Ecstasy Symptoms, Signs and Side Effects

person taking ecstasy at party

Ecstasy is a recreational drug that contains 3,4-methylenedioxymethamphetamine, or MDMA.

Ecstasy goes by several names including MDMA, E, X, and Molly. Ecstasy is a synthetic drug.

Although ecstasy does not produce the same addictive profile as some other drugs like alcohol or cocaine, some people report feeling concerned about their use and eventually seek treatment.

Signs and symptoms of ecstasy addiction revolve around using and obtaining the drug. If excessive time and energy is spent in such a way that it significantly retracts from other areas of your life, such as work or family, those may be signs of addiction.

Ecstasy Use Symptoms

The symptoms of ecstasy use include euphoria, elation, increased sociability, extroversion, relaxation and a decreased need for sleep. People report heightened sensory perceptions and experiences when they use the drug.

The physiological effects experienced while under the influence of ecstasy and MDMA are dose-dependent. The bigger the dose consumed, the bigger and more severe the side effects can be. Quantitative studies reveal positive effects predominate up to approximately 100 mg, Dosages greater than 120 mg to 180 mg produced solely adverse and undesirable response in people.

Ecstasy Side Effects

Ecstasy, Molly or MDMA side effects vary based on the person and the concentration taken. Side effects generally include anxiety, bruxism (grinding or clenching of teeth), trismus (stiff or lockjaw), headaches, shaking and loss of consciousness.

Other common side effects of ecstasy include:

  • Restlessness
  • Agitation
  • Disorientation
  • Hypertension (high blood pressure)
  • Tachycardia (fast heart rate)
  • Hyperthermia (increased body temperature)
  • Sweating
  • Nausea
  • Dry Mouth

Dangerous and life-threatening side effects of ecstasy use include:

  • High blood pressure
  • Hyperthermia (a result of increased heat production and decreased heat dissipation – hot, dense club environment)
  • Serotonin syndrome
  • Hyponatremia and electrolyte imbalances (partially due to excessive water intake)
  • Loss of consciousness
  • Death (some fatalities have been reported)

The side effects of ecstasy on the body and brain can be from the substance itself but also from the contamination of tablets or powders with other toxic chemicals or illicit substances. The adulteration of ecstasy is common and as a result, the physiological effects and associated side effects are often unpredictable.

Ecstasy carries substantial side effects alone, but often ecstasy tablets contain other illegal or legal substances such as amphetamines, ketamine, caffeine and acetaminophen. Given the unpredictability of each tablet, the physiological effects and physical side effects can vary greatly.

Effects of Ecstasy on the Brain

Ecstasy’s mechanism of action is twofold: it causes the release of feel-good neurotransmitters and prevents their re-uptake and degradation. Both of these effects act to increase the amount of neurotransmitters available. Ecstasy predominantly exerts its effects via the serotonin neurotransmitter system. 

The increase in neurotransmitters are responsible for the cognitive effects of ecstasy including euphoria, arousal, relaxation, enhanced mood, extroversion, increased feelings of sociability, decreased perception to negative emotions and cues and increased sensory perceptions. 

Ecstasy also lessens people’s response to threatening stimuli while simultaneously enhancing rewards associated with positive social signals. This process is thought to contribute to the feelings of increased sociability and expressive inclusion.  

Physical Effects of Ecstasy Use

The excessive neurotransmitter release associated with ecstasy may be responsible for the subjective effects of elation, but those same neurotransmitters also control important bodily functions such as thermoregulation (body temperature), sleep patterns, appetite signals and reward pathways.  

The effects of ecstasy on the body are dose-dependent and include increased blood pressure, increased body temperature, increased heart rate and increased cortisol release. Ecstasy’s toxic effect on the body includes involvement of the cardiovascular system and heart, immune system, liver and kidneys. Ecstasy also causes the release of large amounts of cortisol and prolactin. 

There is also some evidence that ecstasy may affect men and women differently. Females may be more susceptible to the acute negative effects on mood, which is thought to be related to pre-existing serotonin metabolism gender differences. 

