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Short-Term Effects of MDMA

When MDMA is taken in tablet or capsule form, a person begins feeling the effects 45 minutes later, on average. These effects peak 15 to 30 minutes after they are first felt and last an average of 3 hours, though side effects could be experienced up to days later.

People typically take one to two tablets on each occasion, with each tablet generally containing between 50 and 150 milligrams of MDMA. People often take a second dose of the drug as the effects of the first dose begin to fade, increasing the risk of adverse side effects as doses combine.

Effects Include:

  • Enhanced sense of well-being
  • Increased extroversion
  • Emotional warmth
  • Empathy toward others
  • Willingness to discuss emotionally-charged memories
  • Enhanced sensory perception

Symptoms of MDMA Overdose

While fatal overdoses on MDMA are rare, they can potentially be life-threatening—with symptoms including high blood pressure (hypertension), faintness, panic attacks, and in severe cases, a loss of consciousness and seizures.

Adverse Health Effects of MDMA Use

MDMA can cause a number of acute adverse health effects. Because of its stimulant properties and the situations in which it is often taken, MDMA is associated with vigorous physical activity for extended periods in warm environments. This can lead to one of the most significant, although rare, acute adverse effects—a marked rise in body temperature (hyperthermia). Treatment of hyperthermia requires prompt medical attention, as it can rapidly lead to muscle breakdown or an electrolyte (sodium) imbalance, which can in turn produce kidney failure or fatal swelling of the brain, especially in women.

MDMA use in combination with vigorous exercise causes dehydration, leading some people to drink large amounts of liquids. However, this could increase the risk of electrolyte imbalance or brain swelling because MDMA causes the body to retain water. One modest dose of MDMA can also reduce the pumping efficiency of the heart in people who use regularly, which is of particular concern during periods of increased physical activity.

Other adverse health effects can include:

  • Involuntary jaw clenching & teeth grinding
  • Lack of appetite
  • Mild detachment from oneself (depersonalization)
  • Illogical or disorganized thoughts
  • Restless legs
  • Nausea
  • Hot flashes or chills
  • Headache
  • Sweating
  • Muscle or joint stiffness
  • Marked rise in body temperature (hyperthermia)
  • Dehydration
  • Electrolyte (sodium) imbalance
  • High blood pressure (hypertension)
  • Faintness
  • Panic attacks
  • Loss of consciousness
  • Seizures
  • Kidney failure

In the hours after taking the drug, MDMA produces significant reductions in perceiving and predicting motion—for example, the ability to judge whether a driver is in danger of colliding with another car. This emphasizes the potential dangers of performing complex or skilled activities, such as driving a car, while under the influence of this drug.

Once MDMA is metabolized, or broken down in the body, its byproducts interfere with the body's ability to metabolize MDMA. As a result, additional doses of MDMA can produce unexpectedly high blood levels, which could worsen the toxic effects of this drug. In addition, combining MDMA with other substances, such as caffeine, amphetamines, the amphetamine-like mephedrone, marijuana, or alcohol, may increase the risk of adverse health effects associated with MDMA.

Effects of an MDMA Binge

Recreational use of MDMA is often characterized by repeated drug taking over a number of days (binges), followed by periods of no drug taking. In one animal study, this pattern of use produced irregular heartbeat (arrhythmia) and heart damage.

In the week following use of the drug, many people report depression, impaired attention and memory, anxiety, aggression, and irritability.