Ecstasy (MDMA) Effects

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Effects of MDMA Use

MDMA is a man-made stimulant with hallucinogenic properties. It is commonly used at parties and clubs for its energizing, empathic, and euphoric effects.1, 2

However, these sought-after effects can come with a series of unpleasant or even dangerous side effects that may leave a lasting impact on the user.

What Happens When You Take Ecstasy?

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Pure MDMA tends to be sold as a crystalline powder that users swallow or snort. Pressed pills with MDMA in them are known as Ecstasy, and often these pills contain additives such as caffeine, amphetamines, ketamine, cocaine, or opiates to supplement or enhance the MDMA effects.1

MDMA exerts its effects by stimulating the central nervous system, resulting in increased levels of the brain chemicals serotonin, dopamine, and norepinephrine.2 These chemicals are related to mood, energy levels, heart rate, blood pressure, and sexual arousal.

Beyond the euphoric high, MDMA can have damaging effects on the user’s brain. Taking high one-time doses and even repeated moderate doses has been found to result in serotonergic neuronal damage in the neocortex of rats and primates, and other studies in humans have observed cognitive deficits in long-term, heavy users.3

How Long Does It Last?

MDMA and Ecstasy exert their effects within 30 to 45 minutes of ingestion and, depending on the purity of the drug, may last up to 4 to 6 hours.1 The effects that a user may experience will vary depending on:

  • Tolerance.
  • Metabolism.
  • Amount taken.
  • Any additives or adulterant substances.
  • Use with other drugs such as alcohol.

Ecstasy and MDMA Short-term Effects

It reflects the powerful impact that the drug has on neurotransmitters in the brain. Potential short-term effects include:1, 2

  • Enhanced sensory perception.
  • Elevated mood.
  • Heightened empathy toward others.
  • Increased energy.
  • Distortions in time.
  • Increased sex drive.

Side Effects of Ecstasy and MDMA

Man experiencing MDMA side effects
MDMA’s desired euphoric effects don’t come without risk, however. Side effects of use can be unpleasant and even life-threatening. Ecstasy side effects may be even more dangerous depending on the additives used in the pill.

The side effects occur for the same reason the desired effects do: central nervous system stimulation.4

Common Side Effects of MDMA

  • Increased heart rate and blood pressure.
  • Increased sweating.
  • Teeth grinding.
  • Dry mouth.
  • Jaw clenching.
  • Muscle cramps.
  • Blurred vision.
  • Dilated pupils.
  • Nausea.

The side effects of MDMA use extend beyond the high and into the days following use. Almost 80% of MDMA users report extreme exhaustion, anhedonia, and depression following an MDMA high. These unpleasant after-effects are likely due to depletion of serotonin in the brain.3

Life-Threatening Effects

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Increased blood pressure and heart rate can be very dangerous for users with circulatory issues, and heightened body temperature can cause a cascade of risky effects. These risks are heightened by the energetic high in party-like environments. Users may over-exert themselves for hours by dancing without drinking enough water.1, 5

On top of the risks associated with MDMA alone, its use can have unpredictable effects on the user if they do not know what substances the MDMA is mixed with. Even intentionally mixing drugs with MDMA can result in dangerous combined effects on the user, possibly even more dangerous than MDMA alone.6

MDMA’s dangerous and life-threatening effects can include:1, 4, 5

  • Extremely high body temperature (hyperpyrexia/hyperthermia).
  • Liver failure.
  • Kidney failure.
  • Cardiovascular failure.
  • Muscle breakdown (rhabdomyolysis).
  • Brain swelling (cerebral edema).
  • Intense thirst and overconsumption of water (hyperdipsia).
  • Abnormal heart rhythms.
  • Severe anxiety and panic attacks.
  • Seizures.
  • Loss of consciousness.
  • Sudden death.

Another potentially deadly condition that can develop with heavy MDMA use is serotonin syndrome.7 When the brain gets flooded with serotonin, very dangerous symptoms may present in addition to the effects listed above, including hallucinations, loss of coordination, nausea, hyperactive reflexes, diarrhea, and vomiting.7

Re-dosing is another issue that some MDMA users face. When a person takes MDMA, the drug can interfere with the body’s ability to metabolize it, resulting in a high blood concentration level.5 Re-dosing can drastically increase the amount of MDMA in the bloodstream, leading to enhanced dangers of use.


Long-Term Effects of MDMA

Long-term effects may include depression, anxiety, and sleep problems.

Ecstasy long-term effects will vary depending on how much a person takes and how often.

Over long-term use, heavy MDMA users may suffer very damage to the serotonin system.3 Users who abuse or struggle with an addiction to MDMA or Ecstasy are more likely to suffer the more serious effects of extended use.

Definitive long-term effects of MDMA are still under investigation, but effects may include:2, 3

  • Severe depression.
  • Brain damage in the neocortex.
  • Decreased appetite.
  • Anxiety.
  • Lower sex drive.
  • Sleep problems.
  • Cognitive performance deficits, including some memory problems.

Get Help for Ecstasy Abuse and Addiction

If you are concerned that you or a loved one is struggling with MDMA abuse and may be at risk of negative consequences, don’t wait to seek help. Call 1-888-319-2606 Helpline Information to speak with a recovery program advisor and get help finding a program that fits your needs.


[1]. Drug Enforcement Administration. Drug fact sheet: Ecstasy or MDMA.

[2]. National Institute on Drug Abuse. (2016). Drug facts: MDMA (Ecstasy/Molly).

[3]. Parrott, A. C. (2001). Human psychopharmacology of Ecstasy (MDMA): a review of 15 years of empirical research. Human Psychopharmacology: Clinical and Experimental, 16. 557-577.

[4]. Hall, A. P., Henry, J. A. (2006). Acute toxic effects of ‘Ecstasy’ (MDMA) and related compounds: overview of pathophysiology and clinical management. British Journal of Anaesthesia, 96(6). 678-685.

[5]. National Institute on Drug Abuse. (2006). MDMA (Ecstasy) Abuse.

[6]. Hanson, K. L. & Luciana, M. (2010). Neurocognitive impairments in MDMA and other drug users: MDMA alone may not be a cognitive risk factor. Journal of Clinical and Experimental Neuropsychology, 32(4). 337-349.

[7]. U.S. National Library of Medicine. (2014). Serotonin Syndrome. Medline Plus.

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