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Emerg Med J. 2010 Aug;27(8):586-9. doi: 10.1136/emj.2009.079905. Epub 2010 Apr 8.

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

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



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.


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.


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.


The results of this study indicate that beta-blockers may prevent increases in heart rate but not hypertensive and adverse effects of MDMA.

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