A Case of Mao Inhibitor/MDMA Interaction: Agony After Ecstasy
Journal of Toxicology Clinical Toxicology – January 01, 1987
Source: OpenAlex
Summary
A 50-year-old male experienced severe hypertension and altered mental status after taking MDMA alongside the MAO inhibitor phenelzine. Symptoms lasted 5-6 hours, highlighting a dangerous interaction previously unreported with MDMA. This combination can lead to excessive release of neurotransmitters like norepinephrine and serotonin, potentially resulting in hypertensive crises and hyperthermia. Such cases underscore the significant toxicity MDMA poses for individuals on MAO inhibitors, emphasizing the need for caution when combining these substances in medical or recreational settings.
Abstract
After ingesting 3,4-methylene-dioxy-methamphetamine (MDMA) and the monoamine oxidase (MAO) inhibitor phenelzine, a 50 year old male developed marked hypertension, diaphoresis, altered mental status, and hypertonicity lasting 5-6 hours. This clinical course is typical of interaction between MAO inhibitors and some sympathomimetics including amphetamines. Such interaction has not previously been described involving MDMA. Sympathomimetic-MAO inhibitor interactions can cause excessive release of endogenous bioactive amines (e.g. norepinephrine, serotonin). Hypertensive crisis, intracranial hemorrhage, hypertonicity, and severe hyperthermia have occurred due to sympathomimetic-MAO inhibitor interactions. MDMA shares structural and pharmacologic features with other agents capable of causing this interaction, and this case suggests that MDMA can cause significant toxicity in patients taking MAO inhibitors.