In Reply: We described another potential complication of
MDMA abuse. It is not logical to suggest that by describing
possible dextromethorphan toxicity we somehow minimize
the dangers of illicit MDMA. The adverse effects of MDMA
are well-documented and well-known to medical personnel.
We reluctantly omitted an explicit comparison of MDMA
and dextromethorphan toxicity due to space constraints but
strongly agree that both drugs may produce toxic syndromes
with similar signs and symptoms. We also agree that cur-rently
available qualitative urine toxicology screening sys-tems
may not detect MDMA in as many as one third of
samples.
