Ecstasy (or MDMA) use can cause psychoactive effects, lower inhibitions and suppress fatigue and pain, but it can also lead to cognitive impairment and a deadly fever.

Ecstasy (or MDMA) use can cause psychoactive effects, lower inhibitions, and suppress fatigue and pain. While MDMA’s marketers may highlight these effects, they often do not mention nausea, muscle cramps, the potentially deadly temperature spikes, or the cognitive impairment that can follow chronic use.

People also seem to develop a tolerance for Ecstasy fairly rapidly. Thus, with repeated abuse, it becomes difficult, if not impossible, for people to experience the same effects as the first time they took the drug. Here are the short-term and long-term signs, symptoms and side effects of using Ecstasy recreationally.

Article at a Glance:

  • Ecstasy’s physical symptoms include nausea, fever, hallucinations, high heart rate and cramping.
  • A person taking ecstasy may feel increased energy, great pleasure, heightened sexuality and euphoria.
  • Ecstasy is not considered an addictive substance; however, people can become dependent on using it.
  • It is common for someone to believe they are taking ecstasy when they are actually taking an unknown substance that is counterfeit ecstasy.
  • Long-term effects of chronic ecstasy use include insomnia, memory loss, depression and fatigue.

Ecstasy Side Effects

Ecstasy can have numerous undesirable side effects, including transient hypertension and problems with thermoregulation – resulting in elevated body temperature. When individuals begin to abuse Ecstasy habitually, they can develop a tolerance to the substance, so they need larger doses to achieve the same level of effects.

Graphic highlighting the physical symptoms of Ecstasy abuse
Common Side Effects of Ecstasy/MDMA
  • 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

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

Short-Term Effects

Shortly after taking the drug, the individual may experience a range of 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. These can include:

  • A 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

Additional short-term 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.

Long-Term Effects

While research on the long-term effects of Ecstasy abuse is ongoing, certain traits are shared by regular abusers. For example, a large review of studiesregarding MDMA use in animals and humans found irreparable damage to transporters for the neurotransmitters serotonin and dopamine.

Researchers believe that the drug causes a flood of serotonin in the brain during usage, and its overproduction causes the damage. 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 an addictive substance, a report in Scientific American suggests that some people may become dependent on or addicted to the substance. Most people who abuse MDMA restrict their abuse to weekends because frequent misuse quickly reduces the positive effects as a tolerance to the substance develops.

Street drug dealers market MDMA 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 abusers risk overdose and premature death. Moderate to heavy abusers risk addiction, as well as long-term impairments in psychological and cognitive functioning.

Misusers of MDMA often lose their ability to relate to and enjoy being with other people without the influence of a mind-altering, dangerous substance, at least temporarily.

Behavioral Changes

Infographic showing the behavioral signs associated with ecstasy use

Ecstasy abuse is commonly connected with having multiple sexual partners. People abusing the drug can feel they are deeply in love with the person they are involved with, even if they just met. These feelings often persist until the effect wears off.

Even if a person avoids death from overheating or overdose, cravings can very quickly set in. These cravings can drive a person to use Ecstasy continuously, even when they know it is harmful.

Other behavioral signs could include an irregular sleeping schedule and a lack of awareness of pain. For example, if a person gets injured but has no reaction or doesn’t even realize it.

Common Signs of Ecstasy Use

Ecstasy is often taken with other substances, which can alter the symptoms and make it difficult to spot signs of abuse. However, some key symptoms may make it easier to determine that someone is abusing the substance.

Changes in Activities
  • 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
Changes in Physical Appearance
  • Nausea
  • Chills
  • Sweating
  • Blurred vision
  • Dilated pupils
  • Muscle cramps
  • Tight, clenched jaw
  • Overheating
  • Collapsing

When an individual becomes dependent on the drug, they may continue to frequently attend dance parties. They’ll use the substance even though, in lucid moments when not on the drug, they realize the damage they are doing.

Common Symptoms of Ecstasy Use

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 abuse it 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.

Long-Term Ecstasy Symptoms

Some of the signs that someone is chronically abusing Ecstasy include problems sleeping and insomnia, memory loss, anxiety, paranoia, lethargy or fatigue, and depression. They may also exhibit some of the general signs of substance abuse, 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.

Ecstasy abuse can change the brain’s chemistry rapidly, affecting its ability to release and metabolize serotonin.  These changes can result in memory impairment, anxiety, depression, and confusion. Additional symptoms of Ecstasy abuse include poor performance on short-term and long-term memory. Tests have shown that even brief exposure to Ecstasy can result in damage that lasts years.

Many risks come with abusing Ecstasy, including the risk of unknowingly taking a substance other than Ecstasy, as well as short-term and long-term health conditions affecting the body’s temperature regulation system and cardiovascular system. Individuals who take Ecstasy may also participate in riskier and more dangerous behaviors than before. Possessing Ecstasy is also a criminal offense, with legal and financial consequences awaiting the user.

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. Abusing Molly/MDMA/Ecstasy can lead to serious health effects, including death. You can seek professional and medical assistance at a detox and rehab treatment center like The Recovery Village.

Melissa Carmona
Editor – Melissa Carmona
As the content manager at Advanced Recovery Systems, Melissa Carmona puts years of writing and editing experience to work helping people understand substance abuse, addiction and mental health disorders. Read more
Benjamin Caleb Williams
Medically Reviewed By – Benjamin Caleb Williams, RN
Benjamin Caleb Williams is a board-certified Emergency Nurse with several years of clinical experience, including supervisory roles within the ICU and ER settings. Read more

Hanson, Karen; Luciana, Monica. “Neurocognitive impairments in MDMA and other drug users: MDMA alone may not be a cognitive risk factor.” Journal of Clinical and Experimental Neuropsychology, September 30, 2009. Accessed June 15, 2020.

Vegting, Yosta; Reneman, Liesbeth; Booij, Jan. “The effects of ecstasy on neurotransmitter systems: a review on the findings of molecular imaging studies.” Psychopharmocology, August 28, 2016. Accessed June 15, 2020.

Merle Gordon, Susan. “What are the effects of the drug Ecstasy?” Scientific American, July 5, 2001. Accessed June 15, 2020.

National Institute on Drug Abuse. “MDMA (Ecstasy) Abuse Research Report What are MDMA’s effects on the brain?” April 9, 2020. Accessed June 15, 2020.

Wagner, Daniel et al. “A prospective study of learning, memory, and executive function in new MDMA users.” Society for the Study of Addiction, January 2013. Accessed June 15, 2020.

Rodgers, J. et al. “Patterns of Drug Use and the Influence of Gender on Self-Reports of Memory Ability in Ecstasy Users: A Web-Based Study.” Journal of Psychopharmocology, December 1, 2003. Accessed June 15, 2020.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.