Abstract：
Data on medication interactions with psychedelics are limited. Here we present what may be the first published report of a hypertensive emergency following the combination of psilocybin mushrooms with a monoamine oxidase inhibitor (MAOI). A 42-year-old man with treatment-resistant major depressive disorder took 1 g of Psilocybe cubensis mushrooms, while prescribed tranylcypromine, extended-release dextroamphetamine-amphetamine, and other medications. Approximately half an hour later, he developed severe hypertension with chest pain, palpitations, and headache. Upon hospital presentation, the electrocardiogram demonstrated ST-elevation. The patient was diagnosed with a myocardial infarction and treated with lorazepam, nitroglycerin, and aspirin. He subsequently underwent emergency cardiac catheterization, which revealed no significant cardiac abnormalities. Following overnight hospitalization, he was discharged home with no lasting physical sequelae. Though data are few, past studies suggest that classic serotonergic psychedelics (5HT-2A receptor agonists) such as dimethyltryptamine (DMT), lysergic acid (LSD), and synthetic psilocybin should not produce hypertensive emergency when combined with MAOIs. We suspect phenylethylamine, found in Psilocybe cubensis and other species of psilocybin mushrooms, interacted with tranylcypromine and dextroamphetamine-amphetamine to produce this hypertensive emergency. Patients prescribed MAOIs should be warned of the potential for hypertensive emergency when consuming psilocybin mushrooms, particularly when also prescribed norepinephrine releasers such as dextroamphetamine-amphetamine.
摘要：
关于药物与迷幻药相互作用的数据是有限的。在这里，我们介绍了将psilocybin蘑菇与单胺氧化酶抑制剂（MAOI）联合使用后，可能是首次发表的高血压紧急情况报告。一名42岁患有难治性抑郁症的男性服用了1克Psilocybecubensis蘑菇，而开了tranylcypromine,缓释右旋苯丙胺-苯丙胺，和其他药物。大约半小时后，他出现了严重的高血压和胸痛,心悸,和头痛。在医院介绍时，心电图显示ST段抬高.病人被诊断为心肌梗塞,并接受劳拉西泮治疗,硝酸甘油,还有阿司匹林.他随后接受了紧急心导管检查，显示没有明显的心脏异常。住院过夜后，他出院回家，没有持久的身体后遗症。虽然数据很少,过去的研究表明，经典的5-羟色胺能迷幻药（5HT-2A受体激动剂），如二甲基色胺（DMT），麦角酸（LSD），与MAOIs联合使用时，合成的psilocybin不应产生高血压急症。我们怀疑苯乙胺,在裸盖菇和其他种类的裸盖菇中发现，与tranylcypromine和右旋苯丙胺-苯丙胺相互作用产生这种高血压急症。在服用psilocybin蘑菇时，应警告服用MAOIs的患者可能会发生高血压急症，特别是当还处方去甲肾上腺素释放剂，如右苯丙胺-苯丙胺。
