MDMA (Ecstasy) Signs, Symptoms & Side Effects

Last Updated: January 18, 2024

Editorial Policy | Research Policy

Article at a glance:

  • MDMA, also known as ecstasy or Molly, is a synthetic, illegal drug that produces stimulant and hallucinogenic effects.
  • The FDA classifies MDMA as a Schedule I controlled substance with a high potential for abuse and no recognized medicinal use.
  • After ingesting MDMA, a person will experience distorted senses, increased energy, and feelings of joy and empathy.
  • Acute side effects of MDMA include increased body temperature, risky sexual behavior, and impaired driving ability.
  • MDMA overdose can lead to kidney failure, brain swelling, and heart failure.
  • Chronic use of MDMA can deplete serotonin levels, negatively impacting the brain and causing long-term side effects.

While ecstasy is often used for its energy and pleasure-generating effects, the drug is associated with many MDMA side effects, some of which are extremely dangerous.

MDMA, also known as ecstasy or Molly, is a synthetic, illegal substance that produces stimulant and hallucinogenic effects. The popularity of this drug grew in the 1980s at club scenes and “raves” because it generates energy and creates feelings of pleasure. However, MDMA is associated with a host of side effects, some of which are extremely dangerous.

The FDA classifies MDMA as a Schedule I controlled substance, meaning it has no recognized medicinal use and a high potential for abuse. It is important to note MDMA is currently in phase three clinical trials as a potential treatment for post-traumatic syndrome disorder.

What Does Molly (MDMA) Feel Like?

Molly is generally available as a tablet or capsule that is swallowed. Sometimes a user may crush the tablet and snort the powder into the nostrils. When swallowed as a pill, Molly’s effects can be felt in about 45 minutes and last approximately four to six hours.

After ingesting Molly, the person will experience a distorted sense of time and altered sensory perceptions, particularly with the sense of touch. It also gives the individual increased energy and feelings of joy. In addition to euphoria, Molly is well known for enhancing sensations of empathy and closeness to others. It allows the person to feel more self-confident and may increase sexual desire.

MDMA Side Effects

The use of MDMA can result in several adverse reactions. Some have an acute or rapid onset of action. Other side effects, particularly from repeated use, may have long-term consequences. Acute side effects of this drug include:

  • Nausea
  • Muscle cramps
  • Clenching teeth and grinding jaw
  • Loss of appetite
  • Headache
  • Chills
  • Sweating
  • Dehydration
  • Rise in blood pressure
  • Feeling faint
  • Restless legs
  • Panic attacks
  • Lowers the ability of the heart to pump blood (with regular use)
  • Electrolyte imbalance, especially of sodium
  • Elevated body temperature (hyperthermia)
  • Abnormal heart rhythms
  • Kidney failure
  • Swelling of the brain
  • Loss of consciousness
  • Seizures

Other Dangers of MDMA

Due to the environment this drug is usually taken in — dance parties and “raves” — physical activity, like dancing in crowds for long periods, can intensify the elevated body temperature (hyperthermia) side effect. Also, because the drug lowers a user’s inhibitions, an individual is more likely to engage in risky behavior.


MDMA, even in modest amounts, can cause a significant body temperature increase. The hyperthermia effect is amplified if an individual is in hot, crowded areas and dancing/moving for extended periods. Hyperthermia can be fatal, so treatment is necessary if this occurs. As the body temperature rises, muscle breaks down, disrupting the balance of electrolytes, which may lead to kidney failure and brain swelling.

Risky Behavior

MDMA generates feelings of emotional closeness to others, even those you may not know, and it stimulates sexual arousal. Those who ingest MDMA feel a need to touch and be touched. As a result of the combination of these effects, the drug may lead to risky sexual behavior. Males and females are more likely to engage in sexual acts and may be less likely to partake in these behaviors responsibly. For example, you may be less likely to wear a condom, increasing the risk of contracting a sexually transmitted disease like HIV. Because an individual’s senses are altered, their ability to drive a car or operate machinery is also severely compromised.

MDMA Overdose

An individual can certainly overdose on MDMA. Signs and symptoms of an MDMA overdose include:

  • Vomiting
  • Rapid rise in body temperature
  • Increased blood pressure
  • Dizziness
  • Confusion
  • Muscle cramps or twitches
  • Heart palpitations
  • Seizures

Kidney failure and brain swelling may occur due to the dehydration and electrolyte imbalance associated with this drug. MDMA causes the body to retain water, but because people feel dehydrated, they may be inclined to drink large amounts of water, worsening the electrolyte imbalance and increasing the risk for kidney failure and brain swelling. The heart’s ability to pump blood effectively is decreased for those who use Molly regularly; therefore, heart failure may be another impact of overdose.

