Thank you for your query at DoctorSpring com
All beta blockers have class effect. So pindolol effects are similar to metoprolol. Both are cardioselecticve. Tge study says beta blockers only protect against the heart rate rise of mdma but the hypertensive response continues despite beta blockers. So there is no guarantee that using a beta blocker protects you from the ill effects of mdma.
Mdma effect lasts for 8 hours. If you had taken the drug previously and now stopoed it and taking metoprolol then a significant interaction is unlikely unless you are taking them simultaneously.
MDMA can be very dangerous in a patient with DVT specially because it leads to sympathetic overactivity and you had some episodes of 300 pm before ablation. We dont want a repeat of that
So it is advisable that you totally abstain from mdma and continue your beta blockers,
Dr Vivek Mahajan
Patient replied :
Thank you for your response!
Just wanted to see if you could elaborate on a couple of your points.
If the Metoprolol was taken with MDMA or around the same time (within an hour or two) could there be a significant risk of any dangerous interaction with the beta blocker, and if so, what kind of interaction would be possible?
Also, when you say it is very dangerous in an SVT patient, what type of risks would it carry? Is it more likely to lead to serious cardiovascular complications (heart attack, hypertensive crisis, etc) than in people with normal functioning hearts, or does it only increase the risk of having an SVT episode?
Taken simultaneously metoprolol would block the tachycardia due to mdma. It wouldn't block the hypertensive response of mdma. But some theoretical speculations are that hypertensive response maybe aggravated as the alpha blockade by beta blockers would aggravate the vasoconstrictor effect of mdma. However metoprolol has no significant alpha blockade. So the point is metoprolol would block the harmful tachycardia due to mdma but not the hypertensive response. The study didn't show that hypertensive response is worsened but there are some people who fear that hypertensive response may be aggravated. So as far as evidence is concerned beta blockers are partially protective against mdma. Whether it is harmful in other ways like hypertension and specially qith metoprolol is yet unknown. Though we can take the results of pindolol for metoprolol in a broad sense till a study with metoprolol is not available still there may be small difference in the response. So as of now beta blockers only partially protect against mdma effect and whether some harmful aspects are aggravated is unknown
Mdma will aggravate the sympathetic activity and lead to worsening of svt in svt
patients. That is the risk. The risk of heart attacks and strokes will be similar to general population if you are are not a patient of cerebro cardiovascular disease.
Dr Vivek Mahajan