholar

Gama, MP. Diabetic ketoacidosis complicated by the use of ecstasy: a case report. J Med Case Rep 2010;4(1):240.Google Scholar

Johnson, MP, Nichols, DE. Combined administration of a non-neurotoxic 3,4-methylenedioxymethamphetamine analogue with amphetamine produces serotonin neurotoxicity in rats. Neuropharmacology 1991;30(7):819–822.Google Scholar

Vanattou-Saïfoudine, NR. Caffeine promotes dopamine D1 receptor-mediated body temperature, heart rate and behavioural responses to MDMA (‘ecstasy’). Psychopharmacology 2010;211(1):15–25.Google Scholar

Papaseit, E, Vázquez, A, Pérez-Mañá, C, et al. Surviving life-threatening MDMA (3,4-methylenedioxymethamphetamine, ecstasy) toxicity caused by ritonavir (RTV). Intensive Care Med 2012;38(7):1239–1240. https://doi.org/10.1007/s00134-012-2537-9Google Scholar

Antolino-Lobo, I, Meulenbelt, J, Nijmeijer, SM, et al. 3,4-methylenedioxymethamphetamine (MDMA) interacts with therapeutic drugs on CYP3A by inhibition of pregnane X receptor (PXR) activation and catalytic enzyme inhibition. Toxicol Lett 2011;203(1):82–91. https://doi.org/10.1016/j.toxlet.2011.03.007Google Scholar

Davies, N, English, W, Grundlingh, J. MDMA toxicity: management of acute and life-threatening presentations. Br J Nurs 2018;27(11):616–622.Google Scholar

Grunau, BE, Wiens, MO, Brubacher, JR. Dantrolene in the treatment of MDMA-related hyperpyrexia: a systematic review. CJEM 2010;12(5):435–442.Google Scholar

Banks, ML, Sprague, JE. From bench to bedside: understanding the science behind the pharmacologic management of MDMA and other sympathomimetic-mediated hyperthermia. J Pharm Technology. 2011;27(3):123–31.Google Scholar

Kiyatkin, EA, Ren, S, Wakabayashi, KT, Baumann, MH, Shaham, Y. Clinically relevant pharmacological strategies that reverse MDMA-induced brain hyperthermia potentiated by social interaction. Neuropsychopharmacology 2016;41:549–559.Google Scholar

Voizeux, P, Lewandowski, R, Daily, T, et al. Case of cardiac arrest treated with extra-corporeal life support after MDMA intoxication. Case Rep Crit Care 2019;2019:7825915. https://doi.org/10.1155/2019/7825915Google Scholar

Chu, FK, Ming Yim, AK, Ng, SW. A case series of life-threatening 3,4-methylenedioxyamphetamine (MDMA) poisoning in an electronic dance music party in Hong Kong. Asia Pac J Med Toxicol 2018;7:3. http://apjmt.mums.ac.irGoogle Scholar

Parrott, AC. Residual neurocognitive features of ecstasy use: a re-interpretation of Halpern et al. (2011) consistent with serotonergic neurotoxicity. Addiction 2011;106(7):1365–1368.Google Scholar

Green, D, Barry, P, Green, HD. Central cyanosis on a psychiatric unit treated at the Salford Royal Hospital. Thorax 2014;69(12):1157–1158. https://doi.org/10.1136/thoraxjnl-2014-205769Google Scholar

Di Iorio, CR, Watkins, TJ, Dietrich, MS, et al. Evidence for chronically altered serotonin function in the cerebral cortex of female 3,4-methylenedioxymethamphetamine polydrug users. Arch Gen Psychiatry 2012;69(4):399–409. https://doi.org/10.1001/archgenpsychiatry.2011.156Google Scholar

Benningfield, MM, Cowan, RL. Brain serotonin function in MDMA (ecstasy) users: evidence for persisting neurotoxicity. Neuropsychopharmacology 2013;38(1):253–255.Google Scholar

