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This Article Was Originally Published in the Respected Scientific Journal "New Scientist" Date noted below:



Magazine section: Letters

Ecstacy and Prozac

New Scientist vol 148 issue 1999 - 14 October 95, page 51


We read with interest Peter Aldhous's topical article on the toxic effects of Ecstasy (New Scientist, Science, 2 September). A new twist in the tale is that some Ecstasy (MDMA) users are combining the drug with Prozac, and in doing so may be reducing its toxicity.

In the laboratory, serotonin re-uptake inhibitors block MDMA-induced serotonin release and they also block MDMA neurotoxicity. It has been reported that fluoxetine (Prozac), a selective serotonin re-uptake inhibitar antidepressant, does not block MDMA's subjective effect and that MDMA's psychoactive effects may be separate from its neurotoxic action.

Recently it has come to our notice that antidepressants, particularly fluoxetine, are being used as recreational drugs. Reports from some of our patients suggest that fluoxetine, combined with MDMA, is becoming popular with people who go to metropolitan clubs and raves.

We are told good quality MDMA is becoming hard to find, and so users are resorting to drug combinations to enhance its effects, such as MDMA combined with ketamine, an anaesthetic, and with fluaxetine. According to users, the effects of MDMA last approximately two hours, but when combined with fluoxetine the effects are prolonged by a further two hours. Other stated reasons are the easier "come down" following a high and the absence of hangover effects with fluoxetine.

We are concerned that fluoxetine, which is a prescription only medication, has gained "street value" and is being misused, even if it is incidentally mitigating the toxic effects of MDMA.


ASHOK SINGH
CHELSEA AND WESTMINSTER HOSPITAL, LONDON