Q: Which electrolyte imbalance is common in Ecstasy (MDMA) intoxication?

A) Hyperkalemia
B) Hypernatremia
C) Hypokalemia
D) Hyponatremia
E) Hypocalcemia


Answer: D

MDMA has dual effect. It not only causes direct drug-induced inappropriate secretion of ADH decreasing water excretion but also causes polydipsia. Major cause of death in Ecstasy is hyponatremia. It is found to be more common in female gender.



References: 

1. Hartung TK, Schofield E, Short AI, et al. Hyponatraemic states following 3,4-methylenedioxymethamphetamine (MDMA, 'ecstasy') ingestion. QJM 2002; 95:431. 

2. Budisavljevic MN, Stewart L, Sahn SA, Ploth DW. Hyponatremia associated with 3,4-methylenedioxymethylamphetamine ("Ecstasy") abuse. Am J Med Sci 2003; 326:89.