Kish, SJ, Lerch, J, Furukawa, Y, et al. Decreased cerebral cortical serotonin transporter binding in ecstasy users: a positron emission tomography/[(11)C] DASB and structural brain imaging study. Brain 2010;133(Pt 6):1779–1997. https://doi.org10.1093/brain/ awq103Google Scholar

Bauernfeind, AL, Dietrich, MS, Blackford, JU, et al. Human ecstasy use is associated with increased cortical excitability: an fMRI study. Neuropsychopharmacology 2011;36(6):1127–1141. https://doi.org/10.1038/npp.2010.244Google Scholar

Urban, NB, Girgis, RR, Talbot, PS, et al. Sustained recreational use of ecstasy is associated with altered pre and postsynaptic markers of serotonin transmission in neocortical areas: a PET study with [¹¹C]DASB and [¹¹C]MDL 100907. Neuropsychopharmacology 2012;37(6):1465–1473. https://doi.org/10.1038/npp.2011.332Google Scholar

Booij, L, Soucy, JP, Young, SN, et al. Brain serotonin synthesis in MDMA (ecstasy) polydrug users: an alpha-[11C] methyl-tryptophan study. J Neurochem 2014;131(5):634–644. https://doi.org/10.1111/jnc.12826Google Scholar

McCann, UD, Szabo, Z, Vranesic, M, et al. Positron emission tomographic studies of brain dopamine and serotonin transporters in abstinent (±) 3,4-methylenedioxy-methamphetamine (‘ecstasy’) users: relationship to cognitive performance. Psychopharmacology 2008;200(3):439–450. https://doi.org/10.1007/s00213-008-1218-4Google Scholar

Bosch, OG, Wagner, M, Jessen, F, et al. Verbal memory deficits are correlated with prefrontal hypometabolism in 18FDG PET of recreational MDMA users. PLoS ONE 2013;8(4):e61234. https://doi.org/10.1371/journal.pone.0061234Google Scholar

Gouzoulis-Mayfrank, E, Daumann, J. Neurotoxicity of methylenedioxyamphetamines (MDMA; ecstasy) in humans: how strong is the evidence for persistent brain damage? Addiction 2006;101(3):348–361.Google Scholar

Clemens, KJ, McGregor, IS, Hunt, GE, Cornish, JL. MDMA, methamphetamine and their combination: possible lessons for party drug users from recent preclinical research. Drug Alcohol Rev 2007;26(1):9–15.CrossRefGoogle ScholarPubMed

Biezonski, DK, Meyer, JS. The nature of 3,4-methylenedioxymethamphetamine (MDMA)-induced serotonergic dysfunction: evidence for and against the neurodegeneration hypothesis. Curr Neuropharmacol 2011;9(1):84.Google Scholar

Krebs, TS, Pål-Ørjan, J. Methodological weaknesses in non-randomized studies of ecstasy (MDMA) use: a cautionary note to readers and reviewers. Neuropsychopharmacology 2012;37(4):1070.Google Scholar

Erritzoe, D, Frokjaer, VG, Holst, KK, et al. In vivo imaging of cerebral serotonin transporter and serotonin2a receptor binding in 3,4-methylenedioxymethamphetamine (MDMA or ‘ecstasy’) and hallucinogen users. Arch Gen Psychiatry 2011;68(6):562–576. https://doi.org/10.1001/archgenpsychiatry.2011.56Google Scholar

Adamaszek, M, Khaw, AV, Buck, U, Andresen, B, Thomasius, R. Evidence of neurotoxicity of ecstasy: sustained effects on electroencephalographic activity in polydrug users. PLoS ONE 2010;5(11):e14097. https://doi.org/10.1371/journal.pone.0014097Google Scholar

de Win, MM. Sustained effects of ecstasy on the human brain: a prospective neuroimaging study in novel users. Brain 2008;131(11):2936–2945.Google Scholar

Thomasius, R, Zapletalova, P, Petersen, K, et al. Mood, cognition and serotonin transporter availability in current and former ecstasy (MDMA) users: the longitudinal perspective. J Psychopharmacol 2006;20(2):211–225.Google Scholar

