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

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

Research output: Contribution to journalArticle

96 Scopus citations

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
DOIs
StatePublished - Dec 19 2000

ASJC Scopus subject areas

  • Internal Medicine

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