Ecstasy and the dance of death.

short arm of chromosome 6.6 Autosomal recessive inheritance has been proposed as its mode of transmission,67 but further confirmation is awaited. At present it seems likely that other factors, possibly other genes, modify the expression of a juvenile myoclonic epilepsy gene on chromosome 6. The recognition that non-pharmacological factors, such as emotional stress, sleep deprivation, alcohol use, and menses, seem to precipitate seizures',3 allows patients to gain some control of their seizures; most patients, however, will require treatment with drugs. Unfortunately, no prospective, controlled studies of drug treatment for juvenile myoclonic epilepsy have been performed and current information on use of anticonvulsant drugs has been derived exclusively from retrospective studies and anecdotal reports.8 Currently the drug of choice is sodium valproate,9 which completely suppresses seizures in 80-90% of patients.7 Treatment of those patients who respond poorly to valproate is difficult and often requires more than one antiepileptic drug. No other single drug stands out as the ideal second line agent. Though anecdotal reports suggest that most other anticonvulsant drugs may be helpful, overall results are disappointing. In many patients carbamazepine exacerbates myoclonus and juvenile myoclonic epilepsy.'"'3 Juvenile myoclonic epilepsy usually persists throughout life, and patients in their seventh decade have been reported. Attempted drug withdrawal, even after complete suppression of seizures for two or more years, leads to relapses in 80-90% ofpatients.' 28 It is therefore important that a correct diagnosis is made so that patients with juvenile myoclonic epilepsy may be advised that treatment is usually required life long. Severe reactions are unpredictable Ecstasy is the popular name for 3,4-methylenedioxymeth-amphetamine, a synthetic amphetamine derivative. Patented in 1914 by the E Merck Company as an appetite suppressant, it lay virtually forgotten until the 1970s. Apart from a mild amphetamine-like stimulant effect it induces a feeling of euphoria and benevolence and, although it tends to enhance perception, its hallucinogenic potential is low. Because of these properties its psychotherapeutic potential began to be explored in fields as divergent as marriage guidance, alcoholism , and enhancement of perception in elderly people-all without benefit. While its therapeutic possibilities were being discarded its potential for misuse was being discovered, and its use in the United States as a recreational drug became widespread. As a result it was banned there in 1985. In Britain it is banned under the Misuse ofDrugs Act 1971 as a class A drug. It is also a schedule 1 drug, indicating …