Parrott, AC. MDMA and 5-HT neurotoxicity: the empirical evidence for its adverse effects in humans – no need for translation. Br J Pharmacol 2012;166(5):1518–1520; discussion 1521–1522. https://doi.org/10.1111/j.1476-5381.2012.01941.xGoogle Scholar

Peraile, I, Granado, N, Torres, E, et al. Cocaine potentiates MDMA-induced oxidative stress but not dopaminergic neurotoxicity in mice: implications for the pathogenesis of free radical-induced neurodegenerative disorders. Psychopharmacology 2013;230(1):125–135. https://doi.org/10.1007/s00213-013-3142-5Google Scholar

Angoa-Pérez, M, Kane, MJ, Briggs, DI, et al. Mephedrone does not damage dopamine nerve endings of the striatum, but enhances the neurotoxicity of methamphetamine, amphetamine, and MDMA. J Neurochem 2013;125(1):102–110. https://doi.org/10.1111/jnc.12114Google Scholar

Klomp, A, den Hollander, B, de Bruin, K, Booij, J, Reneman, L. The effects of ecstasy (MDMA) on brain serotonin transporters are dependent on age-of-first exposure in recreational users and animals. PLoS ONE 2012;7(10): e47524. https://doi.org/10.1371/journal.pone.0047524Google Scholar

Huang, X, Marona-Lewicka, D, Nichols, DE. p-Methylthioamphetamine is a potent new non-neurotoxic serotonin-releasing agent. Eur J Pharmacol 1992;229(1):31–38.Google Scholar

Nichols, DE, Johnson, MP, Oberlender, R. 5-iodo-2-aminoindan, a nonneurotoxic analogue of piodoamphetamine. Pharmacol Biochem Behav 1991;38(1):135–139.Google Scholar

Nichols, DE, Marona-Lewicka, D, Huang, X, Johnson, MP. Novel serotonergic agents. Drug Des Discov 1993;9(3–4):299–312.Google Scholar

Wagner, D, Becker, B, Koester, P, Gouzoulis-Mayfrank, E, Daumann, J. A prospective study of learning, memory, and executive function in new MDMA users. Addiction 2013;108(1):136–145.Google Scholar

Schilt, T, de Win, MM, Koeter, M, et al. Cognition in novice ecstasy users with minimal exposure to other drugs: a prospective cohort study. Arch Gen Psychiatry 2007;64(6):728–736.Google Scholar

Halpern, JH, Sherwood, AR, Hudson, JI, Gruber, S, Kozin, D, Pope, Jr HG. Residual neurocognitive features of long-term ecstasy users with minimal exposure to other drugs. Addiction 2011;106:777–786.Google Scholar

Taurah, L, Chandler, C, Sanders, G. Depression, impulsiveness, sleep, and memory in past and present polydrug users of 3,4-methylenedioxymethamphetamine (MDMA, ecstasy). Psychopharmacology 2014;231(4):737–751.Google Scholar

Gerra, G, Zaimovic, A, Ampollini, R, et al. Experimentally induced aggressive behavior in subjects with 3,4-methylenedioxy-methamphetamine (‘Ecstasy’) use history: psychobiological correlates. J Subst Abuse 2001;13(4):471–491.Google Scholar

Wetherell, MA, Montgomery, C. Basal functioning of the hypothalamic-pituitary-adrenal (HPA) axis and psychological distress in recreational ecstasy polydrug users. Psychopharmacology 2014;231(7):1365–1375.Google Scholar

Parrott, AC, Montgomery, C, Wetherell, MA, Downey, LA, Stough, C, Scholey, AB. MDMA, cortisol, and heightened stress in recreational ecstasy users. Behav Pharmacol 2014;25(5–6):458–472. https://doi.org/10.1097/FBP.0000000000000060Google Scholar

Sumnall, HR, Cole, JC. Self-reported depressive symptomatology in community samples of polysubstance misusers who report ecstasy use: a meta-analysis. J Psychopharmacol 2005;19(1):84–92.Google Scholar

