People who use MDMA describe themselves as feeling euphoric, open, accepting, unafraid, and connected to those around them.1 Typically used in social settings like festivals, concerts and clubs, MDMA’s effects are stimulated by visuals, sounds, smells and touch, leading to heightened sensations and a desire to intensify these feelings by dancing, talking and touching.

A typical dose of 80 - 125 mg lasts three to six hours. Some people experience nausea at the outset, but after about 45 minutes, report feelings of relaxation and clarity. MDMA also causes dilation of the pupils and, often, sensitivity to light, as well as possible jaw-clenching, tooth-grinding, muscle tension, faintness, and chills or sweating.

After the drug wears off, the theory from preclinical studies is that brain levels of serotonin (a chemical responsible for maintaining mood balance) are depleted, which can lead in some cases to sadness, anxiety, depression and sleep problems.2 If they occur, these symptoms arise in the several days that follow. Generally, they abate within a week, though frequency of use and higher doses can slow or stop this process.3

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  1. RL Carhart-Harris et al., "The effect of acutely administered MDMA on subjective and BOLD-fMRI responses to favourite and worst autobiographical memories," International Journal of Neuropsychopharmacology 17, no. 4 (2014); G. Bedi, D. Hyman, and H. de Wit, "Is ecstasy an "empathogen"? Effects of +/-3,4-methylenedioxymethamphetamine on prosocial feelings and identification of emotional states in others," Biol Psychiatry 68, no. 12 (2010): 1134-40; C. M. Hysek, G. Domes, and M. E. Liechti, "MDMA enhances "mind reading" of positive emotions and impairs "mind reading" of negative emotions," Psychopharmacology (Berl) 222, no. 2 (2012); C. M. Hysek et al., "MDMA enhances emotional empathy and prosocial behavior," Soc Cogn Affect Neurosci 9, no. 11 (2014); M. Kirkpatrick et al., "Prosocial effects of MDMA: A measure of generosity," J Psychopharmacol (2015); M. G. Kirkpatrick and H. de Wit, "MDMA: a social drug in a social context," Psychopharmacology (Berl) 232, no. 6 (2015); M. C. Wardle and H. de Wit, "MDMA alters emotional processing and facilitates positive social interaction," Psychopharmacology (Berl) 231, no. 21 (2014).
  2. National Institute on Drug Abuse, “What does MDMA do to the brain?” (2006),….
  3. Ralph Buchert et al., "Long-Term Effects of “Ecstasy” Use on Serotonin Transporters of the Brain Investigated by PET," Journal of Nuclear Medicine 44, no. 3 (2003): 375-84; Jennifer Do and Susan Schenk, "Self-administered MDMA produces dose- and time-dependent serotonin deficits in the rat brain," Addiction Biology 18, no. 3 (2013): 441-47.