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- Title
Cardiovascular effects of 3,4-methylenedioxymethamphetamine. A double-blind, placebo-controlled trial.
- Authors
Lester, S J; Baggott, M; Welm, S; Schiller, N B; Jones, R T; Foster, E; Mendelson, J
- Abstract
<bold>Background: </bold>The psychoactive stimulant 3, 4-methylenedioxymethamphetamine (MDMA), also known as "ecstasy," is widely used in nonmedical settings. Little is known about its cardiovascular effects.<bold>Objective: </bold>To evaluate the acute cardiovascular effects of MDMA by using transthoracic two-dimensional and Doppler echocardiography.<bold>Design: </bold>Four-session, ascending-dose, double-blind, placebo-controlled trial.<bold>Setting: </bold>Urban hospital.<bold>Patients: </bold>Eight healthy adults who self-reported MDMA use.<bold>Intervention: </bold>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.<bold>Measurements: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>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.
- Subjects
ANALYSIS of variance; BLOOD pressure; CARDIAC output; CLINICAL trials; COMPARATIVE studies; DOPPLER echocardiography; DOSE-effect relationship in pharmacology; HALLUCINOGENIC drugs; HEART beat; HEMODYNAMICS; RESEARCH methodology; ECSTASY (Drug); MEDICAL cooperation; ORAL drug administration; RESEARCH; EVALUATION research; RANDOMIZED controlled trials; OXYGEN consumption; BLIND experiment; STROKE volume (Cardiac output)
- Publication
Annals of Internal Medicine, 2000, Vol 133, Issue 12, p969
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-133-12-200012190-00012