Herbal Ecstasy

In large part due to the popularity of Ecstasy, there has been a boom of so-called herbal ecstasy products in recent years. These products are marketed as safe, legal alternatives to Ecstasy, with many of the same benefits. In reality, herbal ecstasy products are not similar to Ecstasy at all. While the dissimilarity maybe beneficial in some respects, herbal ecstasy has its own set of problems, worries, and contradictions. 

The herbal drug ephedra/Ma Huang is currently being traded as herbal ecstasy . Consumption gives CNS stimulation, but in high amounts can lead to hallucinations, paranoia, and psychosis. 

Ephedra is available in multiple forms. It is a common ingredient in energy boosting bars, sold as Herbal Ecstasy in some health food stores, and is also available as powder that can be mixed with water. Health food stores may sell powdered ephedrine stems, which can be used in a tea, or they may sell infusion, extracts, tinctures, or tablets of ephedra. Health food stores may also sell ephedra as the ma huang herb. Many manufacturers tend to advertise or market ephedra supplements as natural or as a botanical herb, because some consumers equate natural with safe. In China, ephedra may be boiled with cinnamon twig, licorice root, and almond to treat the common cold. 

In New Zealand, herbal ecstasy is a term used for many different herbal formulations, none of which contains ecstasy. Some of the names for these herbs (which can be sold in stores) include The Bomb , Reds , and Sublime . Analysis of The Bomb showed substantial amounts of ephedrine the Ministry of Health in New Zealand removed it from the market. Some symptoms associated with herbal ecstasy include headache, dizziness, palpitation, tachycardia, and raised blood pressure. Thus, in countries where the term herbal ecstasy is commonly used, it is important that those who see patients who have taken herbal ecstasy should not confuse it with ecstasy, as toxicity and medical management may be quite different (133). 

A 21-year-old man presented with hypertension (blood pressure 220/110 mmHg) and ventricular dysrhythmias after taking four capsules of herbal ecstasy (6). He was treated with Udocaine and sodium nitroprusside and his symptoms resolved within 9 hours. 

Ephedra was also sold in combination with many other herbs in obscure combinations. Labels frequently listed 10 or 15 different herbs, but, analysis usually disclosed only the ephedra alkaloids and caffeine as present in sufficient quantities to be physiologically active. After several well-publicized accidental deaths, products clearly intended for abuse, such as herbal ecstasy, and other look-alike drugs (products usually containing ephedrine or phenylpropanolamine designed to look like illicit methamphetamine, but in concentrations higher than recommended by industry or the FDA) were withdrawn from the market. Labels on these products were frequently misleading. For example, one might suppose that a product called Ephedrine 60 contained 60 mg of ephedrine when, in fact, the actual ephedrine content was 25 mg. 

Ma huang, "herbal ecstasy," other phenylpropanolamine analogues Nicotine and withdrawal, anabolic steroids, narcotic withdrawal, methylphenidate, phencyclidine, ketamine, ergotamine and other ergot-containing herbal products, St. John s wort Food Substances Sodium ... 

Herbal substitutes for dru [s of abuse A variety of herbal mixtures are offered for sale in magazines, on the internet and in so-called smart , eco or head shops. Many are marketed as herbal Ecstasy and the plants included in the formulations include Yohimbe bark, Kava-Kava (Piper methysticum),Y-3 e.emi, Hops, Jaborandi and Alisma. One product contains Kava-Kava, Guarana, Uva Ursi and Cascara bark. Many of the products sold as herbal Ecstasy contain either Ephedra sinica (Ma huang) or the Indian plant Sida cordifolia which both contain the alkaloid ephedrine (see R03c, Chapter VI). Other alkaloids may also occur, such as pseudoephedrine, norephedrine and norpseudoephedrine. The side-effects of ephedrine include tachycardia, anxiety, insomnia and arrythmias and a hypotensive crisis may develop if monamine oxidase inhibitors are also taken. Many adverse reactions and more than 20 deaths have been attributed to ephedrine and Ephedra consumption. Research conducted in the US shows that the daily intake of some Ephedra products would give ephedrine levels well above the recommended therapeutic doses. 

Reports of ephedra-related stroke on file with the FDA have not yet been published in the peer reviewed literature. In some of the FDA cases, massive doses of ephedrine were consumed (as with products intended for abuse, such as "herbal ecstasy," now withdrawn from the market). In other cases, toxicology testing was not performed, and it is not known with any certainty whether ephedrine was even taken. In still other cases, the drug identified was not ephedrine Many adverse events attributed to ephedrine have actually been due to ephedrine enantiomers, pseudoephedrine (Loizou et al., 1982 Stoessl et al., 1985) and phenylpropanolamine (Johnson et al., 1983 Glick et al., 1987 Lake et al.,... 

A) Herbal ecstasy causes amphetamine-like effects... 

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