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PMA (para-methoxyamphetamine) is a ring-methoxylated amphetamine that acts as a potent serotonin releaser with additional monoamine oxidase inhibitory activity, a combination that drives a dangerous rise in synaptic serotonin. It has repeatedly been sold deceptively as MDMA or ecstasy, earning the street name "death." Its slow onset relative to MDMA has led users to redose in the belief that nothing is happening, precipitating severe serotonergic toxicity; clinical series document hyperthermia, seizures, arrhythmias, and characteristic hypoglycemia and hyperkalemia, and forensic reviews link it to numerous fatalities dating back to a cluster of deaths in Ontario in 1973. It is markedly more toxic than MDMA and is regarded as one of the more hazardous substances ever passed off as ecstasy.
- Mild stimulation
- Some entactogenic warmth
- Serotonin releaser with MAOI activity and slow onset
- Severe, potentially fatal hyperthermia
- Serotonin toxicity
- Seizures and cardiovascular strain
Mechanism
PMA promotes release of and, to a lesser degree, and , while also inhibiting monoamine oxidase (the enzyme that breaks these transmitters down). That combination produces a strong, poorly controlled build-up of serotonin, which drives severe hyperthermia and serotonin toxicity at doses that feel underwhelming subjectively.
receptor fingerprint
transporterReleaser
Monoamine oxidaseInhibitor
Releaser
Safetyrisks and cautions, not medical advice
PMA has a notoriously slow onset that tempts redosing, and its MAOI activity plus serotonin release makes fatal hyperthermia, seizures, and serotonin syndrome much more likely than with MDMA. It is extremely dangerous combined with other serotonergic drugs, stimulants, or any MAOI. Deaths have occurred at recreational-seeming doses. Not medical advice.
Subjective profileweighing the evidence above
Avoid completely. The slow onset invites redosing, and serotonin release stacked on MAO inhibition produces fatal hyperthermia at doses that feel reasonable. It is sold deceptively as MDMA, which is how most people meet it and why testing pills matters.
Resources
This entry is here for reference.
Research
- 1974first citedPMA deaths in Ontario.
- 2016most recentMedicolegal aspects of PMA-related deaths
- 1.Medicolegal aspects of PMA-related deaths
- 2.Effects of 3,4-methylenedioxymethamphetamine (MDMA, 'Ecstasy') and para-methoxyamphetamine on striatal 5-HT when co-administered with moclobemide
- 3.PMA deaths in Ontario.
- 4.Poisoning with the recreational drug paramethoxyamphetamine ("death").
- 5.Amphetamines as potential inducers of fatalities: a review in the district of Ghent from 1976-2004.
- 6.P-glycoprotein modulation by the designer drugs methylenedioxymethamphetamine, methylenedioxyethylamphetamine and paramethoxyamphetamine.
- 7.Developmental toxicity of 4-substituted amphetamines in mice.
- 8.Metabolism of designer drugs of abuse.
8 listed here; entry last updated August 2026
Reviews
My notesprivate to this device
FAQ
Is PMA just weaker ecstasy?
No. It is far more toxic than MDMA and has caused many deaths, often because its slow onset leads people to take more.
Why is the MAOI activity a problem?
It blocks the breakdown of serotonin and other transmitters, so effects build up uncontrollably and stack dangerously with other drugs.
Can testing catch it?
Reagent testing can flag that a pill is not MDMA; unexpected reactions are a warning sign to not take it.
Adverse effects
- Severe, potentially fatal hyperthermia
- Serotonin toxicity
- Seizures and cardiovascular strain
Notes and cautions
- Deceptively slow onset that invites redosing