Papaseit Esther, Pérez-Mañá Clara, Torrens Marta, Farré Adriana, Poyatos Lourdes, Hladun Olga, Sanvisens Arantza, Muga Roberto, Farré Magi
Departments of Clinical Pharmacology and Internal Medicine, Hospital Universitari Germans Trias I Pujol-IGTP, Badalona, Spain.
Departament of Pharmacology, Medicine and Psychiatry, Universitat Autònoma De Barcelona, Badalona, Spain.
Expert Opin Drug Metab Toxicol. 2020 May;16(5):357-369. doi: 10.1080/17425255.2020.1749262. Epub 2020 Apr 12.
: MDMA (3,4-methylenedioxymethamphetamine), a synthetic ring-substituted amphetamine, has become one of the most widely used recreational psychostimulant drugs in the world. Among recreational ecstasy/MDMA users, polydrug use is a phenomenon whose common purpose is to experience the synergistic effect of the combined drugs, moderate MDMA effects, prevent potential toxicity, enhance a high or come down from a high from other drugs, or simply to treat existing medical conditions. Thus, MDMA-drug interactions (MDMA-DIs) lead to a higher risk of acute and life-threatening MDMA toxicity.: This article provides an overview of the MDMA-DIs with pharmaceuticals and drugs of abuse. In addition, available evidence is summarized along with clinical recommendations. Finally, the increasing importance of MDMA-DIs is highlighted.: There is a reduced number of published MDMA-DIs studies and scarce clinically significant MDMA-DIs documented in the literature. Experimental evidence points out the relevance of MDMA-DI's when MDMA is co-administered with pharmaceuticals that are metabolized by the CYP2D6 due to MDMA inhibitory action and in the case of repeated MDMA administration (MDMA-MDMAIs).
摇头丸（3,4－亚甲基二氧甲基苯丙胺），一种合成的环取代苯丙胺，已成为世界上使用最广泛的消遣性精神刺激药物之一。在消遣性摇头丸/摇头丸使用者中，多药合用是一种现象，其共同目的是体验联合药物的协同作用、减轻摇头丸的效果、预防潜在毒性、增强兴奋感或从其他药物的兴奋状态中恢复，或者仅仅是为了治疗现有的医疗状况。因此，摇头丸与药物的相互作用（MDMA-DIs）会导致急性和危及生命的摇头丸毒性风险更高。本文概述了摇头丸与药物及滥用药物之间的相互作用。此外，还总结了现有证据并给出了临床建议。最后，强调了摇头丸与药物相互作用日益增加的重要性。关于摇头丸与药物相互作用的已发表研究数量减少，文献中记录的具有临床意义的摇头丸与药物相互作用也很少。实验证据指出，当摇头丸与由CYP2D6代谢的药物合用时，由于摇头丸的抑制作用以及在重复使用摇头丸的情况下（MDMA-MDMAIs），摇头丸与药物相互作用具有相关性。