Individuals who mix MDMA with alcohol or opioids are at an increased risk of overdose. Also, because ecstasy/Molly is an illegal drug, it may be combined or “cut” with other drugs that can cause or increase the risk of overdose. Drugs that can be “cut” with MDMA include:

  • Ketamine
  • Caffeine
  • Bath salts
  • Cocaine
  • Methamphetamine
  • Fentanyl

Long-term Side Effects of MDMA

MDMA exerts its effects by working on several chemical messengers in the brain, including serotonin and dopamine. It increases these neurotransmitters, which have a role in controlling mood, sleep, energy, heart rate and blood pressure, sex and activity in the brain’s reward system. These can all be affected long-term with the chronic use of MDMA.

Serotonin Syndrome

MDMA causes a significant release of serotonin into the body. Too much of this neurotransmitter can produce serotonin syndrome, which is a dangerous and potentially fatal reaction characterized by:

  • Rapid rise in heart rate and blood pressure
  • Inability to sleep
  • Confusion
  • Excessive sweating
  • Tremor
  • Hyperthermia
  • Muscle rigidity
  • Muscle twitching or jerking
  • Seizures
  • Renal failure
  • Respiratory failure
  • Coma
  • Death

It is also important to point out that chronic and long-term use of MDMA could deplete the body of serotonin, negatively impacting the brain. It can lead to the following long-term side effects:

  • Depression
  • Anxiety
  • Paranoia
  • Confusion
  • Memory impairment
  • Difficulty focusing
  • Impulsivity and aggression
  • Difficulty sleeping

Dopamine Syndrome

Dopamine is a neurotransmitter involved with the brain’s reward system. For example, when we eat a delicious dessert, dopamine allows us to feel pleasure. This sense of satisfaction or pleasure motivates us to obtain that feeling again. Having too much dopamine causes a person to be more impulsive and, therefore, more likely to engage in risky behaviors like unprotected sex. It can also generate aggressiveness.

MDMA Comedown

The effects of MDMA can last up to six hours; however, coming down from the drug can last several days and is associated with unpleasant feelings. An individual coming down from MDMA may experience the following signs and symptoms:

  • Sleep disturbances
  • Fatigue
  • Muscle aches
  • Anxiety
  • Depression
  • Agitation
  • Difficulty focusing and concentrating

Get Help for MDMA Addiction in South Jersey

Although the perceived positive effects of MDMA seem attractive, the negative physiological, psychological and behavioral consequences are dangerous. Coming off of this drug is difficult and may require medical detox and treatment. The Recovery Village Cherry Hill at Cooper is a full-service addiction rehabilitation center equipped to help anyone with a substance use disorder.

During medical detox, a licensed medical professional will monitor any symptoms you may experience as the drug leaves your body. Our center offers individual and group therapy and treatment for any co-occurring mental health disorders. If you or someone you know is struggling with MDMA abuse, contact us today, and a member of our highly-qualified team will answer any questions and discuss treatment options available for your individual needs.


National Institute on Drug Abuse. “MDMA (Ecstasy) Abuse Research Report: What is MDMA?” September 2017. Accessed August 26, 2022.

Drug Enforcement Administration. “Drug Fact Sheet: Ecstasy/MDMA.” April 2020. Accessed August 26, 2022.

Mitchell, Jennifer M; et al. “MDMA-Assisted Therapy for Severe PTSD: A[…]rolled Phase 3 Study.” Nature Medicine, May 10, 2021. Accessed August 26, 2022. “MDMA.” Accessed August 26, 2022.

National Institute on Drug Abuse. “MDMA (Ecstasy) Abuse Research Report: Wh[…]the Effects of MDMA?” September 2017. Accessed August 26, 2022.

National Institute on Drug Abuse. “MDMA (Ecstasy) Abuse Research Report: Wh[…]ffects on the Brain?” September 2017. Accessed August 26, 2022.

Better Health Channel. “Ecstasy (MDMA).” October 29, 2020. Accessed August 26, 2022.

Volpi-Abadie, Jacqueline; et al. “Serotonin Syndrome.” The Ochsner Journal, 2013. Accessed August 26, 2022.

Arias-Carrion, Oscar; et al. “Dopaminergic Reward System: A Short Integrative Review.” International Archives of Medicine, October 6, 2010. Accessed August 26, 2022.

O’Sullivan, Sean S.; Evans, Andrew H.; Lees, Andrew J. “Dopamine Dysregulation Syndrome: An Over[…]nisms and Management.” CNS Drugs, 2009. Accessed August 26, 2022.

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