Ecstasy (MDMA) Use, Effects, and Treatment

Ecstasy is an illicit drug popular among teens, college students, and young adults.

This article will explain more about the effects of ecstasy, associated risks, and how to get help if you or someone you know has lost control of their ecstasy use.

What Is Ecstasy?

Ecstasy (MDMA, or 3,4-methylenedioxymethamphetamine) is an amphetamine analogue with both stimulant and hallucinogenic effects. Ecstasy is most commonly taken as a tablet or capsule; however, some people will snort a powder or swallow the drug in a liquid form.¹

Other Names for Ecstasy

In addition to ecstasy, other historically used street names for MDMA include:²

• Molly.
• E.
• X.
• XTC.
• Adam.
• Disco Biscuit.
• Hug Drug.

While in the past ecstasy was associated primarily with the rave or club scene, the use of MDMA has become more widespread in recent years.³

Among teens surveyed in 2018, more than 4% of 12th graders in the U.S. reported using ecstasy at some point in their lives. Even some very young teens are experimenting with the drug. More than 1.5% of 8th graders reported ever having used the drug.⁴

Despite evidence to the contrary, the myth that ecstasy is a “safe” drug continues.⁵

What Does Ecstasy Do to the Brain?

Ecstasy increases the activity of three neurotransmitters: serotonin, dopamine, and norepinephrine.¹

• Increased dopamine activity is associated with a boost in energy and acts in the brain reward system to strongly reinforce certain behaviors.
• Norepinephrine speeds heart rate and increases blood pressure.
• Serotonin affects mood, sleep, appetite; a surge in serotonergic activity may underlie the boost in mood, empathy, and emotional closeness sometimes experienced by those using MDMA.⁶

While serotonin is released in abundance during ecstasy use, after use the brain becomes temporarily depleted of this neurotransmitter. This relative dip in serotonin activity could contribute to the feelings of anxiety, fatigue, and depression often associated with an ecstasy comedown.⁷ Chronically decreased active serotonin levels may contribute to the following symptoms commonly seen in regular ecstasy users:⁶

• Bouts of depression.
• Anxiety.
• Paranoia.
• Problems with attention and memory.
• Confusion.

Ecstasy Effects on the Body

Many of MDMA’s effects are dose-dependent, meaning the amount of MDMA taken can have a significant impact on how the drug affects the body. Though substance purity and total dose vary wildly, previous estimates place most tablets between 50 mg and 150 mg; however, short of analyzing the contents in a lab, the dose contained in such an illicit product is anyone’s guess. ⁶

An unexpectedly high dose can cause significant adverse effects. Adding to the danger, people using the drug often take a follow-up dose to prolong the comedown, further risking their health. ⁶

Additionally, ecstasy tablets, especially those sold online on the “dark net,” are more potent than ever before. According to a European study, while tablets in the ’90s and early 2000s average about 50 mg  to 80 mg, the average dose of an ecstasy tablet on the current market is now 125 mg. Some “super pills” have been marketed, with doses ranging between 270 mg and 340 mg.⁸

Side effects that may occur from MDMA use, which may be more intense and likely to occur with higher doses, include: ⁶

• Mild depersonalization.
• Disorganized thoughts.
• Restlessness.
• Headache.
• Jaw clenching.
• Teeth grinding.
• Stiffness in muscles and joints.
• Nausea.
• Loss of appetite.
• High blood pressure.
• Chills.
• Sweating.
• High body temperature.
• Loss of consciousness.
• Seizures.

Is Ecstasy Ever Deadly?

Many mistakenly view ecstasy as a benign recreational drug or a nonaddictive, feel-good substance. However, there have been several reports of MDMA-related deaths.

One particular danger to ecstasy users is hyponatremia, an abnormally low level of sodium in the blood.⁹ Because people often dance for long periods in warm conditions like a club or party while using ecstasy, dehydration is common. Ecstasy users tend to combat dehydration by drinking a lot of water.

Though there are several potential underlying physiological mechanisms at play, excessive water consumption coupled with drug-induced alterations in free water excretion by the kidneys results in a dilutional effect on serum sodium levels. In severe cases, the subsequent shifts of water from the serum compartment to intracellular spaces can result in brain swelling, mental status changes, seizure, coma, and death.¹⁰

Milder symptoms of hyponatremia may include:⁹

• Headache.
• Confusion.
• Fatigue/lethargy.
• Muscle weakness.
• Muscle cramps.
• Nausea.
• Vomiting.

