A Case of Mao Inhibitor/MDMA Interaction: Agony After Ecstasy
Journal of Toxicology Clinical Toxicology January 1, 1987 Martin J. Smilkstein, Susan C. Smolinske, Barry H. Rumack 54 citations
A 50-year-old man who ingested both MDMA and the monoamine oxidase inhibitor phenelzine developed severe hypertension, sweating, altered mental status, and muscle rigidity lasting 5-6 hours. This clinical picture matches known dangerous interactions between MAO inhibitors and sympathomimetic drugs like amphetamines, which can cause excessive release of norepinephrine and serotonin. Such an interaction with MDMA had not been reported before. The case indicates that MDMA can produce serious toxicity in people taking MAO inhibitors, potentially leading to hypertensive crisis, intracranial hemorrhage, and severe hyperthermia.