The Effects of Ecstasy (MDMA)

Ecstasy pills in a person's hand
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Methylenedioxymethamphetamine (MDMA), better known as Ecstasy or Molly, is a synthetic drug derived from amphetamine that acts as both a stimulant and a hallucinogen. People tend to use it recreationally because of the host of effects it can produce within an hour or so after taking a single dose, such as feelings of mental stimulation, decreased anxiety, and enhanced sensory perception. However, as with any street drug, using MDMA also comes with notable risks.


The German pharmaceutical company Merck first developed MDMA in 1912 as a pharmaceutical compound that could be used to develop other medications to control bleeding. They soon realized that it had hallucinogenic properties and patented it in 1914, though the drug wasn't developed further for a few decades.

The 1950s and 1960s

During the Cold War, the U.S. Army and the Central Intelligence Agency (CIA) tested MDMA, along with other hallucinogenic drugs, for use in psychological warfare.

The 1960s and 1970s

A small number of psychiatrists started giving MDMA to their patients as a way to lower their inhibitions during psychotherapy. Despite the fact that MDMA was not approved by the U.S. Food and Drug Administration (FDA), these doctors believed that it lowered their patients' inhibitions, causing them to talk more openly and honestly.

The 1970s and 1980s

This period was MDMA's heyday as it became a mainstream street drug associated with music festivals, raves, concerts, and clubs.

In 1985, the U.S. Drug Enforcement Administration (DEA) placed MDMA on the list of Schedule I drugs, meaning that it isn't used to treat any medical condition and it has a high potential for abuse.


MDMA is still on the list of Schedule I drugs. Studies are currently being conducted to see if it's effective in treating anxiety in people with a terminal illness, as well as those with post-traumatic stress disorder (PTSD).

Other common names for MDMA include:

  • Adam
  • Beans
  • Clarity
  • E
  • Hug
  • Love drug
  • Molly
  • Roll
  • Scooby snacks
  • Snowball
  • X, E, XE, or XTC

How It Works

Often produced as a colorful tablet and imprinted with a logo, MDMA can also come in capsule, powder, or liquid form. It works by boosting the activity of three feel-good brain chemicals called neurotransmitters: dopamine, serotonin, and norepinephrine. These chemicals play a part in a variety of functions such as mood, energy level, appetite, trust, sexual activity, emotions, and sleep. The effects last for three to six hours.

Short-Term Effects

MDMA can produce the positive effects that people seek in as little as 15 minutes, but it can also cause a variety of negative effects.

Positive Effects

  • Mental stimulation

  • An increased sense of well-being

  • Emotional warmth

  • Empathy

  • Feeling less reserved

  • Decreased anxiety

  • Increased energy

  • Enhanced sensory perception

Negative Effects

  • Nausea

  • Chills or hot flashes

  • Sweating

  • Teeth clenching

  • Muscle cramping or stiffness

  • Loss of appetite

  • Disorganized thinking

  • Dehydration

  • Restless legs

  • Agitation


MDMA isn't a harmless drug—there are serious risks involved with taking it, including not knowing what's in it, hyperthermia, cardiovascular effects, impaired mental capabilities, risky behavior, and overdose.

Unknown Content

The majority of today's MDMA contains other potentially dangerous drugs or substances like bath salts, caffeine, PCP, or cocaine, and may contain very little, if any, actual MDMA. This is dangerous both because you don't know for sure what you're ingesting or how your body will react and because of the potential interactions that can occur between the ingredients, as well as any other substances you use with MDMA, such as alcohol, medications, or other drugs.


MDMA is often used during high-energy activity, such as dancing at clubs or music festivals. However, it limits your body's ability to regulate your temperature, so when you engage in vigorous activity for long periods of time, you're at a higher risk of developing hyperthermia, a condition in which your body temperature becomes too high.

Thankfully, hyperthermia is rare, but it needs to be treated immediately because it can quickly lead to muscle breakdown, which can then result in kidney, liver, or heart failure.

Cardiovascular Effects

If you use it regularly, taking MDMA can cause your heart to stop working efficiently, an especially dangerous effect if you're also engaging in strenuous activity.

Impaired Mental Ability

In the hours after you take MDMA, there are significant impairments in your mental abilities such as processing information, memory, concentration, and your capacity to judge motion. This underscores how dangerous it is to engage in activities like driving while you're under the influence of MDMA.

Risky Behavior

Because MDMA lessens your inhibitions and causes feelings of trust and emotional warmth, you're more likely to engage in unsafe sexual activities that may result in getting (or giving) a sexually transmitted disease (STD) like hepatitis or HIV.

Your risk of engaging in unsafe drug use, such as injecting yourself with a dirty needle, is also higher.


Since your body quickly absorbs MDMA, it also has a difficult time metabolizing it. This means that taking more doses can cause you to have even worse cardiovascular and/or negative effects or to overdose, which can be life-threatening. Using other drugs or alcohol with MDMA increases this risk.

Symptoms of overdose include:

  • High blood pressure
  • Feeling faint
  • Panic attacks
  • Loss of consciousness
  • Seizures

Long-Term Effects

Up to a week after using MDMA, many people still feel anxious, restless, irritable, and sad, as well as have memory and concentration problems and lack of pleasure from sex. Similarly, increased anxiety, impulsive behavior, aggression, sleep issues, loss of appetite, and heart disease have been observed in regular MDMA users.

It's not clear if all of these effects are strictly from MDMA use. Some of them may be related to other drugs that people often use along with MDMA, like alcohol or marijuana. These effects may also be chalked up to the other (often unknown) ingredients found in MDMA.

When to Get Help

When you use MDMA, your brain releases a flood of neurotransmitters that bring on the uplifting effects of the drug. Afterward, you may find it difficult to achieve the same levels of happiness because your brain has depleted its serotonin supply. This can lead to withdrawal symptoms like anxiety, confusion, insomnia, poor memory, fatigue, difficulty concentrating, and even depression. An ever-increasing desire for the drug is the natural next step.

Treatment Is Important

If you have withdrawal symptoms, it's crucial that you get treatment. This will help you learn how to stop using MDMA, avoid substituting it with other drugs and improve your mental health.

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