• S J Lester, M Baggott, S Welm, N B Schiller, R T Jones, E Foster, and J Mendelson.
• Mayo Clinic Scottsdale, Cardiology 3A, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA.
• Ann. Intern. Med. 2000 Dec 19; 133 (12): 969-73.

BackgroundThe psychoactive stimulant 3, 4-methylenedioxymethamphetamine (MDMA), also known as "ecstasy," is widely used in nonmedical settings. Little is known about its cardiovascular effects.ObjectiveTo evaluate the acute cardiovascular effects of MDMA by using transthoracic two-dimensional and Doppler echocardiography.DesignFour-session, ascending-dose, double-blind, placebo-controlled trial.SettingUrban hospital.PatientsEight healthy adults who self-reported MDMA use.InterventionEchocardiographic 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.MeasurementsHeart 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.ResultsAt 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.ConclusionsModest 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.

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