Ecstasy Side Effects, Signs, and Symptoms

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Ecstasy was originally developed using the chemical methylenedioxymethamphetamine, and was commonly used as a party drug. It was first used by the United States Army in psychological warfare tests and then resurfaced in the 1960s as a psychotherapy medication to “lower inhibitions.” It wasn’t until the 1970s that MDMA started being used as a party drug.

Ecstasy use can cause psychoactive effects, lower inhibitions and suppresses fatigue and pain. Other stimulants typically used in ecstasy are: methamphetamine, amphetamine, ephedrine and caffeine. Other hallucinogens used in Ecstasy are: PCP, LSD, nexus and ketamine. Because MDMA is a man-made drug, manufacturers can add anything to the substance – like caffeine, dextromethorphan, amphetamines, PCP, or cocaine – so its purity is always questionable.

Ecstasy generally comes in tablets of various shapes and colors, often with recognizable designs stamped on them (hearts, stars, butterflies, clover leaves, etc.). The substance is mainly ingested by swallowing the tablet, but may sometimes be snorted, smoked, or injected intravenously. The dosage of MDMA in one tablet can vary from 12 mg all the way up to 131 mg, so the effects of taking ecstasy can vary considerably.

People seem to develop a tolerance for ecstasy fairly rapidly. Thus, with repeated misuse, it becomes difficult, if not impossible, for people to experience the same effects that they did the first time they took the drug. For some people, ecstasy may create a psychological dependence. As far as physical dependence is concerned, most of the problems caused by ecstasy arise from taking large doses on one occasion.

Ecstasy Side Effects

There are questions as to whether the cognitive impairments are due to MDMA misuse alone or to heavy substance misuse in general, since many individuals who take MDMA also engage in other substance misuse. There is evidence that the persistent cognitive impairments seen in moderate MDMA misusers are no more severe than those seen in heavy substance misusers in general, but that multi-substance misuse in conjunction with MDMA might increase these risks.

When individuals begin to misuse ecstasy habitually they can develop a tolerance to the substance, so they need larger doses to achieve the same level of effects.

Ecstasy Misuse by the Numbers 

  • About 2.8 million Americans (12-years-old and older) reported misusing ecstasy at least once during a year.
  • 2.5 percent of 8th graders, 4.7 percent of high school sophomores and 4.5 percent of high school seniors said that they tried ecstasy.  
  • Other street names for ecstasy are: X, XTC, and love drug.
  • 2 percent of individuals who misused ecstasy within the last year also misused alcohol during those 12 months.

Possible Side Effects of Ecstasy MDMA Use

Often taken in pill or tablet form, ecstasy can have numerous, undesirable side effects, including transient hypertension and problems with thermoregulation – resulting in elevated body temperature.

Like most substances, ecstasy produces unexpected and even dangerous side effects that include:

  • Nausea
  • Muscle cramping
  • Fever
  • Sweating and chills
  • Shaking and tremors
  • Hallucinations
  • Blurred vision
  • Higher heart rate
  • Increased blood pressure  
  • Tension in the mouth, face and jaw
  • Feeling faint
Shortly after taking ecstasy, the individual misusing the substance may experience a range of ecstasy side effects due to the combination of the stimulant and hallucinogenic properties. Some desired effects of ecstasy can begin in as little as 30 minutes and last for up to 6 hours include:

  • Perceived increase in energy levels
  • Euphoric state of being
  • Distorted perception of time
  • Higher pleasure from physical touch
  • Increased levels of sexuality and sexual arousal   
  • Increased energy and focus

Feelings of emotional peace and empathy are also common, possible side effects of ecstasy use. Additional short-term ecstasy side effects include the suppression of certain basic physical needs — for example, eating, drinking and sleeping — because of the stimulant effect of the substance. As a result, an individual on ecstasy may attend contemporary “rave” parties, or dance and music festivals that may exceed 24 or even 48 hours in duration — all while focusing on loud, electronic music, flashing lights, and extended periods of dancing to enhance the effects of the substance.

While research on the long-term effects of ecstasy is ongoing, certain traits are shared by regular misusers. For example, a 1998 study asserted that irreparable damage to serotonin neurotransmitters was observed in a group of individuals who misused ecstasy. Researchers believe that ecstasy causes a flood of serotonin in the brain during usage, and the damage is caused by the overproduction. Because serotonin levels affect learning, sleep and emotional processes, this damage can leave people with an ecstasy use disorder severely impaired.

Without proper functioning neurotransmitters, conditions like depression, anxiety, insomnia and memory loss are more likely to occur. These conditions can be present for long periods of time, even after ecstasy use ended.

Although MDMA is not generally considered to be an addictive substance, recent reports in the scientific literature suggest that some people may become dependent on or addicted to the substance. Most people who misuse MDMA restrict their misuse to weekends because frequent misuse quickly reduces the positive effects as a tolerance to the substance develops.