Brière, FN, Fallu, JS, Janosz, M, Pagani, LS. Prospective associations between meth/amphetamine (speed) and MDMA (ecstasy) use and depressive symptoms in secondary school students. J Epidemiol Community Health 2012;66(11):990–994. https://doi.org/10.1136/jech-2011-200706Google Scholar

McCann, M, Higgins, K, Perra, O, McCartan, C, McLaughlin, A. Adolescent ecstasy use and depression: cause and effect, or two outcomes of home environment? Eur J Public Health 2014;24(5):845–850. https://doi.org/10.1093/eurpub/cku062Google Scholar

Scott, RM, Hides, L, Allen, JS, Burke, R, Lubman, DI. Depressive and anxiety symptomatology in ecstasy users: the relative contribution of genes, trauma, life stress and drug use. Psychopharmacology 2010;209(1):25–36. https://doi.org/10.1007/s00213-009-1763-5Google Scholar

Soar, K, Turner, JJD, Parrott, AC. Psychiatric disorders in ecstasy (MDMA) users: a literature review focusing on personal predisposition and drug history. Hum Psychopharmacol 2001;16(8):641–645.Google Scholar

Bedi, G, Van Dam, NT, Redman, J. Ecstasy (MDMA) and high prevalence psychiatric symptomatology: somatic anxiety symptoms are associated with polydrug, not ecstasy, use. J Psychopharmacol 2010;24(2):233–240. https://doi.org/10.1177/0269881108097631Google Scholar

Daumann, J, Hensen, G, Thimm, B, Rezk, M, Till, B, Gouzoulis-Mayfrank, E. Self-reported psychopathological symptoms in recreational ecstasy (MDMA) users are mainly associated with regular cannabis use: further evidence from a combined cross-sectional/longitudinal investigation. Psychopharmacology 2004;173(3–4):398–404.Google Scholar

Thomasius, R, Petersen, KU, Zapletalova, P, Wartberg, L, Zeichner, D, Schmoldt, A. Mental disorders in current and former heavy ecstasy (MDMA) users. Addiction 2005;100:1310–1319.Google Scholar

Marchesi, C, Tonna, M, Maggini, C. Obsessive-compulsive disorder followed by psychotic episode in long-term ecstasy misuse. World J Biol Psychiatry 2009;10(4–2): 599–602.Google Scholar

Home Office. Drugs Misuse: Findings from the 2018/19 Crime Survey for England and Wales Statistical Bulletin: 21/19. Published September 2019.Google Scholar

Miller, JM, Vorel, SR, Tranguch, AJ, et al. Anhedonia after a selective bilateral lesion of the globus pallidus. Am J Psychiatry 2006;163(5):786–788.Google Scholar

Kouimtsidis, CF. Neurological and psychopathological sequelae associated with a lifetime intake of 40,000 ecstasy tablets. Psychosomatics 2006;47(1):86–87.Google Scholar

Kirkpatrick, MG, Baggott, MJ, Mendelson, JE, et al. MDMA effects consistent across laboratories. Psychopharmacology 2014;231(19):3899–3905. https://doi.org/10.1007/s00213-014-3528-zGoogle Scholar

O’Sullivan, A, Parrott, AC. Deteriorating cost–benefit ratios for ecstasy/MDMA with repeated usage. Open Addiction J 2011;4:38–39.Google Scholar

European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2019: Trends and Developments. Luxembourg, Publications Office of the European Union, 2019.Google Scholar

Degenhardt, L, Bruno, R, Topp, L. Is ecstasy a drug of dependence? Drug Alcohol Depend 2010;107:1–10.Google Scholar

Uosukainen, H, Tacke, U, Winstock, AR. Self-reported prevalence of dependence of MDMA compared to cocaine, mephedrone and ketamine among a sample of recreational poly-drug users. Int J Drug Policy 2015;26(1):78–83. https://doi.org/10.1016/j.drugpo.2014.07.004Google Scholar

Bruno, R, Matthews, AJ, Topp, L, Degenhardt, L, Gomez, R, Dunn, M. Can the severity of dependence scale be usefully applied to ‘ecstasy’? Neuropsychobiology 2009;60(3–4):137–147. https://doi.org/10.1159/ 000253550Google Scholar

