Hypertensive Emergency Secondary to Combining Psilocybin Mushrooms, Extended Release Dextroamphetamine-Amphetamine, and Tranylcypromine
Journal of Psychoactive Drugs June 21, 2024 Peter Kenneth Gillman, Brian S. Barnett, Curtis J. Koons et al. 9 citations
A 42-year-old man with treatment-resistant depression experienced a hypertensive emergency with chest pain, palpitations, headache, and ST-elevation on electrocardiogram about half an hour after taking 1 g of Psilocybe cubensis mushrooms while on tranylcypromine, extended-release dextroamphetamine-amphetamine, and other medications. He was diagnosed with a myocardial infarction, treated with lorazepam, nitroglycerin, and aspirin, and underwent cardiac catheterization that showed no significant abnormalities. He was discharged after overnight hospitalization with no lasting physical effects. The authors suspect phenylethylamine in the mushrooms interacted with the MAOI and amphetamine to cause the event, noting past studies suggest classic serotonergic psychedelics alone with MAOIs should not produce such emergencies.