“…Second, based on its pharmacologic mechanism of action, carvedilol would be predicted to lower the risk for adverse cardiovascular events by decreasing heart rate and systemic blood pressure, which are commonly associated with MDMA intoxication (24). Third, carvedilol provides a markedly improved pharmacologic spectrum of action for the management of sympathomimetic toxicity compared with other nonselective -blockers, such as propranolol and nadolol, which lack affinity for ␣ 1 -or  3 -AR (25), and therefore may enhance ␣ 1 -AR-mediated vasoconstriction and heat retention.…”