Effects of a beta-blocker on the cardiovascular response to MDMA (Ecstasy).
BACKGROUND
MDMA (3,4-methylenedioxymethamphetamine, 'Ecstasy') produces tachycardia and hypertension and is rarely associated with cardiovascular and cerebrovascular complications. In clinical practice, beta-blockers are often withheld in patients with stimulant intoxication because they may increase hypertension and coronary artery vasospasm due to loss of beta(2)-mediated vasodilation and unopposed alpha-receptor activation. However, it is unknown whether beta-blockers affect the cardiovascular response to MDMA.


METHODS
The effects of the non-selective beta-blocker pindolol (20 mg) on the cardiovascular effects of MDMA (1.6 mg/kg) were investigated in a double-blind placebo-controlled crossover study in 16 healthy subjects.


RESULTS
Pindolol prevented MDMA-induced increases in heart rate. Peak values (mean+/-SD) for heart rate were 84+/-13 beats/min after MDMA vs 69+/-7 beats/min after pindolol-MDMA. In contrast, pindolol pretreatment had no effect on increases in mean arterial blood pressure (MAP) after MDMA. Peak MAP values were 115+/-11 mm Hg after MDMA vs 114+/-11 mm Hg after pindolol-MDMA. Pindolol did not change adverse effects of MDMA.


CONCLUSIONS
The results of this study indicate that beta-blockers may prevent increases in heart rate but not hypertensive and adverse effects of MDMA.
Hysek
C M
CM
Division of Clinical Pharmacology and Toxicology, Department of Internal Medicine, University Hospital Basel, Hebelstasse 2, Basel, Switzerland.
Vollenweider
F X
FX
Liechti
M E
ME
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D000704:Analysis of Variance; D001794:Blood Pressure / Q000187:drug effects; D001831:Body Temperature / Q000187:drug effects; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004347:Drug Interactions; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects*; D010869:Pindolol / Q000494:pharmacology*; D016037:Single-Blind Method; D055815:Young Adult
D000319:Adrenergic beta-Antagonists; D010869:Pindolol; D018817:N-Methyl-3,4-methylenedioxyamphetamine