MDA

Uncontrolled or poorly controlled hypertension. MDA produces direct alpha-1 adrenoceptor-mediated vasoconstriction and the strongest pressor response among methylenedioxy amphetamines.

Structural cardiac abnormalities including valvular disease, cardiomyopathy, and congenital heart defects.

Personal or family history of schizophrenia, schizoaffective disorder, or other primary psychotic disorders.

Bipolar disorder type I or type II. Dual risk of manic switching and psychotic decompensation.

Significant hepatic impairment or liver disease.

Pregnancy and breastfeeding. No reproductive toxicity data specific to MDA exist.

Concurrent use of monoamine oxidase inhibitors including phenelzine, tranylcypromine, moclobemide, and ayahuasca.

Concurrent tramadol or other serotonergic opioid use. Mechanistic basis for lethal serotonin toxicity established.