Cottler, LB, Womack, SB, Compton, WM, Ben-Abdallah, A. Ecstasy abuse and dependence among adolescents and young adults: applicability and reliability of DSM-IV criteria. Hum Psychopharmacol Clin Exp 2001;16:599–606.Google Scholar

Yen, C, Hsu, S. Symptoms of ecstasy dependence and correlation with psychopathology in Taiwanese adolescents. J Nerv Ment Dis 2007;195:866–869.Google Scholar

Scheier, L, Abdullah, A, Inciardi, J, Copeland, J, Cottler, L. Tri-city study of ecstasy use problems: a latent class analysis. Drug Alcohol Depend 2008;98:249–263.Google Scholar

Abdallah, A, Scheier, L, Inciardi, J, Copeland, J, Cottler, L. A psycho-economic model of ecstasy consumption and related consequences: a multi-site study with community samples. Subst Use Misuse 2007;42:1651–1684.Google Scholar

Winstock, AR. Drugs and the dance music scene: a survey of current drug use patterns among a sample of dance music enthusiasts in the UK. Drug Alcohol Depend 2001;64(1):9–17.Google Scholar

Milani, RM, Turner, J, Parrott, AC. The contribution of ecstasy dependence and stress to ecstasy-/MDMA-related psychiatric symptoms. Open Addict J 2011;4:28–29.Google Scholar

Topp, L, Hall, W, Hando, J. Is There a Dependence Syndrome for Ecstasy? (National Drug and Alcohol Research Centre Technical Report No. 51). NDARC, 1997.Google Scholar

Parrott, AC. Chronic tolerance to recreational MDMA (3,4-methylenedioxymethamphetamine) or ecstasy. J Psychopharmacol 2005;19:71–83.Google Scholar

McKetin, R, Copeland, J, Norberg, MM, Bruno, R, Hides, L, Khawar, L. The effect of the ecstasy ‘comedown’on the diagnosis of ecstasy dependence. Drug Alcohol Depend 2014;139:26–32. https://doi.org/10.1016/j.drugalcdep.2014.02.697Google Scholar

Schenk, S. MDMA self-administration in laboratory animals: a summary of the literature and proposal for future research. Neuropsychobiology 2009;60(3–4):130.Google Scholar

Public Health England. Drug Statistics from the National Drug Treatment Monitoring System (NDTMS): 2012–2013. PHE, 2013.Google Scholar

Wu, LT, Parrott, AC, Ringwalt, CL, Patkar, AA, Mannelli, P, Blazer, DG. The high prevalence of substance use disorders among recent MDMA users compared with other drug users: implications for intervention. Addict Behav 2009;34(8):654–661. https://doi.org/10.1016/j.addbeh.2009.03.029Google Scholar

Carhart-Harris, RL, Nutt, DJ, Munafo, MR, Christmas, DM, Wilson, SJ. Equivalent effects of acute tryptophan depletion on REM sleep in ecstasy users and controls. Psychopharmacology 2009;206(2):187–196.Google Scholar

McCann, UD. Effects of (±)3,4-methylenedioxymethamphetamine (MDMA) on sleep and circadian rhythms. Scientific World J 2007;7:231–238.Google Scholar

Smithies, V, Broadbear, J, Verdejo-Garcia, A, Conduit, R. Dysfunctional overnight memory consolidation in ecstasy users. J Psychopharmacol 2014;28(8):751–762.Google Scholar

Gledhill, JA. Subarachnoid haemorrhage associated with MDMA abuse. J Neurol Neurosurg Psychiatry 1993;56(9):1036.Google Scholar

Karch, SB. A historical review of MDMA. Open Forensic Sci J 2011;4:20–24.Google Scholar

Droogmans, SB. Possible association between 3,4-methylenedioxymethamphetamine abuse and valvular heart disease. Am J Cardiol (2007);100(9):1442–1445.Google Scholar

Bhattacharyya, SA. Drug-induced fibrotic valvular heart disease. Lancet 2009;374(9689):577–585.Google Scholar

