Fatalities Caused by the MDMA-Related Drug Paramethoxyamphetamine (PMA)
Journal of Analytical Toxicology October 1, 2001 James C. Kraner, Damon Mccoy, Mark A. Evans et al. 89 citations
Recreational use of MDMA (Ecstasy) has risen, especially among young people at raves. Paramethoxyamphetamine (PMA), structurally and pharmacologically similar to MDMA but a more potent central stimulant affecting serotonin, has caused fatalities in Australia and now three in the midwestern United States. The decedents—two males aged 19 and 24 and a female aged 18—believed they were ingesting MDMA but had postmortem blood PMA concentrations of 1.07, 0.60, and 1.90 mg/L, with no MDMA detected. Symptoms included agitation, bruxism, severe hyperthermia, convulsions, and hemorrhage. PMA is metabolized by cytochrome P450 2D6, which is genetically polymorphic; slow metabolizers may have higher peak blood concentrations. The Marquis Test can distinguish PMA from MDMA: MDMA yields dark purple, PMA no color change. PMA pills often bear a Mitsubishi symbol.