MDMA is marketed by street drug dealers as a safe, non-addictive recreational drug that enhances a person’s enjoyment and ability to interact with others. Nothing could be further from the truth. Even the occasional light misusers of MDMA risk overdose and premature death. Moderate to heavy misusers risk addiction, as well as long-term impairments in psychological and cognitive functioning. All misusers of MDMA at least temporarily lose their ability to relate to and enjoy being with other people without the influence of a mind-altering, dangerous substance.

Ecstasy Signs and Symptoms

Evidence that an individual may be misusing ecstasy regularly is the presence of small colored pills in the person’s pockets or bags, or candy necklaces on stretchy strings. Some of the “candy” may be ecstasy tablets. Other signs of ecstasy misuse could include an irregular sleeping schedule and a lack of awareness of pain. For example, if a person gets injured but had no reaction or didn’t even realize it, they could be misusing ecstasy.

Ecstasy misuse is commonly connected with multiple sexual partners. A sign of ecstasy misuse includes an individual feeling they are in love with the person they are involved with, even if they just met. One of the most dangerous ecstasy signs and symptoms (other than the possibility of death from overheating or overdose) is the cravings that can very quickly set in. These cravings can drive a person to use ecstasy continuously, even when they know it is harmful.

Signs of Ecstasy

It can be difficult to spot signs of ecstasy misuse due to the fact that it is so often taken with other substances, which alters the symptoms. There are, however, some key ecstasy symptoms that may make it easier to determine that someone is misusing the substance.

Changes in activities signs can include:

  • High levels of stimulation
  • Unusual levels of energy
  • Long hours awake
  • Acting abnormally friendly
  • Dancing for long periods of time

Changes in reactions:

  • Overly sensitive to music or lights
  • Exaggerated pleasure from touch
  • Pain is dulled

Physical Changes:

  • Nausea
  • Chills
  • Sweating
  • Blurred vision
  • Dilated pupils
  • Muscle cramps
  • Tight, clenched jaw
  • Overheating
  • Collapse

When an individual becomes dependent on ecstasy, they may continue to go to dance parties and use the substance even though, in lucid moments when not on the drug, they realize the damage they are doing.

Ecstasy Symptoms

Ecstasy stands out from other illicit substances for its ability to heighten feelings of empathy, love, and sexual arousal in those who take it. People who misuse ecstasy report feeling love for everyone in the room and overwhelming joy. They also often experience distortions in the way time passes and may be delighted by their senses, enjoying bright colors and soft textures.

It’s easy to see how this substance could be addictive. MDMA causes the brain to produce an overload of serotonin, dopamine, and norepinephrine. These chemicals are all known to create feelings of happiness and pleasure and reduce depression and anxiety. Once the substance leaves the body, the brain compensates by producing less of these agents, and people often experience depression, anxiety, confusion, sleep problems, and cravings for ecstasy after coming down, even after the first time trying it.  

Not all people who are part of the electronic dance music (EDM) scene misuse ecstasy and not all people who misuse ecstasy will become addicted to it. However, the substance has a high potential for both psychological and physical addiction. Misusing the substance does not mean there is an addiction, however, one study found that 43 percent of surveyed ecstasy misusers fit the criteria for dependence. Psychological dependence requires frequent cravings with the substance and unease when it’s not available.

Some of the signs that someone is chronically misusing ecstasy include problems sleeping and insomnia, memory loss, anxiety, paranoia, lethargy or fatigue and depression. If someone is habitually misusing MDMA, they may also exhibit some of the general signs of substance misuse, which can include a decline in their physical health and their outward appearance, nausea, sweating, coordination problems, changes in sleep and eating habits, laziness or lethargy, mood swings and secrecy.

Individuals who take ecstasy may also participate in what seem like generally risky behaviors compared to what they used to do in the past. Many risks come with misusing ecstasy, including the risk of unknowingly taking a substance other than ecstasy, as well as short-term and long-term health problems that deal with serious issues like the body’s temperature regulation system and cardiovascular issues.

Recent research reveals that changes in the brain take place very quickly after a person starts to misuse ecstasy. These changes can result in anxiety, depression and confusion. Additional symptoms of ecstasy misuse include poor performance on tests requiring memory or cognitive ability. Tests have shown that even brief exposure to ecstasy can result in damage that lasts years.

If you recognize the symptoms of ecstasy use disorder in a loved one or even yourself, it’s important to speak with a representative at The Recovery Village. Misusing Molly, MDMA and ecstasy can lead to serious health effects, including death. For this reason, it’s important to seek professional and medical assistance at a detox and rehab treatment center, like The Recovery Village.

Burch, Kelly. “Record Amount of Cocaine Seized During 2016.” The Fix, 2 Mar. 2017, Accessed 10 Mar. 2017.

CESAR (Center for Substance Abuse Research). “Cocaine.” CESAR (Center for Substance Abuse Research), 29 Oct. 2013, Accessed 10 Mar. 2017.

Doward, Jamie. “Warning of Extra Heart Dangers from Mixing Cocaine and Alcohol.” The Guardian, 7 Nov. 2009, Accessed 10 Mar. 2017.