Cardiovascular effects of 3,4-methylenedioxymethamphetamine: A double-blind, placebo-controlled trial

Steven Jay Lester, M. Baggott, S. Welm, N. B. Schiller, R. T. Jones, E. Foster, J. Mendelson

Research output: Contribution to journalArticle

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Abstract

Background: The psychoactive Stimulant 3,4-methylenedioxymethamphetamine (MDMA), also known as 'ecstasy,' is widely used in nonmedical settings. Little is known about its cardiovascular effects. Objective: To evaluate the acute cardiovascular effects of MDMA by using transthoracic two-dimensional and Doppler echocardiography. Design: Four-session, ascending-dose, double-blind, placebocontrolled trial. Setting: Urban hospital. Patients: Eight healthy adults who self-reported MDMA use. Intervention: Echocardiographic effects of dobutamine (5, 20, and 40 μg/kg of body weight per minute) were measured in a preliminary session. Oral MDMA (0.5 and 1.5 mg/kg of body weight) or placebo was administered I hour before echocardiographic measurements in three weekly sessions. Measurements: Heart rate and blood pressure were measured at regular intervals before and after MDMA administration. Echocardiographic measures of stroke volume, ejection fraction, cardiac output, and meridional wall stress were obtained I hour after MDMA administration and during dobutamine infusions. Results: At a dose of 1.5 mg/kg, MDMA increased mean heart rate (by 28 beats/min), systolic blood pressure (by 25 mm Hg), diastolic blood pressure (by 7 mm Hg), and cardiac output (by 2 L/min). The effects of MDMA were similar to those of dobutamine, 20 and 40 μg/kg per minute. Inotropism, measured by using meridional wall stress corrected for ejection fraction, decreased after administration of dobutamine, 40 μg/kg per minute, but did not change after either dose of MDMA. Conclusions: Modest oral doses of MDMA increase heart rate, blood pressure, and myocardial oxygen consumption in a magnitude similar to dobutamine, 20 to 40 μg/kg per minute. In contrast to dobutamine, MDMA has no measurable inotropic effects.

Original languageEnglish (US)
Pages (from-to)969-973
Number of pages5
JournalAnnals of Internal Medicine
Volume133
Issue number12
StatePublished - Dec 19 2000
Externally publishedYes

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N-Methyl-3,4-methylenedioxyamphetamine
Placebos
Dobutamine
Blood Pressure
Heart Rate
Cardiac Output
Body Weight
Doppler Echocardiography
Urban Hospitals
Muscle Contraction
Oxygen Consumption
Stroke Volume

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Lester, S. J., Baggott, M., Welm, S., Schiller, N. B., Jones, R. T., Foster, E., & Mendelson, J. (2000). Cardiovascular effects of 3,4-methylenedioxymethamphetamine: A double-blind, placebo-controlled trial. Annals of Internal Medicine, 133(12), 969-973.

Cardiovascular effects of 3,4-methylenedioxymethamphetamine : A double-blind, placebo-controlled trial. / Lester, Steven Jay; Baggott, M.; Welm, S.; Schiller, N. B.; Jones, R. T.; Foster, E.; Mendelson, J.

In: Annals of Internal Medicine, Vol. 133, No. 12, 19.12.2000, p. 969-973.

Research output: Contribution to journalArticle

Lester, SJ, Baggott, M, Welm, S, Schiller, NB, Jones, RT, Foster, E & Mendelson, J 2000, 'Cardiovascular effects of 3,4-methylenedioxymethamphetamine: A double-blind, placebo-controlled trial', Annals of Internal Medicine, vol. 133, no. 12, pp. 969-973.
Lester SJ, Baggott M, Welm S, Schiller NB, Jones RT, Foster E et al. Cardiovascular effects of 3,4-methylenedioxymethamphetamine: A double-blind, placebo-controlled trial. Annals of Internal Medicine. 2000 Dec 19;133(12):969-973.
Lester, Steven Jay ; Baggott, M. ; Welm, S. ; Schiller, N. B. ; Jones, R. T. ; Foster, E. ; Mendelson, J. / Cardiovascular effects of 3,4-methylenedioxymethamphetamine : A double-blind, placebo-controlled trial. In: Annals of Internal Medicine. 2000 ; Vol. 133, No. 12. pp. 969-973.
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