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Learn how MDMA, also known as molly or ecstasy, affects the brain and body, and find treatment for misuse.

What is MDMA?

MDMA, which is short for 3,4-methylenedioxy-methamphetamine, is a drug that is chemically similar to both stimulants and hallucinogens. MDMA can make people feel euphoria, increased alertness, emotional warmth, and sexual closeness. It can also distort people’s senses and generate unpleasant effects.

MDMA is sold on the street in colorful pills — often stamped with logos or shaped into amusing patterns. These tablets are swallowed or are crushed and snorted. MDMA is also distributed in powder, crystal, or liquid forms. Doses of MDMA are usually between 50 and 150 milligrams. Effects start after about 30 minutes and last up to six hours.

The molly or ecstasy sold on the street is rarely pure MDMA — and may even contain little or no MDMA. Illegally sold products might be tainted with dangerous or poisonous chemicals such as cocaine, methamphetamine, fentanyl, ketamine, or “bath salts” (synthetic cathinones, which are stimulant drugs related to the khat plant).

Taking MDMA can cause health problems and lead to dependence — especially if you take MDMA frequently, in higher doses, or with alcohol or other drugs. Even a regular dose of pure MDMA can harm the body’s ability to regulate temperature, which can cause organ failure and other serious problems.

More health problems tend to occur in people who take high doses of MDMA, which some experts say is anything above 150 milligrams. These problems may include elevations in blood pressure and body temperature. Taking multiple doses of pure MDMA at once, or combining it with alcohol or other illegal or prescription drugs, makes it even less safe. Microdosing — taking a smaller dose, around 20–40 milligrams — can also produce negative side effects, particularly when the microdose is repeated within a short time frame.

What are the differences between MDMA, molly, and ecstasy?

MDMA is short for 3,4-methylenedioxy-methamphetamine. Ecstasy and molly are common slang terms for the substance.

People sometimes think of molly as pure MDMA, but experts warn that illicit molly and ecstasy — whether in pill, powder, crystal, or liquid form — are often laced with other drugs, including fentanyl. Laced MDMA products can be more addictive and have more dangerous effects.

History of MDMA

Experts trace the creation of MDMA to the early 1900s, when it was manufactured for use as a medicinal compound. Starting in the 1970s, it was briefly explored for use in psychiatry. Around the same time, people began taking MDMA recreationally. Now its use is widespread in the United States and around the globe. People often use MDMA to boost their energy and mood while attending clubs, concerts, and all-night dance parties (“raves”).

MDMA is not legal in the United States. However, MDMA is among several drugs being studied for their therapeutic properties for mental health conditions.

Can MDMA treat PTSD and other health conditions?

MDMA is being explored as a treatment for certain medical conditions, such as post-traumatic stress disorder (PTSD) and depression. Researchers are studying how drugs with psychedelic properties, including MDMA, can be used to treat mental health conditions.

Limited research shows that controlled doses of pure MDMA could help treat symptoms of PTSD, depression, and other mental health conditions; the social symptoms of autism spectrum disorder; and anxiety in patients with a terminal illness. In 2017, early proof of MDMA’s potential as a PTSD treatment led the U.S. Food and Drug Administration to grant it “breakthrough therapy” status, a designation that can speed drug development.

However, studies of MDMA’s therapeutic possibilities — and lasting physical effects — are limited due to its classification as a controlled substance. MDMA is still not considered safe for recreational use or approved for medical use.

Effects of MDMA

What does MDMA do to your brain?

MDMA primarily stimulates three brain chemicals (known as neurotransmitters): 

  • Dopamine — giving a feeling of energy.
  • Norepinephrine — increasing heart rate and blood pressure and potentially harming people with heart and vascular conditions.
  • Serotonin — affecting appetite and sleep and stimulating sexual desire and closeness.

Some research indicates that MDMA can damage brain cells, memory, and the ability to learn and feel pleasure. MDMA use can trigger depression, anxiety, and — in rare cases — psychosis. Experts have called for more studies on MDMA’s lasting effects on the brain.


What does MDMA do to your body?

A “normal” oral dose of pure MDMA — usually between 50 and 150 milligrams — can take effect within 30 minutes. The stimulating effects of a single dose tend to peak at 1 1/2 to two hours and go away within four hours, but aftereffects may last for a few days or longer.

People taking a “normal” dose of pure MDMA report feeling more positive and sociable, less aggressive, more emotionally in tune with other people, and more alert. 

Those who use MDMA can also have nausea, sweats, or muscle cramps and can clench their teeth. Some people experience other negative effects for up to a week after taking MDMA; these include anxiety, irritability, sleep issues, and lower pleasure from and desire for sex. 

People with MDMA-induced euphoria who dance or exert themselves in hot or confined areas, such as at a rave, club, or dance party, are at risk of experiencing heatstroke. Hyperthermia, a dangerous spike in body temperature, is one of the most common and serious side effects of MDMA use. Elevations in blood pressure can also occur. People may try to lessen these effects by taking time to cool off and drink fluids — ideally juice or drinks with electrolytes. However, dehydrated MDMA users who quench their thirst with too much water could experience a drop in blood sodium. This condition, called hyponatremia, can cause cramping, vomiting, and, in serious cases, brain damage.

