Drug interactions
Methylenedioxymethamphetamine + Trazodone
Severity: Major
Methylenedioxymethamphetamine and Trazodone: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
MDMA causes massive serotonin release, and trazodone's serotonergic activity may add to the risk of serotonin syndrome, hyperthermia and cardiovascular toxicity. Trazodone's CYP2D6-related effects may also alter MDMA exposure.
What this interaction means in plain words
Methylenedioxymethamphetamine and Trazodone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive serotonergic effects, with MDMA-induced serotonin release and trazodone serotonergic actions.
What to do
Advise patients to avoid MDMA while on trazodone. Treat suspected serotonin syndrome with supportive care, benzodiazepines, cooling and drug discontinuation.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Trazodone
- Arsenic trioxide + Trazodone Contraindicated
- Ibutilide + Trazodone Contraindicated
- Isocarboxazid + Trazodone Contraindicated
- Levoketoconazole + Trazodone Contraindicated
- Methylene blue + Trazodone Contraindicated
- Phenelzine + Trazodone Contraindicated
Frequently asked questions
Can I take Methylenedioxymethamphetamine with Trazodone?
MediHelp rates the interaction as major. Methylenedioxymethamphetamine and Trazodone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. MDMA causes massive serotonin release, and trazodone's serotonergic activity may add to the risk of serotonin syndrome, hyperthermia and cardiovascular toxicity. Trazodone's CYP2D6-related effects may also alter MDMA exposure.
How serious is the interaction between Methylenedioxymethamphetamine and Trazodone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise patients to avoid MDMA while on trazodone. Treat suspected serotonin syndrome with supportive care, benzodiazepines, cooling and drug discontinuation.
What other medicines interact with Trazodone?
MediHelp also lists interactions of Trazodone with, for example, Arsenic trioxide, Ibutilide, Isocarboxazid. The full list is on the Trazodone page.
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