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In Western societies, a considerable percentage of young people use 3,4-methylenedioxymethamphetamine (MDMA or 'ecstasy'). The use of alcohol (ethanol) in combination with ecstasy is common. The aim of the present study was to assess the acute psychomotor and subjective effects of (co-) administration of MDMA and ethanol over time and in relation to the pharmacokinetics. We performed a four-way, double blind, randomized, crossover, placebo-controlled study in 16 healthy volunteers (nine men, seven women) between the ages of 18 and 29. MDMA (100 mg) was given orally while blood alcohol concentration was maintained at pseudo-steady state levels of approximately 0.6‰ for 3 h by a 10% intravenous ethanol clamp. MDMA significantly increased psychomotor speed but did not affect psychomotor accuracy and induced subjective arousal. Ethanol impaired both psychomotor speed and accuracy and induced sedation. Coadministration of ethanol and MDMA improved psychomotor speed but impaired psychomotor accuracy compared with placebo and reversed ethanol-induced sedation. Pharmacokinetics and pharmacodynamics showed maximal effects at 90-150 min after MDMA administration after which drug effects declined in spite of persisting MDMA plasma concentration, with the exception of ethanol-induced sedation, which manifested itself fully only after the infusion was stopped. In conclusion, results show that subjects were more aroused when intoxicated with both substances combined compared with placebo, but psychomotor accuracy was significantly impaired. These findings may have implications for general neuropsychological functioning as this may provide a sense of adequate performance that does not agree with a significant reduction in psychomotor accuracy. [ABSTRACT FROM AUTHOR]

Alcohol is frequently used in combination with 3,4-methylenedioxymethamphetamine (MDMA). Both drugs affect cardiovascular function, hydration and temperature regulation, but may have partly opposing effects. The present study aims to assess the acute physiologic effects of (co-) administration of MDMA and ethanol over time. A fourway, double blind, randomized, crossover, placebo-controlled study in 16 healthy volunteers (9 male and 7 female) between the ages of 18 and 29. MDMA (100 mg) was given orally and blood ethanol concentration was maintained at pseudo-steady state levels of 0.6‰ by a three-hour 10% intravenous ethanol clamp. Cardiovascular function, temperature and hydration measures were recorded throughout the study days. Ethanol did not significantly affect physiologic function, with the exception of a short lasting increase in heart rate. MDMA potently increased heart rate and blood pressure and induced fluid retention as well as an increase in temperature. Co-administration of ethanol with MDMA did not affect cardiovascular function compared to the MDMA alone condition, but attenuated the effects of MDMA on fluid retention and showed a trend for attenuation of MDMA-induced temperature increase. In conclusion, coadministration of ethanol and MDMA did not exacerbate physiologic effects compared to all other drug conditions, and moderated some effects of MDMA alone. [ABSTRACT FROM AUTHOR]

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 first 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 reflecting 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 dose-response 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 significant 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. [ABSTRACT FROM AUTHOR]