MDMA is an illegal drug that acts as both a stimulant and psychedelic, producing an energizing effect, as well as distortions in time and perception and enhanced enjoyment from tactile experiences.^1,2 Typically, MDMA (an acronym for its chemical name 3,4-methylenedioxymethamphetamine) is taken orally, usually in a tablet or capsule, and its effects last approximately 3 to 6 hours. The average reported dose is one to two tablets, with each tablet typically containing between 60 and 120 milligrams of MDMA.¹ It is not uncommon for users to take a second dose of the drug as the effects of the first dose begin to fade.

MDMA can affect the brain by altering the activity of chemical messengers, or neurotransmitters, which enable nerve cells in the brain to communicate with one another. Research in animals has shown that MDMA in moderate to high doses can be toxic to nerve cells that contain serotonin and can cause long-lasting damage to them.^1,3 Furthermore, MDMA raises body temperature. On rare but largely unpredictable occasions, this has led to severe medical consequences, including death.^3,4 Also, MDMA causes the release of another neurotransmitter, norepinephrine, which is likely the cause of the increase in heart rate and blood pressure that often accompanies MDMA use.^5,6

Although MDMA is known universally among users as ecstasy, researchers have determined that many ecstasy tablets contain not only MDMA but also a number of other drugs or drug combinations that can be harmful as well. Adulterants found in MDMA tablets purchased on the street include methamphetamine, caffeine, the over-the-counter cough suppressant dextromethorphan, the diet drug ephedrine, and cocaine.^7,8 Also, as with many other drugs of abuse, MDMA is rarely used alone. It is not uncommon for users to mix MDMA with other substances, such as alcohol and marijuana.