What Effects Does MDMA Have?

Whoever consumes MDMA can experience the intoxicating effects of the drug around 45 minutes after taking a single dose. Those effects include an intensified sense of well-being, increased extroversion, emotional warmth, empathy for others, and a willingness to discuss emotionally charged memories. Furthermore, people report intensifying sensory perception as a hallmark of the MDMA experience.

However, MDMA can also cause several acute side effects. For example, while lethal MDMA overdoses are uncommon, they can potentially be life-threatening, with symptoms such as high blood pressure (hypertension), fainting or dizziness, panic attacks, and, in severe cases, loss of knowledge and seizures.

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Because of its stimulating properties and the situations in which it is frequently consumed, MDMA is associated with vigorous physical activity for extended periods in hot environments. This can cause one of the most important, but rare, acute side effects: a marked increase in body temperature (hyperthermia).

The results of research with rats show that even a moderate dose of MDMA interferes with the body's ability to regulate its temperature, which can potentially have fatal consequences in hot environments. Treatment of hyperthermia requires immediate medical attention, as it can quickly lead to the breakdown of muscle tissue or electrolyte (sodium) imbalance, which in turn can cause kidney failure or fatal inflammation of the brain, particularly in women.

Consuming MDMA in combination with vigorous exercise causes dehydration, leading some people to drink large amounts of fluids. However, this could increase the electrolyte imbalance or inflammation of the brain because MDMA causes the body to retain water. A moderate dose of MDMA can also reduce the heart's pumping efficiency in people who consume it regularly, which is a special concern during periods of intense physical activity.

MDMA can also cause adverse side effects, including involuntary jaw strain, loss of appetite, slight detachment from self (depersonalization), illogical or disorganized thoughts, restless legs, nausea, hot flashes or chills, headache, sweat, and muscle or joint stiffness.

In the hours following consumption, MDMA produces a significant reduction in the perception and prediction of movement, for example, the ability to assess whether a driver is in danger of colliding with another vehicle. This highlights the dangers of performing activities that are complex or require specific skills, such as driving a car, while under the influence of this drug.

Once MDMA is metabolized or broken down in the body, its derivatives interfere with the body's ability to metabolize the drug. Consequently, additional doses of MDMA can produce unexpectedly high blood levels, which may exacerbate the toxic effects of the drug.

Furthermore, the combination of MDMA with other substances such as caffeine, amphetamines, mephedrone (a drug similar to amphetamines), marijuana or alcohol may increase the risk of adverse side effects related to MDMA.

Sub-acute effects

Recreational use of MDMA is often characterized by taking the drug repeatedly for several days (binging) and then not using it for a time. In an animal study, this pattern of consumption produced irregular heartbeats (arrhythmia) and cardiac injury. In the weeks following drug use, many people report depression, impaired memory, and attention, anxiety, aggressiveness, and irritability.

Effects of regular MDMA consumption

Regular consumption of MDMA has been associated with sleep problems, loss of appetite, difficulty concentrating, depression, heart diseases, and impulsivity. Furthermore, the heavy consumption of MDMA over two years is associated with decreased cognitive function.

Some of these problems may not be directly attributable to MDMA but may be related to some of the other drugs that are used in combination with MDMA, such as cocaine, alcohol, or marijuana, or to the adulterants commonly found in MDMA tablets. More research is needed to understand what the specific effects of regular MDMA consumption are.