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Boyer EW, Quang L, Woolf A, Shannon M, Magnani B. 
“Dextromethorphan and Ecstasy Pills”. 
JAMA. 2001 Jan;285(4):409.
To the Editor: In their Research Letter, Mr Baggott and colleagues report that they performed a chemical analysis of 3,4-methylenedioxymethamphetamine (MDMA) tablets, also known as 'ecstasy,' and found that such tablets frequently contain dextromethorphan. The authors imply that findings of 'lethargy or hyperexcitability, tachycardia, ataxia, and nystagmus, as well as a phencyclidine-like psychosis' can occur only in dextromethor-phan toxicity. Furthermore, they suggest that these findings in patients admitting ecstasy use, but in whom the results of toxi-cology screens are negative for MDMAand amphetamines, should lead clinicians to consider dextromethorphan toxicity. Both of these statements are misleading.
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