Montastruc, F, Montastruc, G, Vigreux, P, et al. Valvular heart disease in a patient taking 3,4-methylenedioxymethamphetamine (MDMA, ‘ecstasy’). Br J Clin Pharmacol 2012;74(3):547–548. https://doi.org/10.1111/j.1365-2125.2012.04252.xGoogle Scholar

Patel, MM, Belson, MG, Wright, D, Lu, H, Heninger, M, Miller, MA. Methylenedioxymethamphetamine (ecstasy)-related myocardial hypertrophy: an autopsy study. Resuscitation 2005;66(2):197–202.Google Scholar

Marsden, J, Stillwell, G, Barlow, H, et al. An evaluation of a brief motivational intervention among young ecstasy and cocaine users: no effect on substance and alcohol use outcomes. Addiction 2006;101(7):1014–1026.Google Scholar

Norberg, MM, Hides, L, Olivier, J, Khawar, L, McKetin, R, Copeland, J. Brief interventions to reduce ecstasy use: a multi-site randomized controlled trial. Behav Ther 2014;45(6):745–759. https://doi.org/10.1016/j.beth.2014.05.006Google Scholar

Martin, G, Copeland, J. Brief intervention for regular ecstasy (MDMA) users: pilot randomized trial of a check-up model. J Subst Use 2010;15(2):131–142.Google Scholar

Fox, HC. Ecstasy use: cognitive deficits related to dosage rather than self-reported problematic use of the drug. J Psychopharmacol 2001;15(4):273–281.Google Scholar

Larkin, M. Dangerous sports and recreational drug use: rationalizing and contextualizing risk. J Community Applied Social Psychol 2004;14(4):215–232.Google Scholar

Gamma, AL. Is ecstasy perceived to be safe? A critical survey. Drug Alcohol Depend 2005;77(2):185–193.Google Scholar

Baggott, MJ. Preventing problems in ecstasy users: reduce use to reduce harm. J Psychoactive Drugs 2002;34(2):145–162.Google Scholar

Davies, C, Murray, R, eds. United Kingdom Drug Situation: Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), 2013. United Kingdom Focal Point at Public Health England, 2013.Google Scholar

Liechti, ME. Acute psychological effects of 3,4-methylenedioxymethamphetamine (MDMA, ‘ecstasy’) are attenuated by the serotonin uptake inhibitor citalopram. Neuropsychopharmacology 2000;22(5):513–521.Google Scholar

Piper, BJ. Dissociation of the neurochemical and behavioral toxicology of MDMA (‘ecstasy’) by citalopram. Neuropsychopharmacology 2007;33(5):1192–1205.Google Scholar

Fisk, JE, Murphy, PN, Montgomery, C, Hadjiefthyvoulou, F. Modelling the adverse effects associated with ecstasy use. Addiction 2011;106(4):798–805. https://doi.org/10.1111/j.1360-0443.2010.03272.xGoogle Scholar

Vanden Eede, H, Montenij, LJ, Touw, DJ, Norris, EM. Rhabdomyolysis in MDMA intoxication: a rapid and underestimated killer. ‘ Clean’ ecstasy, a safe party drug? J Emerg Med 2012;42(6):655–658. https://doi.org/10.1016/j.jemermed.2009.04.057Google Scholar

Advisory Council on the Misuse of Drugs (ACMD). 6-APB and 5-APB: A Review of the Evidence of Use and Harm. Published 2013. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/261783/Benzofuran_compounds_report.pdf [last accessed 23 April 2022].Google Scholar

Sainsbury, PD, Kicman, AT, Archer, RP, King, LA, Braithwaite, RA. Aminoindanes – the next wave of ‘legal highs’? Drug Test Anal 2011;3(7–8):479–482. https://doi.org/10.1002/dta.318Google Scholar

Barceló B, , Gomila I, , Rotolo MC, et al. Intoxication caused by new psychostimulants: analytical methods to disclose acute and chronic use of benzofurans and ethylphenidate. Int J Legal Med 2017;131:1543–1553. https://doi.org/10.1007/s00414-017-1648-9Google Scholar