In addition to harming the body’s ability to regulate temperature, MDMA can cause other adverse effects, and the risk of these effects increases at higher doses. At very high doses, MDMA can stress the heart, damage other organs, and, in rare cases, lead to death. And taking MDMA with alcohol or other drugs can lead to poisoning and death.


Is MDMA addictive?

Pure MDMA is not considered as addictive as other illicit drugs such as cocaine, but some people can develop a dependence on the drug and have withdrawal symptoms when they stop using it. Withdrawal symptoms include fatigue, depression, impaired concentration, and loss of appetite.

Can you overdose on MDMA?

Using pure MDMA rarely leads to fatal overdoses. But the illicit form of the drug is not always “pure”: MDMA products are often laced with other dangerous chemicals, including fentanyl. MDMA poisoning more often occurs when the drug is taken with large amounts of alcohol or with other drugs, combinations that increase its toxicity and risk to health.

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Treatment for consequences of MDMA use

To safety stop use of MDMA, seek out a licensed medical professional who can help you develop a treatment plan.

Therapy: Your provider may refer you to a cognitive behavioral therapist, who can help you avoid resuming use of MDMA. Your provider may also suggest group therapy, a 12-step or other support group, or a residential treatment program.

Medication: There is not yet an approved medicine to treat dependence on MDMA.

Holistic recovery: Other ways to promote your recovery could involve complementary and alternative activities such as acupuncture, meditation, spiritual or religious practices, yoga, and art or music therapy. Learn more about pathways to recovery.


Content reviewed by Jasleen Salwan, M.D., MPH, FASAM, August 2023.


3,4-Methylenedioxymethamphetamine (MDMA)-Assisted Therapy in Hawaii: A Brief Review, Cureus, June 2022

Can You Overdose on MDMA? Facts About MDMA, Drug Policy Alliance, August 2015

Ecstasy/MDMA, Drug Fact Sheet, Department of Justice/Drug Enforcement Administration, April 2020

Ecstasy Pills Increasingly Made With Child-Friendly Logos, Says Expert, The Guardian, June 21, 2016

Fact Sheet: Breakthrough Therapies, U.S. Food and Drug Administration, March 28, 2018

How Are MDMA Use Disorders Treated? MDMA (Ecstasy) Abuse Research Report, National Institute on Drug Abuse, April 13, 2021

How To Microdose Drugs Based on What You’re Using, Vice, March 28, 2022

Human Psychobiology of MDMA or ‘Ecstasy’: An Overview of 25 Years of Empirical Research, Human Psychopharmacology: Clinical and Experimental, 2013  

Hyponatremia, Cleveland Clinic, Aug. 22, 2022  

Introduction, MDMA (Ecstasy) Abuse Research Report, National Institute on Drug Abuse, December 19, 2022

Lifetime Use of MDMA/Ecstasy and Psilocybin Is Associated With Reduced Odds of Major Depressive Episodes, Journal of Psychopharmacology, Jan. 5, 2022

MDMA To Treat PTSD in Adults, Psychopharmacology Bulletin, June 2021

MDMA Interactions With Pharmaceuticals and Drugs of Abuse, Expert Opinion on Drug Metabolism & Toxicology, April 2020  

MDMA and the Brain: A Short Review on the Role of Neurotransmitters in Neurotoxicity, Basic and Clinical Neuroscience, July-August 2020

MDMA-Related Deaths: Stop Calling Them Overdoses, DanceSafe, July 10, 2014

Miller et al. The ASAM Principles of Addiction Medicine, Sixth Edition

Reduction in Social Anxiety After MDMA-Assisted Psychotherapy With Autistic Adults: A Randomized, Double-Blind, Placebo-Controlled Pilot Study, Psychopharmacology, November 2018

Study Comparing Three Doses of MDMA Along With Therapy in Veterans With Posttraumatic Stress Disorder,, U.S. National Library of Medicine, July 11, 2022 

The History of MDMA as an Underground Drug in the United States, 1960–1979, Journal of Psychoactive Drugs, 2016

The Promises and Perils of Psychedelic Health Care, The New York Times, Jan. 12, 2022

The Use of Art and Music Therapy in Substance Abuse Treatment Programs, Journal of Addictions Nursing, October 2014  

Urinary MDMA, MDA, HMMA, and HMA Excretion Following Controlled MDMA Administration to Humans, Journal of Analytical Toxicology, October 2009

What Is MDMA? MDMA (Ecstasy/Molly) DrugFacts, National Institute on Drug Abuse, June 2020

What Is the History of MDMA? MDMA (Ecstasy) Abuse Research Report, National Institute on Drug Abuse, April 13, 2021  

What Are the Effects of MDMA? MDMA (Ecstasy) Abuse Research Report, National Institute on Drug Abuse, April 13, 2021

What’s the Difference Between Molly, Ecstasy, and MDMA? Facts About MDMA, Drug Policy Alliance, August 2015  

What You Need To Know About High-Dose MDMA Pills, Drug Information and Alerts Aotearoa New Zealand, Dec. 9, 2022

Where Do 12-Step or Self-Help Programs Fit Into Drug Addiction Treatment? Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition), National Institute on Drug Abuse, January 2018 

Who Is ‘Molly’? MDMA Adulterants by Product Name and the Impact of Harm-Reduction Services at Raves, Journal of Psychopharmacology, August 2017