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Side Effects of Ecstasy Abuse

Ecstasy is an intoxicating, hallucinogenic, psychedelic drug, known generically as 3,4-methylenedioxymethamphetamine (MDMA). It is also known as Molly.

Ecstasy abuse can cause various side effects, ranging from minor symptoms like increased thirst to severe effects such as brain damage. 

Why Does Ecstasy Cause Side Effects? 

This drug was synthesized prior to World War I, but it did not become a popular pharmaceutical or prescription medication until the 1970s. At this time, therapists in the U.S. began to prescribe small doses to clients who needed to depersonalize themselves from their trauma or feel closer to their therapist or their spouse during marriage counseling.

Ecstasy was so misused throughout the 1970s and 1980s in the nightclub, disco, and rave scenes, that the  U.S. Drug Enforcement Administration (DEA) moved it to the Schedule I list. Under the Controlled Substances Act (CSA), this means that there is no medical use for ecstasy. It is instead designated as a dangerous, addictive chemical that should not be used.

Ecstasy was so misused throughout the 1970s and 1980s in the nightclub, disco, and rave scenes, that the  U.S. Drug Enforcement Administration (DEA) moved it to the Schedule I list. Under the Controlled Substances Act (CSA), this means that there is no medical use for ecstasy. It is instead designated as a dangerous, addictive chemical that should not be used.

When taking ecstasy, people seek a euphoric high, greater pleasure from touch or sounds, stimulation to dance all night, and feeling good about other people and the world. The flood of serotonin and dopamine triggered by ecstasy can lead to intense, exuberant feelings, which lead people to use the drug repeatedly.

There are several negative side effects due to overstimulation of the brain. These can become dangerous and can lead to overdose, which is an acute risk of abusing ecstasy. The side effects can also cause long-term damage to the brain and body. 

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Short-Term Side Effects

Ecstasy causes an intense, euphoric high, but it can also trigger other short-term side effects that are much more uncomfortable and even harmful.

  • Heightened senses
  • Dissociation from reality
  • Muscle tension
  • Hallucinations, including sounds, sights, and tactile sensations
  • Anxiety
  • Paranoia
  • Restlessness
  • Irritability
  • Nausea
  • Vomiting
  • Clenching the teeth or jaw
  • Dehydration
  • Elevated body temperature
  • Extreme relaxation, which may lead to passing out
  • High blood pressure
  • Heart rhythm problems
  • Faintness
  • Chills and sweating, like having the flu
  • Blurry vision or nystagmus (rapid quivering of the pupils)

These side effects are uncomfortable, but dehydration and high body temperature can be very dangerous.

Dehydration occurs when you lose more fluids than you take back in. Your body no longer has enough water for normal cell functions. Replacing fluids is important.

Anyone can suffer from dehydration, although children and elderly adults are the most at risk.

Dehydration is also a serious risk among club-goers. They may combine ecstasy with other stimulants, psychedelics, depressants, or alcohol. At a dance party, there is also a lot of physical activity, which leads to sweating and high body temperature. This increases the risk of becoming dehydrated.

Adult dehydration symptoms include the following:

  • Extreme thirst
  • Less frequent urination
  • Dark urine
  • Dizziness
  • Fatigue
  • Confusion

Someone on ecstasy may not be able to recognize these initial symptoms, and they may not feel them as intensely. This can lead to severe dehydration, which includes life-threatening symptoms.

  • Heat injury if the area is too hot
  • Urinary trouble
  • Kidney damage
  • Seizures
  • Low blood volume, or hypovolemic shock, which causes a drop in blood pressure and can reduce how much oxygen your body gets

Hyperthermia and Heat-Related Issues

Hyperthermia, or overheating, is also a serious risk while on ecstasy. Hyperthermia starts with heat stress when your body is no longer able to keep you cool with sweating. This may lead to exhaustion and heat stroke. You may feel dizzy, weak, thirsty, nauseated, and develop a headache.

Woman awake at night from Ecstasy abuse

You will then develop heat fatigue, after long hours, which makes focusing on tasks difficult.

Heat syncope is the medical term for fainting due to heat stroke, which makes it more difficult for you to stay safe and prevent further hyperthermic complications.

Heat cramps are muscle problems due to less water and high heat. Heat edema is swelling caused by hyperthermia, which is usually due to too much sodium in the blood. Heat rash is red, pimple-like bumps on your skin that go away after you cool down.

Heat exhaustion can also be associated with a rapid pulse, which can damage the heart or increase the risk of cardiac arrest.

Heat stroke is the most serious stage of hyperthermia, requiring medical attention. This begins when the body’s internal temperature reaches 104 degrees Fahrenheit, or 40 degrees Celsius. The first sign is fainting, but there are other signs. 

  • Confusion
  • Irritability
  • Loss of physical coordination
  • Flushed skin
  • Reduced or cessation of sweating
  • Rapid or weak pulse

Like dehydration, someone high on ecstasy may not notice the signs of hyperthermia until it becomes heat stroke. This can seriously damage the body and brain.

Severe Harm From Sustained Abuse

Becoming addicted to ecstasy or consistently abusing it can lead to dependence on the drug, which occurs when the brain needs the presence of the chemical to feel normal. You can also become tolerant to ecstasy, meaning you need to take more to feel the same high as the first dose.

These are problematic experiences because they indicate that you are abusing a lot of a dangerous substance.

Long-term side effects from abusing ecstasy include the following:

  • Confusion
  • Depression
  • Paradoxical anxiety
  • Sleep problems, including insomnia or night terrors
  • Cravings for the drug, leading to binges
  • Paranoia
  • Memory loss

Depletion of serotonin can lead to dementia symptoms over time. Long-lasting memory damage is a symptom that may not heal for years, and damage to internal organs like the kidneys will require ongoing medical treatment for life.

Sometimes, ecstasy abuse can trigger psychosis, which will require either short-term treatment in a hospital until symptoms go away or ongoing medical treatment and counseling if it becomes a chronic mental illness.

The only way to avoid long-term problems from ecstasy is to quit abusing it. This will likely require medical treatment at a detox program and comprehensive therapy. These are evidence-based approaches to treatment, which have been shown to help people avoid relapse.


(October 29, 2013). Ecstasy. Center for Substance Abuse Research (CESAR). from

(September 2017). What are MDMA’s Effects on the Brain? National Institute on Drug Abuse (NIDA). from


(May 23, 2017). What is Hyperthermia and How is it Treated? Healthline. from

Ecstasy (MDMA). Student Health and Counseling Services, UC Davis. from

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