A review of acute effects of 3,4-methylenedioxymethamphetamine in healthy volunteers

A review of the literature on MDMA (ecstasy) in healthy volunteers found that the drug produces robust effects on subjective experiences and physiological measures, but evidence for cognitive effects is limited. Cardiovascular effects showed a clear dose-response relationship: doses below 1.0 mg/kg caused no change compared to placebo, while higher doses consistently increased heart rate and blood pressure. MDMA also reliably increased pupil size, plasma cortisol, and plasma prolactin levels. Subjective effects matched an entactogenic profile. The authors recommend further research, especially into cognitive effects and potential therapeutic uses.

Study at a glance

Abstract

This review of the literature aims to identify the acute effects of MDMA (ecstasy) in healthy volunteers. The wide range of relevant but methodologically diverse tests was .rst grouped into clusters to allow an evaluation of tests that would otherwise have been excluded due to their low frequency of utilization. The following three types of tests were evaluated: (1) functional tests quantifying executive, attention, visual, motor, visuomotor and auditory functions, (2) phenomenological tests assessing personal, subjective experiences, and (3) physiological measures re.ecting neurophysiological, endocrine and physiological parameters. MDMA showed robust effects on most of the phenomenological and physiological tests. Functional tests were scarce, preventing any meaningful conclusions to be drawn from their evaluation other than that these tests should be incorporated into future acute-effect studies. A striking doseñresponse relationship appeared for cardiovascular effects. At doses below 1.0 mg/kg MDMA no change was observed relative to placebo while above this dose all studies reported signi.cant increases. Furthermore, pupil size, plasma cortisol and plasma prolactin levels proved responsive to MDMA administration. The reported subjective effects of MDMA matched the entactogenic profile. Although interest in the action of MDMA is considerable, the existing knowledge about the cognitive effects of MDMA in humans is still rather limited and further research into the drug's effects is recommended, also in view of potential therapeutic uses of the drug.