Department of Forensic Medicine, Monash University, 57-83 Kavanagh Street, Southbank 3006, Victoria, Australia.
J Anal Toxicol. 2011 May;35(4):219-26. doi: 10.1093/anatox/35.4.219.
The increasing use of 3,4-methylenedioxymethamphetamine (MDMA, "ecstasy") and tendency of users to combine MDMA with pharmaceutical agents (especially serotonergic medication) warrants a thorough understanding of MDMA's toxicity profile and potential for drug interactions. This study examined the involvement of MDMA and concurrently administered pharmaceutical drugs in cases reported to the Victorian State Coroner. The National Coroners Information System was used to conduct a comprehensive search and examination of all closed cases between 2002 and 2008 where MDMA was detected. Pathology, toxicology, and Coroners' findings were considered in all cases. In all, 106 fatalities were identified, of which 43 (41%) cases involved the concomitant use of MDMA with other drugs, including pharmaceuticals that were likely to result in an adverse drug reaction or varying risks (4 high-risk cases involved moclobemide and MDMA, in addition to 10 moderate-risk cases, and 5 minor-risk cases). These findings highlight the importance of recognizing and publicizing potential drug interactions between MDMA and pharmaceutical preparations that may result in lethal toxicity, in particular serotonin toxicity.
3,4-亚甲二氧基甲基苯丙胺（MDMA，“摇头丸”）的使用不断增加，且使用者倾向于将 MDMA 与药物制剂（特别是血清素能药物）合用，这使得人们必须深入了解 MDMA 的毒性概况和药物相互作用的潜力。本研究调查了维多利亚州验尸官报告的案例中 MDMA 和同时给予的药物制剂的参与情况。国家验尸官信息系统被用于对 2002 年至 2008 年间所有已结案的 MDMA 检测案例进行全面检索和审查。在所有案例中均考虑了病理学、毒理学和验尸官的发现。共有 106 例死亡，其中 43 例（41%）涉及 MDMA 与其他药物同时使用，包括可能导致不良反应或不同风险的药物（4 例高风险病例涉及吗氯贝胺和 MDMA，此外还有 10 例中度风险病例和 5 例低风险病例）。这些发现强调了认识和宣传 MDMA 与可能导致致命毒性的药物制剂之间潜在药物相互作用的重要性，特别是血清素毒性。
