Intentional use of hallucinogenic mushrooms remains a significant problem in the US and Europe, especially in northwest Poland's harbor complex. A case is described of an 18-year-old man who developed Wolff-Parkinson-White syndrome, arrhythmia, and myocardial infarction after Psilocybe intoxication. The indole concentrations in hallucinogenic mushrooms may predict the risk for adverse central nervous system and cardiac toxicity.
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.