Effects of a β-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, β-blockers are often withheld in patients with stimulant intoxication because they may increase hypertension and coronary artery vasospasm due to loss of β2-mediated vasodilation and unopposed α-receptor activation. However, it is unknown whether β-blockers affect the cardiovascular response to MDMA.Methods The effects of the non-selective β-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.Conclusion The results of this study indicate that β-blockers may prevent increases in heart rate but not hypertensive and adverse effects of MDMA.