The Side Effects of Molly (MDMA): Short-Term, Long-Term, & Comedown

Molly may have an innocent-sounding name, but this synthetic drug is guilty of having both stimulant and hallucinogenic properties.

Often sold as a powder-filled capsule, this form of 3,4-methylenedioxy-methamphetamine (MDMA/ecstasy) is supposedly the “purest” form of MDMA; however, Molly capsules often contain adulterant substances and, in some cases, may contain no MDMA at all.¹ As a result, Molly drug effects can encompass a wide range of symptoms, ranging from desirable to dangerous.

This page will discuss the short-and-long-term effects of molly use, the impact on the body, and how to get help if you or someone you care about are struggling with molly misuse.

Common Side Effects of Molly (MDMA)

There are both short and long-term side effects of molly use. Some of these effects of molly use dissipate after the drug wears off. However, some effects of ecstasy may be more long-lasting or require medical intervention.

The Short-Term Effects of a Molly High

The high from ecstasy, or Molly, is often characterized by a series of pleasurable symptoms for users.

Some common Molly high effects include:¹

• Elevated mood.
• Increased sense of alertness.
• Heightened energy.
• Enhanced sense of physical touch.

Most notably, Molly is associated with heightened feelings of love, trust, empathy, and sexual desire. This may be due to the increased serotonin activity that Molly initiates throughout specific brain systems.¹ 

Most often, users will ingest Molly orally. Many people begin to feel a euphoric high in about 20 to 40 minutes, with effects peaking in intensity within approximately 90 minutes of ingestion.³ The initial Molly high typically lasts between 3 and 6 hours.¹

Long-Term Effects of Molly

Along with the short-term aftereffects of Molly, repeated ecstasy use may also lead to long-term consequences.

Possible long-term effects of Molly use include:^2,3,5

• Impulsive behaviors.
• Aggression.
• Cognitive impairment, including memory problems.
• Disrupted sleep.
• Anorexia.
• Drug cravings.
• Confusion.
• Severe anxiety.
• Paranoia.
• Risky sexual behavior resulting in unwanted pregnancy or STDs.
• Impaired ability to perform sexually.
• Dental problems due to teeth clenching.
• A relative depletion of serotonin in the brain.

Dangerous Side Effects of Molly

While the ecstasy high may bring on feelings of love and desire, not all the effects are so pleasurable. A person can experience numerous adverse effects while intoxicated by MDMA.²

Some potential Molly side effects include:^2,3

• Hyperthermia (especially when dancing), which may result in life-threatening problems with the kidneys, heart, or liver.
• Heat exhaustion or heat stroke.
• Severe dehydration (increased risk when alcohol is consumed in combination with Molly).
• Electrolyte imbalances from excessive water consumption to combat dehydration.
• Overdose.

Molly powder, ecstasy tablets, or capsules may contain dangerous adulterants such as fentanyl, a potent opioid.⁷ If opioid involvement is suspected in an overdose, administrating Narcan can potentially save someone’s life.⁸

Overdose is an emergency that requires immediate medical attention.

Molly Comedown: The Aftereffects

As Molly wears off, the user may be faced with the dreaded MDMA comedown, a series of Molly aftereffects that often include negative and uncomfortable symptoms.

During a Molly comedown, users may experience a variety of symptoms, including:¹

• Feelings of depression.
• Anxiety.
• Irritability and aggression.
• Impulsivity.
• Loss of appetite.
• Insomnia.
• Fatigue.
• Memory problems.
• Impaired ability to pay attention.
• Loss of interest in sex.

Some users describe coming down from Molly as “suicide Tuesday” due to the associated anxiety and depression.⁴ Ecstasy use is particularly troubling in the adolescent population, as evidence has shown that young people who use ecstasy attempt suicide at higher rates than adolescents who use drugs other than MDMA or those who don’t use drugs at all.

How Molly Affects the Brain

Most of Molly’s effects are thought to primarily result from increases in the activity of 3 neurotransmitters in the brain:¹

• Serotonin.
• Dopamine.
• Norepinephrine.

Dopamine release is associated with pleasurable feelings and the reinforcement of behaviors that led to them. The effects of MDMA, ecstasy, and Molly on this neurotransmitter can increase feelings of energy and happiness while activating the brain’s reward system encouraging repeated use.¹ While increases in dopamine levels can lead to psychological changes, increased activity of norepinephrine can raise blood pressure and heart rate.¹

Many of the effects of Molly (both desirable and unwanted) are also said to be the result of its influence on the serotonin system, which is involved with regulating not just mood, but sexual behavior, aggression, sensitivity to pain, sleep, and memory.^1,2

Many substances influence the activity of serotonin, but Molly is unique in the rapid changes to this neurotransmitter system its use results in, which may result in particularly long-lasting decreases in serotonin activity.⁶

Primates exposed only briefly to MDMA were shown to have a lowered number of serotonergic neurons 7 years later. Reduced serotonin is thought to play a role in the depression, anxiety, memory impairment, and confusion commonly seen with chronic users of MDMA.⁶

Treatment for MDMA Use in Texas

At Greenhouse Treatment Center, our inpatient rehab in Dallas has experienced and licensed medical staff to help patients undergo treatment specific to their needs. Together we can help you reach long-term sobriety through various levels of addiction treatment. If you or a loved one are seeking help for an addiction to Molly, call today to speak with an admissions navigator to discuss how to pay for rehab, answer your questions about health insurance that covers rehab, and start treatment.

You can also verify your insurance coverage using the confidential .