Fact Sheet - Ecstasy

• Psychological effects from using MDMA (ecstasy) can include confusion, depression, sleep problems, drug craving, and severe anxiety. These problems can occur while taking MDMA, and sometimes days or weeks afterward.

• Ecstasy tablets may contain other substances in addition to MDMA, such as ephedrine (a stimulant); dextromethorphan (DXM, a cough suppressant that has PCP-like effects at high doses); ketamine (an anesthetic used mostly by veterinarians that also has PCP-like effects); caffeine; cocaine; and methamphetamine.

• MDMA can interfere with the body's ability to regulate its temperature, which can cause dangerous overheating (hyperthermia). This, in turn, can lead to serious heart, kidney, and liver problems, and rarely, death.

• Methylenedioxyamphetamine (MDA), methylenedioxyethylamphetamine (MDEA), and paramethoxyamphetamine (PMA) are chemically similar to MDMA. They are sometimes found in ecstasy tablets and can produce deleterious health effects.

• MDMA is usually taken orally, via a tablet or capsule. Its effects last approximately 3 to 6 hours, though depression, sleep problems, and anxiety have been reported for days to weeks afterwards.

• MDMA can cause a marked increase in body temperature (hyperthermia), which may further be exacerbated by hot and crowded conditions characteristic of the rave environment. Hyperthermia can lead to liver, kidney, and cardiovascular system failure. MDMA can interfere with its own metabolism (breakdown), so repeated use over a short interval of time can lead to especially elevated and harmful levels in the body.

• MDMA users can become dehydrated, prompting increased water consumption. In some cases, this has led to the problem of "water intoxication" or hyponatremia [low sodium], a potentially fatal condition in which excessive water consumption causes a dramatic decrease in sodium concentrations in the blood and extracellular fluids. MDMA can affect the hormone that regulates the amount of sodium in the blood, which can also cause hyponatremia.

• Recent animal studies have shown that binge use of MDMA is toxic to the heart. Health effects observed included arrhythmia, heart muscle damage, and reductions in heart rate and blood pressure. (Initially, MDMA increases heart rate and blood pressure, but following repeated use, this effect is reversed.)

• The 2003 and 2004 Monitoring the Future Surveys report a significant increase in the percentages of U.S. 10th graders perceiving occasional MDMA use as risky. The surveys also found that significantly more 10th and 12th graders disapprove of taking MDMA once or twice. Perceived availability of MDMA significantly decreased among 8th-, 10th-, and 12th-grade students.

• Brain imaging research in humans indicates that MDMA may affect neurons that use the chemical serotonin to communicate with other neurons. The serotonin system plays a direct role in regulating mood, aggression, sexual activity, sleep, and sensitivity to pain.

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