Ecstasy increases body temperature.

Robert R. Freedman said:

Abstract:
Although 3,4-methylenedioxymethamphetamine
(MDMA; Ecstasy) has been reported to
cause fatal hyperthermia, few studies of the effects of
MDMA on core body temperature in humans have been
conducted demonstrating increased body temperature. In
rats, MDMA causes hyperthermia at warm ambient temperatures
but hypothermia at cold ones. Objectives: In this
study, the physiological and subjective effects of MDMA
in humans were determined at cold (18°C) and warm
(30°C) ambient temperatures in a temperature and humidity-
controlled laboratory. Methods: Ten healthy volunteers
who were recreational users ofMDMAwere recruited. Four
laboratory sessions were conducted in a 2×2 design [i.e.,
two sessions at 30°C and two at 18°C, two during MDMA
(2 mg/kg, p.o.) and two during placebo, in double-blind
fashion]. Core body temperature (ingested radiotelemetry
pill), skin temperature (four weighted sites), heart rate,
blood pressure, metabolic rate (indirect calorimetry), shivering
(electromyogram levels), and sweat rate (capacitance
hygrometry) were measured as well as subjective effects for
several time periods following capsule ingestion. Results:
MDMA produced significant elevations in core body temperature
and metabolic rate in both warm and cold
conditions. MDMA also produced significant elevations
in blood pressure and heart rate and significantly increased
several ratings of subjective effects similar to those previously
reported. There were no differences related to
ambient temperature for any of the subjective effects,
except that ratings of cold and warm were appropriate to
the ambient temperature and were not influenced by MDMA.

Conclusions:
Unlike findings in rats, MDMA
increased core body temperature regardless of ambient
temperature in humans. These increases appeared related to
increases in metabolic rate, which were substantial. These
findings warrant further investigations on the role of
MDMA and other stimulants in altering metabolism and
thermogenesis.

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Robert R. Freedman said:

In addition to the temperature-related effects, MDMA
also significantly increased heart rate and blood pressure,
in agreement with previous findings (Vollenweider et al.
1998; Lester et al. 2000; Tancer and Johanson 2003), and
these changes were similar under both temperature conditions.
Likewise, the subjective effects of MDMA were
similar to those previously reported (Tancer and Johanson
2003), although they were generally of a smaller magnitude.
Furthermore, they were completely unaffected by
ambient temperature.
While these findings are provocative, there are several
limitations in the present study. Only a single dose of
MDMA was administered, whereas in the natural environment,
individuals may take higher doses repeatedly in
combination with other drugs such as cocaine and methamphetamine,
and thus, the effects may be even greater.
Unfortunately both federal and local agencies have required
that the maximum number of ingestions in laboratory
studies be limited to two or three, making it impossible
to test additional doses or temperatures with the present
design.
In conclusion, MDMA produced hyperthermia at warm
and cold ambient temperatures most likely due to increased
metabolic rate and also to inhibition of sweating. However,
a complete loss of thermoregulation did not occur, as core
body temperature also increased in the cold environment,
and shivering and thermal perceptions were not impaired.
Given that neurotoxicity may be related to core body
temperature (Malberg and Seiden 1998), these findings
should be of some concern, particularly given the recent
initiation of investigations of MDMA’s putative therapeutic
effects. Furthermore, unlike rats, moving to a cold environment
does not protect completely against increases in
core body temperature, although it is true that the absolute
core temperature is greater in the warm environment.
Finally, there is evidence that the increases are actually
mediated by increases in metabolism that may involve
mechanisms related to thermogenesis. Because of the recent
increase in abuse of methamphetamine, future studies
comparing MDMA and methamphetamine are warranted,
particularly those designed to investigate neurochemical
mechanisms of action.
Acknowledgements Supported by RO1 DA-14874 from the
National Institute on Drug Abuse (P.I. Tancer) and Joe Young, Sr.
funds from the state of Michigan. The authors would like to thank
James Granneman for his input on issues of thermogenesis.

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