MAOI & MDMA

Critical Risk: Risk of serotonin syndrome and hypertensive crisis

Critical RiskClass-based

Risk Assessment

Critical Risk

MAO inhibitors block the enzymatic breakdown of serotonin, dopamine and noradrenaline. MDMA releases large amounts of serotonin and also increases dopamine and noradrenaline. Combined, this can lead to uncontrolled accumulation of these neurotransmitters, with the risk of life-threatening serotonin syndrome (high fever, muscle rigidity, autonomic instability) and hypertensive crisis. This is one of the best-documented potentially fatal substance interactions.

Pharmacological Mechanism

MAO-Hemmung blockiert den enzymatischen Serotoninabbau + SERT-Umkehrtransport (MDMA) setzt massiv Serotonin frei = unkontrollierte Serotoninakkumulation
Zusätzliche Noradrenalin- und Dopaminakkumulation erhöht das Risiko für hypertensive Krise

Mechanism data is language-neutral pharmacological notation.

Substance Profiles

MAOI

MDMA

Empathogene

SERT-UmkehrtransportSerotoninfreisetzungNoradrenalinfreisetzungDopaminfreisetzung

SERTNETDAT

Evidence Base

Curated Interaction DataAvailable

Data ProvenanceClass-based

Community Mentions0

Shared Receptors0

Sources

Safer Use Guidelines

This combination is documented in the medical literature as potentially fatal — deaths have been reported.
MAO inhibitors include prescription medicines (such as tranylcypromine, phenelzine or moclobemide) as well as some plant-derived substances (such as harmala alkaloids).
High fever, muscle rigidity, clouded consciousness or seizures require immediate emergency medical care; active cooling and benzodiazepines are first-line measures administered by professionals.

This page is based on curated pharmacological data and/or community signals. It is intended for scientific education and harm reduction only. It does not replace professional medical advice. Not all interactions are covered — always consult a healthcare professional when in doubt. In emergencies, call your local emergency number.

Laden…

Risk Assessment

Critical Risk

Pharmacological Mechanism

MAO-Hemmung blockiert den enzymatischen Serotoninabbau + SERT-Umkehrtransport (MDMA) setzt massiv Serotonin frei = unkontrollierte Serotoninakkumulation
Zusätzliche Noradrenalin- und Dopaminakkumulation erhöht das Risiko für hypertensive Krise

Mechanism data is language-neutral pharmacological notation.

Safer Use Guidelines

This combination is documented in the medical literature as potentially fatal — deaths have been reported.
MAO inhibitors include prescription medicines (such as tranylcypromine, phenelzine or moclobemide) as well as some plant-derived substances (such as harmala alkaloids).
High fever, muscle rigidity, clouded consciousness or seizures require immediate emergency medical care; active cooling and benzodiazepines are first-line measures administered by professionals.