Physiological Effects of MDMA Use :: Health Drugs Essays

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.