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MDMA (Ecstasy) Abuse

What are the effects of MDMA?

MDMA has become a popular drug, in part because of the positive effects that a person may experience within an hour or so after taking a single dose. Those effects include feelings of mental stimulation, emotional warmth, empathy toward others, a general sense of well being, and decreased anxiety. In addition, users report enhanced sensory perception as a hallmark of the MDMA experience.1,2

Effects of MDMA

Reported Undesirable Effects Effects (up to 1 week post-MMDA, or longer):

  • Anxiety
  • Restlessness
  • Irritability
  • Sadness
  • Impulsiveness
  • Aggression
  • Sleep Disturbances
  • Lack of appetite
  • Thirst
  • Reduced interest in and pleasure from sex
  • Significant reductions in mental abilities

Potential Adverse Health Effects:

  • Nausea
  • Chills
  • Sweating
  • Involuntary jaw clenching and teeth grinding
  • Muscle cramping
  • Blurred vision
  • Marked rise in body temperature (hyperthermia)
  • Dehydration
  • High Blood Pressure
  • Heart failure
  • Kidney failure
  • Arrythmia

Symptoms of MDMA Overdose:

  • High Blood Pressure
  • Faintness
  • Panic attacks
  • Loss of consciousness
  • Seizures

As noted, MDMA is not a benign drug. MDMA can produce a variety of adverse health effects, including nausea, chills, sweating, involuntary teeth clenching, muscle cramping, and blurred vision.2 MDMA overdose can also occur—the symptoms can include high blood pressure, faintness, panic attacks, and in severe cases, a loss of consciousness and seizures.1

Because of its stimulant properties and the environments in which it is often taken, MDMA is associated with vigorous physical activity for extended periods.2 This can lead to one of the most significant, although rare, acute adverse effects—a marked rise in body temperature (hyperthermia).3,4 Treatment of hyperthermia requires prompt medical attention, as it can rapidly lead to muscle breakdown, which can in turn result in kidney failure. In addition, dehydration, hypertension, and heart failure may occur in susceptible individuals. MDMA can also reduce the pumping efficiency of the heart,6 of particular concern during periods of increased physical activity, further complicating these problems.

MDMA is rapidly absorbed into the human bloodstream, but once in the body, MDMA metabolites interfere with the body's ability to metabolize, or break down, the drug.8 As a result, additional doses of MDMA can produce unexpectedly high blood levels, which could worsen the cardiovascular and other toxic effects of this drug. MDMA also interferes with the metabolism of other drugs, including some of the adulterants that may be found in MDMA tablets.

In the hours after taking the drug, MDMA produces significant reductions in mental abilities. These changes, particularly those affecting memory, can last for up to a week, and possibly longer in regular users. The fact that MDMA markedly impairs information processing emphasizes the potential dangers of performing complex or skilled activities, such as driving a car, while under the influence of this drug2,14.

The Neurobiology of Ecstasy (MDMA)

Illiustration of a synapse showing Ecstasy binding to serotonin transporters

Over the course of a week following moderate use of the drug, many MDMA users report feeling a range of emotions, including anxiety, restlessness, irritability, and sadness that in some individuals can be as severe as true clinical depression.15 Similarly, elevated anxiety, impulsiveness, and aggression, as well as sleep disturbances, lack of appetite, and reduced interest in and pleasure from sex have been observed in regular MDMA users.16,17 Some of these disturbances may not be directly attributable to MDMA, but may be related to some of the other drugs often used in combination with MDMA, such as cocaine or marijuana, or to adulterants commonly found in MDMA tablets.

This page was last updated March 2006