Bipolar Disorder The Effect of MDMA on Bipolar Disorder By Kimberly Read Kimberly Read Kimberly Read is a writer with experience covering mental health conditions, including bipolar disorder. Learn about our editorial process Updated on September 17, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Diverse Images/Getty Images Ecstasy, also known as E, X, M, XTC, clarity, essence, Adam, beans, rolls, decadence, and M & M — is a popular street drug. Made from a chemical compound called 3,4- Methylendedioxymethamphetamine (MDMA), it is considered to be a psychedelic amphetamine. Ecstasy is most commonly found as tablets which are ingested, but it may also be seen as a powder which is in ingested and may be snorted or smoked (rare); very rarely it may be injected. There is some debate whether Ecstasy can be physically addictive, though withdrawal symptoms such as fatigue, depression, anxiety, irritability, and loss of appetite have been reported. It does have the potential to be psychologically addictive, and there is also the potential for tolerance to build. Effects of MDMA MDMA is a synthetic psychoactive drug that combines both mildly hallucinogenic and amphetamine-like effects. The more common physical effects of MDMA include an increase in energy, heightened awareness of the senses, visual distortions, appetite loss, nystagmus (rapid, involuntary eye jiggling), restlessness, change in body temperature regulation, jaw clenching and teeth grinding. While the overall experience can vary widely from person to person, psychologically MDMA is a drug that increases empathy. These effects include an extreme mood lift, increased communication, a sense of closeness and belonging as well as a strong desire to be hugged and touched by people. Dangers of MDMA Use Ecstasy is associated with memory loss, confusion, and other issues which can continue long after a dose of the drug has worn off. It also causes problems with temperature regulation in the body, which can lead to hypothermia and organ failure. Ecstasy, like all street drugs, is prepared and sold by non-licensed individuals who may add any number of other substances. Caffeine, ephedrine, and other stimulants are often added. Ecstasy is often mixed with other recreational drugs further contributing to medical risks. Bipolar-Specific Issues With MDMA Use Because most people with bipolar diagnoses are already on at least one medication, and (by definition) have mood-related challenges, taking ecstasy can be particularly risky. Often, bipolar individuals using Ecstasy are attempting to "self-medicate," meaning that they are choosing to use illicit drugs in order to try and alter bipolar symptoms. Obviously, this is not an ideal approach to managing any illness. Drug Interactions: Never mix Ecstasy with monoamine oxidase inhibitors (MAOI). MAOIs, such as Parnate and Nardil among many others, are prescribed for depression. Deaths have occurred due to interactions between Ecstasy and MAO inhibitors. Complications with bipolar disorder: Some users, most especially those who frequently take Ecstasy or take high doses, experience depression when coming back down. In addition, MDMA can potentially trigger mania and psychosis. Those already struggling with mood disorders (unipolar or bipolar) may find that Ecstasy exacerbates the condition. Overview of Treatment Options for Depression 8 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Institute on Drug Abuse. DrugFacts: MDMA (Ecstasy/Molly). Degenhardt L, Bruno R, Topp L. Is ecstasy a drug of dependence?. Drug Alcohol Depend. 2010;107(1):1-10. doi:10.1016/j.drugalcdep.2009.09.009 National Institute on Drug Abuse. MDMA (Ecstasy) Abuse. What are the effects of MDMA? Heifets, BD, Malenka, RC. MDMA as a probe and treatment for social behaviors. Cell. 2016;166(2):269-272. doi:10.1016/j.cell.2016.06.045 Pázmány P, Petschner P, Ádori C, et al. [The cognitive effects of ecstasy]. Neuropsychopharmacol Hung. 2013;15(4):214-22. PMID:24380962 Parrott AC. MDMA and temperature: a review of the thermal effects of 'Ecstasy' in humans. Drug Alcohol Depend. 2012;121(1-2):1-9. doi:10.1016/j.drugalcdep.2011.08.012 Vuori, E, Henry, J, Ojanpera, I, Nieminen, R, Savolainen, T, Wahlsten, P, Jantti, M. Death following injestion of MDMA (ecstasy) and moclobemide. Addiction. 2003;98(3):365-368. doi:10.1046/j.1360-0443.2003.00292.x Michael white C. How MDMA's pharmacology and pharmacokinetics drive desired effects and harms. J Clin Pharmacol. 2014;54(3):245-52. doi:10.1002/jcph.266 Additional Reading Office of National Drug Control Policy (ONDCP). Information About "Club" Drug Use. DanceSafe. What Is Ecstasy? Drugs.com. Ecstasy. Erowid. (2000, August 21). MDMA Basics. 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