Management of Hypertension induced by MDMA

[TheCrazyMyco]

Hello,

I was reading some journal articles on the medical management of MDMA toxicity.

What I have seen in many articles is the recommendation that Labetalol is used to control the hypertension.

I was wondering what are the other recommendations in patients where beta blockers are contra-indicated such as Asthma and COPD.

I was thinking could something like a calcium channel blocker be used or glyceryl trinitrate? Or if there is a very specific reason Labetalol is recommended in so many papers

Thank You!!
TheCrazyMyco

 

[TheCrazyMyco]

Bump

 

[T. Calderone]

I'm going to move this over to the MDMA forum so hopefully, someone can give you an answer.

 

[Jaredborgetti]

Hello, I have used Lisinopril before with MDMA, but I have found Beetroot juice and garlic an hour before dosing controls the blood pressure more, benzodiazepeines also lower heart rate and blood pressure while on the drug but they blunt the experience, try the beetroot juice with garlic, it maintains your blood pressure really nicely with mdma.

 

[steewith2ees]

I would really think twice about using something as drastic as a hypertensive while using MDMA. Yes, it does raise blood pressure but in most cases it is what one would expect if exposed to any other exertion and is not generally as drastic as seen with more classic or straightforward stimulants such as cocaine. If you are using the drug at rest it is usally negligible and if using it as a dance drug than the use of general 'safer dancing' HR guidelines (i.e. just CHILL the f**k out - about everything ! ) should see you through and sorted.

As stated above, benzo's will dampen or more likely just kill off the effect and are best used in tight spots (they are first line treatments when treating people with stimulant poising).

 

[Inds]

I've wondered about this too. If benzos dull the experience, couldn't something like a betablocker which only lowers blood pressure and nothing else be the perfect combo? As someone who has had multiple panic attacks during his rolls (even the good trips) it would be a plus not to deal with those annoying speedy effects especially during the comeup.

 

[steewith2ees]

I've wondered about this too. If benzos dull the experience, couldn't something like a betablocker which only lowers blood pressure and nothing else be the perfect combo? As someone who has had multiple panic attacks during his rolls (even the good trips) it would be a plus not to deal with those annoying speedy effects especially during the comeup.

Its a good question and has logic to it but although I am no authority on the matter I have plenty of personal thoughts from smashing too much ecstasy and benzos for two decades (not as a combo, first one followed by 'tother for hangover management).

Since my first wig out on an E, I have only once been able to roll again and that was only by removing myself from the club and having a second pill on the way home. I started wigging out while high from my refusal to calm down on my excessive use which saw me enjoying my weekends out dancing but at the expense of spending most of the time otherwise ridden with anxiety. As someone who has always mismanaged everything via a quick fix, I became instantly psychologically dependant on benzodiazepines and although I did not need to take them continuously I found that having access to them when needed was enough to all but remove my anxiety for a long period of time and as such the same rule applied to when on an MDXX drug. Having experimented with using 5mg diazepam while coming up I found that regardless of the low dose, it ruined any chance of a 'roll' and since I have carried them on me for the purposes of 'smash glass in case of emergency' type situations and this has been enough to ensure that I have not had a bad psychological reaction to them since.

My method relies on the fact that I know that if I do hit the stop button, then that is the end of that. If you find that you are generally OK once you have come up over the top of the roller-coaster then I would ride through the anxiety episodes during the ascent (with my fast acting benzo on hand in case in becomes distressing) but if you are having a full blown panic attack then I would seriously consider how worth it it is, as all of my own experiences of PA's have been awful, indistinguishable from a heart attack and requiring hours of recovery if no benzodiazepine was available (which is why I have made sure since 2001 that there always is). Serious panic attacks and continued use of MD contraindicate each other more or less full on, and as the drug is an amphetamine, 'speedy' effects and episodes of anxiety should be seen as occupational hazards as opposed to trying to micromanaging every negative effect that the drug has and as amazing as the drug is, I feel unwell in some way or another most nights I am out dancing, though usually more through being sick from taking too much and excessive body load.

Although betablockers are effective in dealing with generalised anxiety, taking ecstasy is anything but and they may only not just be ineffective but could really start pulling your cardiovascular system in every direction. Sometimes we need something nasty to happen to warn us that trouble is on the way and any attempt to simply dampen those warning signs, instead of as I said shutting the party down then and there with a benzo, may mean that you become quickly ill without having at least a few minutes to get help.

Hope this made sense.

 

[CFC]

Some people occasionally say that beta-blockers don't cripple the high, but that's not the case in my experience, though perhaps one that doesn't cross the blood-brain barrier and is pretty selective might suit some, at a low dose (though not me).

Similarly I find calcium channel blockers do the same, which isn't surprising given how blocking those channels is likely to attenuate some aspects of the 'pleasant' stimulant effect.

As for glyceryl trinitrate, it's too fast acting to be of much use unfortunately.

 

[steewith2ees]

Some people occasionally say that beta-blockers don't cripple the high, but that's not the case in my experience, though perhaps one that doesn't cross the blood-brain barrier and is pretty selective might suit some, at a low dose (though not me).

Similarly I find calcium channel blockers do the same, which isn't surprising given how blocking those channels is likely to attenuate some aspects of the 'pleasant' stimulant effect.

As for glyceryl trinitrate, it's too fast acting to be of much use unfortunately.

Good evening! All gud in the hud bud?

 

[Jaredborgetti]

About the comment of MDMA and moderate activity, a light jog or light moderate cardio can easily get you to 160-170 systolic BP if you have normal resting BP and people can mantain that for hours, intense cardio can get you to 200 systolic easily but is not maintainable for long, you can get into the 200s with intense weightlifting but for short bursts, ive read that powerlifters (the guys who break world records lifting a thousand pounds or more) can get into the 400s systolic but usually nosebleeds and strokes can happen at those stages thats why powerlifters often have heart hypertrophy and bleed onstage, I have a resting BP of 105/60, an MDMA session can get it into 150/80 if im calm and if I took my beetroot juice with garlic, on heavier mdma trips ive had it up to 180/85 and that persists for longer than the psychoactive effects, and im extremelly physically fit so you can except to have pretty severe hypertension for 6 hours+, if you roll once every 3 months its not that much of a problem but it adds up, cocaine and other substances can cause even more hypertension, beetroot juice with garlic will help you as much as blood pressure medication (I took 10mg lisinopril once before rolling to see if it would help and it had less of an effect than the beetroot juice with garlic).