Cardiovascular Effects of 3,4-Methylenedioxymethamphetamine: A Double-Blind, Placebo-Controlled Trial
Steven J. Lester, Matthew J. Baggott, Susette Welm, Nelson B. Schiller, Reese T. Jones, Elyse Foster, John Mendelson
Annals of Internal Medicine December 19, 2000 DOI: 10.7326/0003-4819-133-12-200012190-00012 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Placebo-controlled Double-blind Peer reviewed |
|---|---|
| Sample size | 8 |
| Population | Healthy adults who self-reported MDMA use |
| Interventions | MDMA dobutamine |
| Dose | 0.5 and 1.5 mg/kg of body weight |
| Duration | Three weekly sessions |
| Topics | MDMA |
| Keywords | Heart rate Blood pressure Dobutamine Ejection fraction Placebo Anesthesia Stroke volume Cardiology Cardiac output Hemodynamics Heart failure Pharmacology |
| Citations | 140 |
| Key findings | Oral MDMA (1.5 mg/kg) increases heart rate, blood pressure, and cardiac output similarly to dobutamine at 20 to 40 micrograms per kilogram per minute, but does not have measurable inotropic effects. |
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, placebo-controlled trial.
Setting: Urban hospital. PATIENTS: Eight healthy adults who self-reported MDMA use. INTERVENTION: Echocardiographic effects of dobutamine (5, 20, and 40 microg/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 1 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 1 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 microg/kg per minute. Inotropism, measured by using meridional wall stress corrected for ejection fraction, decreased after administration of dobutamine, 40 microg/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 microg/kg per minute. In contrast to dobutamine, MDMA has no measurable inotropic effects.