Death following ingestion of MDMA (ecstasy) and moclobemide

Abstract

Four deaths following the ingestion of moclobemide and MDMA ('ecstasy') are described. The probable cause of death in each case was serotonin syndrome as a result of an interaction between the two drugs. As none of the victims had been prescribed moclobemide it seems that each had taken the drug to enhance the effects of MDMA, with fatal consequences. Warnings are needed against misinformed attempts to potentiate the pharmacological effects of illicit drugs.

The Dark Side of Ecstasy: Neuropsychiatric Symptoms after Exposure to 3,4‐Methylenedioxymethamphetamine

“…For example, it has been estimated that only 1 out of every 10,000 with a history of acute MDMA exposure is in need of medical attention, and the death rate of those treated for intoxication does not exceed 2% [38]. Monoamine oxidase inhibitors [41], selective serotonin reuptake inhibitors [20] and CYP2D6 inhibitors [16] are examples of compounds that may modulate the acute effects of MDMA in human beings. There is, however, no obvious connection between genetic CYP2D6 deficiency and onset and course of acute MDMA intoxications [23].…”

Pautas y problemas derivados del consumo de fármacos entre los consumidores de éxtasis en Australia

“…La reabsorción de inhibidores de la serotonina (p. e., ISRS, IRSN) influye de forma menos peligrosa en los niveles de serotonina cuando se consume con éxtasis, ya que estos fármacos compiten con el MDMA en el punto receptor de la serotonina y, por tanto, reducen los efectos del éxtasis 24,40,41 . Por el contrario, el consumo de éxtasis con moclobemida (RIMA) e IMAO puede producir graves aumentos de la serotonina 41,45 , porque estos antidepresivos combaten la disminución de la serotonina. Consumir éxtasis (liberador de la serotonina) con otros liberadores de la serotonina como las anfetaminas aumenta la probabilidad de sufrir síndrome serotoninérgico 25 .…”

“…Los investigadores observaron que las asociaciones entre sildenafil, conductas sexuales de riesgo e infecciones de transmisión sexual (véanse 26,27 ) no se limitaban a hombres que mantenían relaciones con hombres y, por tanto, las consecuencias para la salud pública son más amplias de lo que se pensó en principio 10,49 . Estos aspectos exigen estudios poswith moclobemide (RIMA) and MAOIs may lead to serious increases in serotonin 41,45 , as these antidepressants prevent serotonin breakdown. Using ecstasy (a serotonin releaser) with other serotonin releasers such as amphetamine increase the likelihood of serotonin syndrome 25 .…”

ST elevation myocardial infarction in a young patient after ingestion of caffeinated energy drink and ecstasy

“…[13][14][15][16] There are reports on morbidity and mortality due to cardiac effects of MDMA by coronary thrombosis and arrhythmia. [15][16][17][18] In conclusion, though the cardiac hazards of caffeine and MDMA are known, there are no descriptions of their combined effects so far. Moreover, there are no descriptions in the literature of cardiac mortality due to ingestion of energy drinks, though their use (or abuse) is a growing problem worldwide.…”