Advisory Council on the Misuse of Drugs (ACMD). Benzofurans: A Review of the Evidence of Use and Harm. Published 2013. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/261783/Benzofuran_compounds_report.pdf [last accessed 23 April 2022].Google Scholar

Jebadurai, J, Schifano, F, Deluca, P. Recreational use of 1-(2-naphthyl)-2-(1-pyrrolidinyl)-1-pentanone hydrochloride (NRG-1), 6-(2-aminopropyl) benzofuran (Benzofury/6-APB) and NRG-2 with review of available evidence-based literature. Hum Psychopharmacol Clin Exp 2013;28(4):356–364.Google Scholar

Iversen, L, Gibbons, S, Treble, R, Setola, V, Huang, XP, Roth, BL. Neurochemical profiles of some novel psychoactive substances. Eur J Pharmacol 2013; 700(1–3): 147–151. https://doi.org/10.1016/j. ejphar.2012.12.006Google Scholar

Dawson, P, Opacka-Juffry, J, Moffatt, JD, et al. The effects of benzofury (5-APB) on the dopamine transporter and 5-HT2-dependent vasoconstriction in the rat. Prog Neuropsychopharmacol Biol Psychiatry 2014;48:57–63.Google Scholar

Baron, M, Elie, M, Elie, L. An analysis of legal highs – do they contain what it says on the tin? Drug Test Anal 2011;3(9):576–581Google Scholar

Barceló, B, Gomila, I, Rotolo, MC, et al.Intoxication caused by new psychostimulants: analytical methods to disclose acute and chronic use of benzofurans and ethylphenidate. Int J Legal Med 2017;131:1543–1553. https://doi.org/10.1007/s00414-017-1648-9Google Scholar

Greene, SL. Benzofurans and benzodifurans. In: Dargan, PI, DM Wood, , eds., Novel Psychoactive Substances: Classification, Pharmacology and Toxicology. Oxford, Elsevier, 2013.Google Scholar

Hölzemann, G, Böttcher, H, Schiemann, K, et al. Benzofuran compounds and their use as antidepressants and anxiolytics. US Patent No. 7,262,216 (28 August 2007).Google Scholar

Chan, WL, Wood, DM, Hudson, S, Dargan, PI. Acute psychosis associated with recreational use of benzofuran 6-(2-aminopropyl)benzofuran (6-APB) and cannabis. J Med Toxicol 2013;9:278–281. https://doi.org/10.1007/s13181-013-0306-yGoogle Scholar

Barceló, B, Gomila, I, Rotolo, MC, et al.Intoxication caused by new psychostimulants: analytical methods to disclose acute and chronic use of benzofurans and ethylphenidate. Int J Legal Med 2017;131:1543–1553. https://doi.org/10.1007/s00414-017-1648-9Google Scholar

Bravo R, Roque, Carmo, H, CarvalhoF, Dias da Silva D., Benzo fury: a new trend in the drug misuse scene. J Appl Toxicol 2019;39(8):1083–1095.Google Scholar

Liechti, M. Novel psychoactive substances (designer drugs): overview and pharmacology of modulators of monoamine signalling. Swiss Med Wkly 2015;45:w14043.Google Scholar

Hofer, KE, Faber, K, Müller, DM, et al. Acute toxicity associated with the recreational use of the novel psychoactive benzofuran N-methyl-5-(2 aminopropyl)benzofuran. Ann Emerg Med 2017;69(1):79–82. https://doi.org/10.1016/j.annemergmed.2016.03.042Google Scholar

Rothman, RB, Baumann, MH, Savage, JE, et al. Evidence for possible involvement of 5-HT(2B) receptors in the cardiac vulvulopathy associated with fenfluramine and other serotonergic medications. Circulation 2000;102:2836–2841.Google Scholar

Dawson, PO, Moffott, JD. Cardiovascular toxicity of novel psychoactive drugs: lessons from the past. Prog Neuropsychopharm Biol Pschiatr 2012;39:244–252.Google Scholar