PMA and PMMA: Reactions with other drugs or substances

Last modified: Saturday, 20. June 2009 - 2:55 pm

PMA in ecstasy tablets
PMA is not deliberately used recreationally in its pure form. PMA is sold on the illicit drug market being portrayed as ecstasy tablets. Pure PMA tablets may be sold as ecstasy, but frequently PMA is found in combination with ecstasy. Because PMA can be present in ecstasy pills, it may be used along with any drug normally consumed in combination with ecstasy pills. Ecstasy is frequently used in combination with other club drugs such as LSD, psilocybin mushrooms, GHB, ketamine, and nitrous oxide. Ecstasy is also used with marijuana, methamphetamine, heroin, powder cocaine, diverted prescription depressants, and Viagra. If PMA is ingested in the presence of these other illicit drugs, prescription drugs, alcohol, or caffeine, its toxicity is greatly increased. Lethal repercussions of PMA usage are even more likely in the presence of these other substances. Small doses of PMA that are not normally lethal become lethal in the presence of many other drugs.
An example of PMA toxicity in the presence of other drugs is a victim who died in the late 1990s after ingesting what she believed to be an ecstasy tablet. Toxicological analysis of her blood postmortem revealed elevated but not lethal levels of PMA and therapeutic levels of the prescription drug fluoxetine (Prozac). Ecstasy was not detected in her blood samples. Drug users often abuse fluoxetine to enhance the euphoric and energizing effects of ecstasy. This patient died from cerebral hemorrhage despite the low levels of PMA she had ingested. It is thought that the fluoxetine used all the enzyme normally responsible for metabolizing PMA, hence its unusual toxicity. The fluoxetine may also have had some other reaction with PMA to enhance its toxicity and produce the fatality.
Cocaine, amphetamine, methamphetamine, alcohol, and cannabinoids have already been suspected as aggravating the deadly effects of PMA. As with all drugs, the potency and quality of PMA pills may deviate substantially from one batch to another. Different pills may contain varying amounts of the drug. The clandestine labs that manufacture these illicit drugs are often very dirty, and the pills they generate may contain many dangerous contaminates in addition to PMA.

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