Cardiovascular Effects of 3,4-Methylenedioxymethamphetamine (MDMA, "Ecstasy")

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The summary below is from the full report titled "Cardiovascular Effects of 3,4-Methylenedioxymethamphetamine. A Double-Blind, Placebo-Controlled Trial." It is in the 19 December 2000 issue of Annals of Internal Medicine (volume 133, pages 969-973). The authors are SJ Lester, M Baggott, S Welm, NB Schiller, RT Jones, E Foster, and J Mendelson.

What is the problem and what is known about it so far?

3,4-Methylenedioxymethamphetamine, also known as MDMA and "ecstasy," is a stimulant drug that is widely used in nonmedical settings, such as nightclubs. The use of MDMA appears to be increasing. It is estimated that over 7 out of every 100 young adults have used MDMA at some time in their lives. Although MDMA can result in serious heart-related complications and death, little is known about what exactly MDMA does to blood pressure and heart function.

Why did the researchers do this particular study?

To study how MDMA affects the heart and blood pressure.

Who was studied?

The study included 8 healthy adults (5 men and 3 women) who reported that they had used MDMA in the past.

How was the study done?

In a carefully monitored research laboratory, the researchers measured participants' blood pressure and heart rate before and after giving them a dose of MDMA. They also obtained echocardiograms (ultrasound pictures of participants' hearts) 1 hour after MDMA was given. Echocardiograms permitted the researchers to study cardiac output, which is a measure of how hard the heart is working. For comparison, the researchers also obtained echocardiograms on participants while giving them a dose of dobutamine, a drug used in medical settings that is known to stimulate the heart.

What did the researchers find?

Use of MDMA increased study participants' heart rate, blood pressure, and cardiac output. The effects of MDMA on the workload of the heart were similar to the effects of dobutamine, except that dobutamine also increased the efficiency of heart muscle contraction while MDMA did not.

What were the limitations of the study?

The highly controlled setting and dose of MDMA used in this study may not apply to the actual settings in which people take this drug. Taking the drug in higher doses, during vigorous dancing, or with other substances (alcohol or nicotine) may accentuate the effects of MDMA on the heart and blood pressure. In addition, it is important to note that none of the study participants had preexisting heart disease. The effects of the drug may be different and more damaging in persons with a history of heart conditions.

What are the implications of the study?

The drug MDMA produces changes in blood pressure, heart rate, and how hard the heart is working that may put users at risk for cardiovascular complications.