Deadly drug can cause depression, breakdown and strokes

Ecstasy or MDMA first appeared in British clubs in the summer of 1989, writes Liz Hunt. For recreational users it was the dream drug, producing a mild, euphoric "rush", together with feelings of exhilaration, for only £10-£20 per tablet or capsule. At higher doses it triggered hallucinations which enhanced the frenzied atmosphere of raves. Ecstasy combined in one drug the more desirable effects of both amphetamines and LSD - and it was non-addictive.

But almost immediately ecstasy was claiming victims. The side-effects range from raging thirst and raised body temperature to convulsions, collapse and death. Since 1990 there have been more than 50 ecstasy-related deaths documented and the true number is probably higher.

Dr John Henry, a consultant physician at the National Poisons Unit at Guy's and St Thomas's Hospital, London, estimates about 20 deaths a year from ecstasy, with several hospitalisations every weekend. This compares with 52 heroin-related deaths (excluding suicides) and two LSD-related deaths in 1992, the last year for which figures are available.

In 46 of the 50 fatalities, heatstroke was to blame - the body's temperature rises uncontrollably, affecting every organ. "The drug allows people to exert themselves for a long time without rest and without fluid. That can lead to blood disorders, heart and kidney damage, and muscle breakdown," Dr Henry said. "People may suffer strokes, with bleeding into the brain, or clotting or inflammation of the brain. We've seen all of these. Psychotic episodes have also been reported."

Some long-term users suffer depression, panic attacks, mental breakdown and possibly schizophrenia. Animal studies have shown that ecstasy destroys the serotoninergic nervous system in the brain which is involved in emotional response, and some scientists believe humans are equally susceptible to these effects. There is only a small difference between the "safe" level and that which causes harm. It is impossible to predict how an individual will react to the drug. Serious adverse effects have been reported in first time users and in regular users.

Dr Henry says it is difficult to dissuade people from trying ecstasy because taking the occasional tablet it is not perceived as "substance abuse" despite its Class A status. Possession or trade in it carries the threat of a substantial fine or prison sentence.