Adding to the dangers of altered fluid balance and hyponatremia is the risk of severe increases in body temperature (hyperthermia). Animal studies suggest that ecstasy may impair thermoregulation, or the body’s ability to regulate its temperature.

MDMA use is commonly associated with increased physical activity for extended durations in particularly hot environments such as a packed dance club—a perfect formula for a dangerous spike in body temperature. ⁶

Untreated hyperthermia may lead to a life-threatening condition called rhabdomyolysis, wherein muscles begin to break down and spill their protein contents into the bloodstream.⁶ Hyperthermia may also further contribute to electrolyte imbalances and fluid shifts, which can lead to kidney failure or swelling of the brain.⁶

Ecstasy, SSRIs, and Serotonin Syndrome

People who take selective serotonin reuptake inhibitors (SSRIs)—for example, Prozac—and use ecstasy, may be at increased risk of a serious condition called serotonin syndrome.¹¹ Serotonin syndrome symptoms include:¹²

• Agitation.
• Hallucinations.
• Coordination problems.
• Abnormal movements of the eyes.
• Nausea.
• Vomiting.
• Diarrhea.
• Rapid heart rate.
• Rapidly changing blood pressure.
• Fever.
• Excessive sweating.
• Shivering.
• Tremors.
• Coma.

When treated quickly, the prognosis is good. However, untreated serotonin syndrome may progress in severity and could potentially lead to marked agitation, hyperthermia, muscle breakdown, renal damage, and death.¹²

Can MDMA Be Laced With Other Drugs?

Illicit samples of ecstasy commonly contain other adulterant drugs and may even be completely devoid of MDMA. Other drugs that have been found in products sold as MDMA include:²

• Ephedrine.
• Dextromethorphan (DXM).
• Ketamine.
• Methamphetamine.
• MDA (methylenedioxyamphetamine).
• PMA (paramethoxyamphetamine).

The truth is that no one buying ecstasy will know with certainty what drug or drugs they are consuming, so anyone seeking the desirable effects of MDMA is truly putting their health—and sometimes their life—at risk.

Signs of MDMA/Ecstasy Addiction

A person using ecstasy may think their use will never be problematic because they view the substance as safe to use in moderation. Though typical patterns of use differ somewhat from more conventionally addictive substances, such as cocaine and heroin, there is evidence of addiction-related phenomenon in association with ecstasy use, including tolerance, withdrawal,  and drug cravings. ⁶

There are warning signs to look for in someone who uses ecstasy. Such signs may be somewhat indicative of a tipping point when occasional recreational use has escalated to a more problematic, compulsive pattern of drug taking. Problematic ecstasy use may include some of the following signs or changes in behavior:¹³

• Pulling away from friends, family, coworkers, and social functions to go and get high instead.
• Inability to cut down or stop despite attempts to do so.
• Persistent use or abuse of ecstasy when it is causing emotional, financial, legal, health-related, or other problems in life.
• Spending a lot of time and energy focused on buying and using the drug.
• Using more ecstasy than originally intended (e.g., taking multiple doses before night’s end to keep the high going).

Some individuals who use this drug may exhibit outward symptoms of psychiatric problems, such as paranoia and extreme anxiety that causes panic attacks.⁶

MDMA/Ecstasy Addiction Treatment

Professional treatment for an ecstasy or MDMA use disorder may take place in various settings. Treatment will consist of therapy and behavioral interventions, since there are no approved medications to treat MDMA addiction.¹

The appropriate setting and treatment plan should be determined by a person’s individual needs.¹⁴ Factors to consider are:

• The severity of the addiction.
• The presence of any co-occurring mental health conditions.
• Facility location and available programs.
• Financing options (and whether they accept insurance).

At inpatient addiction treatment facility near Dallas, we offer comprehensive rehab for ecstasy/MDMA addiction. Our levels of addiction treatment and services include:

• Medical detox.
• Inpatient or residential treatment.
• Partial hospitalization.
• Intensive outpatient.
• Standard outpatient.
• Sober living.

To learn more about our transformative programming, rehab facility amenities, and admissions process, call us at today. Our staff is available 24/7 to answer your questions, review rehab payment options, and check to see if your health insurance covers rehab.

You can also find out whether we accept your health insurance plan and confirm your benefits by filling out this quick and secure .

Don’t let your addiction reach rock bottom. If you or someone you love is struggling with substance abuse and unsure where to turn, we are ready to help you get the treatment you need.