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Can ecstasy cause a rise in intercranial pressure?

I'm writing to ask if you've ever heard about the effects of ecstasy in causing a rise in intercranial pressure - ocular blood pressure and bleeding from the ears and hair follicles. I've recently been quoted this as side effects (extreme I presume) and wondered if there's any proof or references which suggest these are side effects.

Reply from Dr Forrest

Nicholas has passed your question on to me.

1) Raised intraocular pressure. Since in normal use MDMA does dilate the
pupil and has a general sympathomimetic activity one would expect to to
raise the intra ocular pressure. I am not aware of any formal studies of
effects on intraocular pressure in humans, and I wouldn't like to try
to get one past a research ethics committee......

2) Raised intracranial presssure. Yes. In the syndrome where e users
drink large amounts of water and get a dilutional hyponatraemia they can
get rasied intra ocular pressure to the extent that they can cone. ive
seen a brain at pm with the hypothalamus squashed flat and pituitary
necrosis. This is hens teeth rare, but I always tell the SHOs when i'm
talking about e to look for papilloedema and if present to start raised
intercranial lowering Rx even before the lab results come back (serum U&E
urine & serum osmolality) when they are presented with a confused/
altered conciousness patient brought in from a rave.

3) bleeding from ears and hair follicles. Possible as a concomitant of
disseminated intravascular coagulation (DIC), a very rare but potentially
lethal complication of e use associated with hyperpyrexia & dehydration.

A R W Forrest LLM, FRCP, FRCPath
Assistant Deputy Coroner
Sheffield, UK