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Effects of a beta-blocker on the cardiovascular response to MDMA (Ecstasy)

C M Hysek1, F X Vollenweider, M E Liechti

  • 1Division of Clinical Pharmacology and Toxicology, Department of Internal Medicine, University Hospital Basel, Hebelstasse 2, Basel, Switzerland.

Emergency Medicine Journal : EMJ
|April 10, 2010
PubMed
Abstract

Insights

Beta-blockers like pindolol can prevent heart rate increases from 3,4-methylenedioxymethamphetamine (MDMA) but do not affect blood pressure or adverse effects. This suggests caution when using beta-blockers with MDMA.

Area of Science:

  • Pharmacology
  • Cardiovascular Physiology
  • Toxicology

Background:

  • 3,4-methylenedioxymethamphetamine (MDMA, 'Ecstasy') is known to cause tachycardia and hypertension.
  • Beta-blockers are often avoided in stimulant intoxication due to concerns of unopposed alpha-receptor activation and potential vasospasm.
  • The impact of beta-blockers on MDMA's cardiovascular effects remains unclear.

Purpose of the Study:

  • To investigate the effects of a non-selective beta-blocker, pindolol, on the cardiovascular response to MDMA.
  • To determine if beta-blockers mitigate MDMA-induced tachycardia and hypertension.

Main Methods:

  • A double-blind, placebo-controlled, crossover study was conducted.
  • Sixteen healthy subjects received either pindolol (20 mg) or placebo, followed by MDMA (1.6 mg/kg).
  • Cardiovascular parameters including heart rate and mean arterial blood pressure (MAP) were monitored.

Main Results:

  • Pindolol significantly prevented the increase in heart rate induced by MDMA.
  • Pindolol did not alter the hypertensive response to MDMA.
  • No significant difference in adverse effects was observed between the MDMA and pindolol-MDMA groups.

Conclusions:

  • Beta-blockers may attenuate MDMA-induced tachycardia.
  • Beta-blockers do not appear to prevent MDMA-induced hypertension or other adverse effects.
  • These findings suggest careful consideration is needed when administering beta-blockers to individuals with MDMA exposure.

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