Effects of a β-blocker on the cardiovascular response to MDMA (Ecstasy)
This double-blind cross-over study (n=16) finds that pindolol (medication for hypertension, 20mg) prevents the heart-raising effects of MDMA (112mg/70kg) but not the elevation of blood pressure.
Authors
- Matthias Liechti
- Franz Vollenweider
- Cédric Hysek
Published
Abstract
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.
Research Summary of 'Effects of a β-blocker on the cardiovascular response to MDMA (Ecstasy)'
Introduction
Earlier research documents that MDMA (3,4-methylenedioxymethamphetamine, 'Ecstasy') produces marked cardiostimulant effects — notably tachycardia and hypertension — and has been rarely associated with serious vascular events such as myocardial infarction, intracranial haemorrhage and cerebral infarction. In clinical practice, the use of β-adrenergic blockers (β-blockers) in stimulant intoxication is controversial because blockade of β-receptors may, theoretically, remove β 2 -mediated vasodilation and leave unopposed α-receptor vasoconstriction, thereby worsening hypertension or coronary vasospasm. It was unknown whether β-blockers alter the cardiovascular responses to MDMA in humans. M. and colleagues set out to assess the haemodynamic effects of the non-selective β-blocker pindolol on MDMA-induced cardiovascular changes in healthy volunteers. The study aimed to test whether pindolol modifies MDMA-induced increases in heart rate, blood pressure and body temperature, and whether it alters acute adverse effect burden. The cardiovascular and adverse-effect outcomes reported here were secondary outcomes from a controlled human study whose primary subjective and neurocognitive results were reported elsewhere.
Expert Research Summaries
Go Pro to access AI-powered section-by-section summaries, editorial takes, and the full research toolkit.
Full Text PDF
Full Paper PDF
Create a free account to open full-text PDFs.
Study Details
- Study Typeindividual
- Journal
- Compound
- Topics
- Authors
- APA Citation
Hysek, C. M., Vollenweider, F. X., & Liechti, M. E. (2010). Effects of a β-blocker on the cardiovascular response to MDMA (Ecstasy). Emergency Medicine Journal, 27(8), 586-589. https://doi.org/10.1136/emj.2009.079905
References (3)
Papers cited by this study that are also in Blossom
Liechti, M. E., Gamma, A., Vollenweider, F. X. · Psychopharmacology (2001)
Hasler, F., Ludewig, S. · Journal of Psychopharmacology (2008)
Liechti, M. E., Baumann, C., Gamma, A. et al. · Neuropsychopharmacology (2000)
Cited By (10)
Papers in Blossom that reference this study
Arikci, D., Holze, F., Mueller, L. et al. · Clinical Pharmacology and Therapeutics (2025)
Sarmanlu, M., Kuypers, K. P. C., Vizeli, P. et al. · Progress in Neuro-Psychopharmacology and Biological Psychiatry (2023)
Straumann, I., Ley, L., Holze, F. et al. · Neuropsychopharmacology (2023)
Ley, L., Holze, F., Arikci, D. et al. · Neuropsychopharmacology (2023)
Vizeli, P., Straumann, I., Duthaler, U. et al. · Frontiers in Pharmacology (2022)
Sarparast, A., Thomas, K., Malcolm, B. et al. · Psychopharmacology (2022)
Holze, F., Ley, L., Müller, F. et al. · Neuropsychopharmacology (2022)
Holze, F., Vizeli, P., Ley, L. et al. · Neuropsychopharmacology (2020)
Holze, F., Vizeli, P., Müller, F. et al. · Neuropsychopharmacology (2019)
Danforth, A. L., Struble, C., Yazar-Klosinski, B. et al. · Progress in Neuro-Psychopharmacology and Biological Psychiatry (2016)
Your Personal Research Library
Go Pro to save papers, add notes, rate studies, and organize your research into custom shelves.