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A troubling case of 'ecstasy' induced heatstroke. (10/19/04)
A 20-year old woman was admitted to an Emergency Room in Chicago with a core body temperature of 107.2 F and a pulse in the 170s. Rhabdomyolysis (muscle breakdown) was reported, but her blood chemistry/physical exam was otherwise unremarkable. She had reportedly consumed two 'ecstasy' tablets (actual contents unknown, the attending physicians did not order a drug test beyond a quick screen that identified the presence of "amphetamines" in her system.)
With aggressive cooling (ice packs and pumping ice water through her stomach) her body temperature dropped to 105.5 F within 30 minutes, and to 100.2 F in another 20 minutes. After nine days in the hospital, the patient was released "without any significant" continuing problems. The treating doctors credit the aggressive and immediate physical cooling with her survival/recovery.
This was reportedly the first time the victim had taken 'ecstasy'. As is so often the case in such reports, the drug taken was not definitively identified, and may have been anything from real MDMA to methamphetamine to the feared PMA. Given that she was a first time user, I can't help but wonder if she suffered a panic attack, causing a boost in adrenaline release, increasing metabolism, pulse, etc. Although I have long assumed that panic attacks were not medically dangerous in cardiovascularly healthy people, perhaps proper consideration hasn't been given to the potential role of panic attacks in triggering or exacerbating overheating in the case of stimulant drugs.