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If MDMA is FDA-approved it will be important to understand what medications may pose a risk of drug\u2013drug interactions. The goal of this study was to evaluate the risks due to MDMA ingestion alone or in combination with other common medications and drugs of abuse using the FDA drug safety surveillance data. To date, nearly one thousand reports of MDMA use have been reported to the FDA. The majority of these reports include covariates such as co-ingested substances and demographic parameters. Univariate and multivariate logistic regression was employed to uncover the contributing factors to the reported risk of death among MDMA users. Several drug classes (MDMA metabolites or analogs, anesthetics, muscle relaxants, amphetamines and stimulants, benzodiazepines, ethanol, opioids), four antidepressants (bupropion, sertraline, venlafaxine and citalopram) and olanzapine demonstrated increased odds ratios for the reported risk of death. Future drug\u2013drug interaction clinical trials should evaluate if any of the other drug\u2013drug interactions described in our results actually pose a risk of morbidity or mortality in controlled medical settings.<\/jats:p>","DOI":"10.1038\/s41598-021-85389-x","type":"journal-article","created":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T11:14:42Z","timestamp":1615893282000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Concomitant drugs associated with increased mortality for MDMA users reported in a drug safety surveillance database"],"prefix":"10.1038","volume":"11","author":[{"given":"Isaac V.","family":"Cohen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tigran","family":"Makunts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruben","family":"Abagyan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelan","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,16]]},"reference":[{"key":"85389_CR1","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.1177\/0269881117715596","volume":"31","author":"S Saleemi","year":"2017","unstructured":"Saleemi, S., Pennybaker, S. 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All other authors declare no conflict of financial or non-financial interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}],"article-number":"5997"}}