The Effects of Ecstasy or MDMA on the Brain

two women sharing pills with wine at a bar

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Illegal drugs of abuse cause some effect on the brain. Generally, that is why people take drugs in the first place, because they act in the brain altering their mental states to get them high, enhance their mood, or cause changes in perceptions.

Unfortunately for the user, most drugs not only affect the regions of the brain that makes them feel differently, they can affect other parts of the brain that are essential for functioning, learning, or remembering.

MDMA, better known as ecstasy or Molly, is no exception. It acts on the neurotransmitters in the brain to give users an extreme alteration of their mood, but can also cause a variety of unwanted cognitive defects and physical effects.

Serotonin, Dopamine, and Norepinephrine

When someone takes MDMA, it causes serotonin, dopamine, and norepinephrine to be released from their neuron storage sites. This results in an increase in neurotransmitter activity in the brain.

The release of excessive amounts of these neurotransmitters by drug use can cause the brain to become depleted of these chemical messengers with many negative consequences.

Serotonin, dopamine, and norepinephrine communicate information throughout the brain. They relay signals between nerve cells in the following ways:

  • Serotonin: Helps maintain a stable mood and other emotional functions and also is involved in the regulation of sleep cycles, pain control, and digestion, among others
  • Dopamine: Involved in regulating mood and focus as well as other central nervous system functions
  • Norepinephrine: Part of the "fight and flight" response and in the regulation of mood, anxiety, sleep, energy, and focus

Researchers believe that it is the release of excessive amounts of serotonin that produces the mood-elevating effects experienced by MDMA users.

But, serotonin also plays a significant role in the regulation of sleep, pain, emotion, appetite, and other functions. When MDMA causes the release of large amounts of serotonin, the brain can become depleted of it and contribute to the unpleasant after-effects that many ecstasy users experience after taking MDMA.

Long-Lasting Effects on the Brain

Animal research has shown that the damage that MDMA use causes to serotonin-containing neurons can be long-lasting. Measuring the long-lasting effect of MDMA use in humans has proven to be more difficult for scientists, but some studies have found that some heavy MDMA users experience:

  • Depression
  • Impaired attention processes
  • Working memory impairment

Changes in Brain Activity

Some human imaging studies of Molly users have found that the drug changes activity in the brain regions involved in:

  • Cognition
  • Emotion
  • Motor function

Impact of Other Drugs

Another difficulty investigators have had with evaluating the effects of MDMA use on the brain is that many times the ecstasy tablets users purchase on the street are not pure MDMA, but contain other drugs or substances.

There is also the likelihood that ecstasy users are also using other drugs like marijuana or alcohol, which have their own effects on the brain. Therefore, it is difficult for researchers to determine if the effects they observe are from MDMA alone, the other drugs, or a combination of the two.

Other Factors That Could Play a Role

Along with the possible use of other drugs, other factors that could play a role in some of the cognitive deficits observed in MDMA users include:

  • Age of first use
  • Dosage
  • Frequency of use
  • Gender
  • Genetic and environmental factors

Additional Effects of MDMA on the Brain

There are studies of long-term MDMA users that have indicated several other effects of heavy use of the drug:

  • Global form processing: One study found that recreational MDMA use affected the users' ability to process certain types of visual information, such as the ability to integrate local orientation information into a global form percept.
  • Impaired impulse control: Other researchers believe that, like many other drugs, MDMA affects the region of the brain involved with impulse control and therefore can contribute to the development of substance abuse disorders.
  • Impaired sexual arousal: Because MDMA affects serotonin levels more than dopamine levels in some users, some researchers believe long-time use may impact sexual arousal.

Effects on Unborn Children

There is some research that indicates that MDMA use not only affects the brains of the users but also the brains of the unborn children of the pregnant users of the drug.

Animal studies have found significant adverse effects on learning and memory when exposed to MDMA during a developmental period equivalent to the third trimester in humans.

Researchers are concerned about the potential adverse effects of MDMA on developing unborn children when female users of the drug who are pregnant continue to use because they mistakenly believe that Molly is a "safe drug."

4 Sources
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  1. National Institute on Drug Abuse. What are MDMA’s effects on the brain? Updated September 2017.

  2. White C, Edwards M, Brown J, Bell J. The Impact of Recreational MDMA 'Ecstasy' Use on Global Form Processing. J Psychopharmacol (Oxford). 2014;28(11):1018-1029. doi:10.1177/0269881114546709

  3. Schenk S, Aronsen D. Contribution of Impulsivity and Serotonin Receptor Neuroadaptations to the Development of an MDMA ('Ecstasy') Substance Use Disorder. Curr Top Behav Neurosci. 2017;34:17-32. doi:10.1007/7854_2015_421

  4. Schmid Y, Hysek CM, Preller KH, et al. Effects of Methylphenidate and MDMA on Appraisal of Erotic Stimuli and Intimate Relationships. Eur Neuropsychopharmacol. 2015;25(1):17-25. doi:10.1016/j.euroneuro.2014.11.020