Long-Term Effects of Ecstasy Use

Chronic or repetitive use of MDMA may inhibit the serotonin transport system. This effect is correlated with use intensity. Some studies have shown that chronic use is associated with lasting cognitive deficits, most pronounced in learning and short-term memory. Fortunately, these changes are likely reversible when use is discontinued. Much more research is required before substantiated evidence can be produced on the long-term results of ecstasy abuse.

Ecstasy Withdrawal Symptoms

Withdrawal effects of ecstasy are sometimes referred to as “come-down” symptoms. Although the withdrawal may be mild in comparison with that of alcohol or opioids, users report a decreased mood occurring two to five days after use. While ecstasy withdrawal may be uncomfortable, it is not life-threatening.

Ecstasy Overdose Symptoms

An ecstasy overdose is an issue complicated by poly-substance use. That is, many people report combining ecstasy with legal and illegal substances, such as alcohol, marijuana, opioids and cocaine. The risk of overdose is much more substantial when multiple substances are ingested. 

Ecstasy overdose symptoms include:

  • Hyperthermia 
  • Serotonin syndrome
  • Hyponatremia
  • Liver failure
  • Stroke 
  • Acute anxiety and panic 

Overdoses generally follow consumption of large quantities, although there have been reports of lethal overdose upon single ingestion. Some individuals may have genetic predispositions that make them particularly susceptible to the effects of ecstasy.

How to Get Ecstasy Out of Your System

Ecstasy is broken-down by enzymes in the liver. Pre-existing genetic variations in these enzymes affect the efficiency of MDMA metabolism. The half-life of ecstasy is approximately seven hours, which means it takes seven hours to eliminate half the amount consumed. 

There are no medications, over-the-counter or prescribed, that can aid with ecstasy detoxification. The most effective way is to refrain from using ecstasy while focusing on healthy eating and living habits. Some rehab centers can provide people with high-quality treatment for ecstasy use disorders. The Recovery Village Ridgefield offers medical detox and rehab services serving the state of Washington and Oregon.

Key Points: Understanding Ecstasy Effects and Addiction 

Here are some important points to remember about ecstasy:

  • Negative cognitive effects from ecstasy use include anxiety, mental restlessness and panic 
  • Physical effects of ecstasy use include restlessness, increased blood pressure and heart rate and increased body temperature
  • Ecstasy withdrawal may occur two to five days after use and is characterized by low mood
  • Long-term results of repetitive ecstasy use may include difficulties in concentration as well as memory and attention problems

If you or a loved one is struggling with ecstasy use, The Recovery Village Ridgefield can help. Call today to speak with a representative about how professional addiction treatment can help.

Meyer, Jerrold. “3,4-methylenedioxymethamphetamine (MDMA): Current Perspectives.” Journal of Substance Abuse and Rehabilitation, November 21 2013. Accessed August 13, 2019.

Wood, David; et al. “Variability in the 3,4-methylenedioxymethamphetamine content of ‘ecstasy’ tablets in the UK.” Journal of Emergency Medicine, 2011. Accessed August 12, 2019.

Bedi, Gillinder; Phan, K. Luan; Angstadt, Mike; de Wit, Harriet. “Effects of MDMA on sociability and neural response to social threat and social reward.” Psychopharmacology, November 2009. Accessed August 14, 2019. 

Verheyden, Suzanne; Hadfield, Joanne; Calin, Tara; Curran, Valerie.Sub-acute effects of MDMA (3,4-methylenedioxymethamphetamine, ‘ecstasy’) on mood: evidence of gender differences.” Psychopharmacology, April 2002. Accessed August 15, 2019. 

Buchert, Ralph; et al. “Long-Term Effects of “Ecstasy” Use on Serotonin Transporters of the Brain Investigated by PET.” The Journal of Nuclear Medicine, March 1, 2003. Accessed August 12, 2019. 

Kalechstein, Ari; et al. “MDMA Use and Neurocognition: A Meta-Analytic Review.” Journal of Psychopharmacology, November 3 2006. Accessed August 14, 2019.

Nulsen, Claire; Fox, Allison; Hammond, Geoffrey. “Differential Effects of Ecstasy on Short-Term and Working Memory: A Meta-Analysis.” Neuropsychology Review, March 2010. Accessed August 15, 2019.