Patient: Are you the pharmacist?
R.Ph.: Yes, what can I do for you?
Patient: I was just wondering if it would hurt me if I took 40,000 Ecstasy pills?
That's a lot of ecstasy for one person to be taking. Check out the paper at:
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I find it interesting that d/c the cannabis caused several of Mr. A's most severe symptoms to go away. That leaves recurrent anxiety, depression, and muscle rigidity. I agree that the muscle rigidity is likely related to the classic MDMA jaw clench.
ReplyDeleteThe case mentions that there was no psychiatric history before the drug use, but to me that only means that he simply never sought psychiatric help before then. I believe that cannabis use often covers up existing anxiety problems - or possibly causes them in the long run. For me, this casts doubt that the anxiety can be traced back to MDMA.
Depression, again, may be something the patient was, in effect, self-treating with MDMA, cannabis, and etc. Though I have heard of rebound disaffect after MDMA cessation. It is not hard to imagine that manipulating serotonin regulation for so long would have some lasting effect.
So the guy may have taken 40,000 MDMA tabs in his life - which is an impressive number, I'll admit - but I don't see much here that I would trust as true sequelae. If anything, I see evidence that MDMA is fairly well tolerated. Can you think of many other pills that can be taken 25x a day? At that point, the guy was probably barely feeling buzzed, but wow.