A Case of Toxic Psychosis Induced by 'Eve' (3,4-Methylenedioxyethylam-phetamine)

To the Editor.—  3,4-Methylenedio- xyethylamphetamine (MDE; "eve") evokes similar psychotropic effects in humans as 3,4-methylenedioxymethamphetamine (MDMA; "ecstasy"), and became popular as a recreational drug after the restriction of MDMA in 1985. The controversy about MDMA is explained by its popularity and illegal abuse, its claimed usefulness as an adjunct in psychotherapy, and its possible neurotoxicity in hu- mans.^1-3 Anecdotal reports about the psychotropic effects of MDMA and MDE describe a subtle, well-controllable state with pleasant, peaceful feelings; insightfulness; empathy; and closeness to others. In general, MDMA and MDE are thought to be "safe" drugs. However, dysphoric reactions,⁴ "bizarre and risky behaviours,"⁵ and psychosis⁶ were also reported in single cases of recreational MDMA use. Such observations suggest an underlying potential of MDMA and MDE for amphetaminelike and psychotomimetic effects. However, interpretation is difficult because of cross-reactions with other substances of abuse and because of the uncertain chemical