Physiological Effects of MDMA Use

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Physiological Effects of MDMA Use

MDMA has significant cardiovascular effects. This is

consistent with its norepinephrine releasing (Johnson et al.

1991; Rothman et al. 2001) and £\_2 adrenergic agonist (Lavelle et

al. 1999) properties. MDMA dose dependently produces robust

increases in heart rate and blood pressure (de la Torre et al.

2000a; de la Torre et al. 2000b; Grob et al.). Peak

cardiovascular effects occur between 1 and 2 hours after MDMA

administration and largely subside within 6 hours of drug

administration.

A study suggested that the relationship between MDMA dose

and cardiovascular effects was supralinear by de la Torre et al.

(2000a) who reported unexpectedly high drug exposures (measured

as AUCplasma for MDMA) and diastolic blood pressure increases in

two volunteers given 150 mg MDMA. While pharmacokinetic data

suggest MDMA has nonlinear kinetics, there is no clear evidence

of supralinear relationships between dose and blood pressure or

heart rate. In fact, there may be less increase in heart rate

after higher doses. The tendency toward less heart rate increase

with higher dose is consistent with a study using both conscious

and anesthetized rats (O'Cain et al. 2000). In this rat study, 3

mg/kg IV MDMA decreased heart rate, while lower doses tended to

increase it or leave it unchanged.

Studies monitoring blood pressure found significant

relationships between MDMA use and blood pressure. In one study,

(Vollenweider et al. 1998) involving subjects without a history

of MDMA use, one subject experienced hypertensive crisis from a

dose typical of recreational use. The correlation of blood

pressure is described, "A two way ANOVA for systolic blood

pressure revealed a significant main effect of drug [F(1,2) =

41.09; p < 02] and a significant drug x time interaction [F(3,6)

= 11.31; p < 007]. Significant changes occurred in the 0 to 75

minutes and 75 to 150 minutes interval (one way ANOVAs). Two way

ANOVA for diastolic blood pressure was not significant, but one

way ANOVAs showed significant changes in the 75 to 150 minutes

and the 150 to 300 minutes interval. Increases were in the range

of 10 to 30 mm Hg for systolic blood pressure and 5 to 10 mm Hg

for diastolic blood pressure." (Vollenweider et al. 1998

pp.245_246) This study shows a similarity in changes in systolic

blood pressure, and a lesser similarity in changes in diastolic

blood pressure. The occurrence of hypertensive crisis suggests

caution in potential use and study.

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