Qualitative Review of Serotonin Syndrome, Ecstasy (MDMA) and the use of Other Serotonergic Substances: Hierarchy of Risk
Australian & New Zealand Journal of Psychiatry July 25, 2007 Edmund Silins, Jan Copeland, Paul Dillon 76 citations
Combining ecstasy (MDMA) with other serotonergic drugs can cause serotonin syndrome, a potentially life-threatening condition. A review of online databases created a hierarchy of risk: substances that inhibit serotonin re-uptake are less likely to cause dangerous serotonin elevations with ecstasy. High doses or repeated use of stimulants like methamphetamine and cocaine with ecstasy increase risk, as does pharmaceutical amphetamine. Serotonin precursors also influence the syndrome. Monoamine oxidase inhibitors pose the highest risk of serious serotonin increases. Findings underscore the need to screen for ecstasy and other serotonergic substance use when prescribing antidepressants.