MDMA is a recreational drug of abuse that is broadly known as Ecstasy when diluted. It has a wide range of psychoactive effects including an intense feeling of excitement, increased energy, enhanced mood, and increased sociability. Continue reading this article to learn about the health effects of MDMA.

3,4-methylenedioxymethamphetamine (MDMA) is a well known synthetic drug that has psychoactive properties [1].

It is chemically similar to the amphetamine group of drugs like methamphetamine and MDA (3,4-methylenedioxy-amphetamine, a breakdown product of MDMA) .

The drug was originally developed by the German pharmaceutical company Merck in 1912.

Initially, MDMA was meant to be used for psychotherapeutic reasons. However, due to its widespread use for recreational purposes in the 1980s, the drug was banned from medical use in 1985.

Notwithstanding, the drug is sold illegally around the world. According to a United Nations report, around 18.8 million people had used MDMA in the year 2015.

MDMA is mostly sold in the form of pills, which is largely combined with other substances such as caffeine, ephedrine, ketamine, and Tylenol.

The drug is primarily consumed by young adults in highly social situations such as festivals and dance parties. MDMA is usually taken orally as a tablet or capsule, although some people prefer to store it in powder form.

A pure form of MDMA is available in a crystal powder, with a number of street names including Molly, Adam, or Mandy.

MDMA Mechanism of Action

When administered orally, MDMA absorbs rapidly into the bloodstream and reaches the brain to initiate its actions. Effects start within 30-45 minutes following oral ingestion, peaks in 70-120 minutes, and can last for 3-3.4 hours.

Once in the brain, MDMA increases the release of the neurotransmitters serotoninnorepinephrine, and dopamine. The serotonin effects seem to be more significant than for the other neurotransmitters.

The large and rapid release of these neurotransmitters in the brain causes psychoactive changes in the body, including emotional excitation, positive mood, increased social behaviors, and self-confidence.

MDMA increases neurotransmitter levels by acting as a VMAT2 (DAT, NET, and SERT) inhibitor .

VMAT2’s are neurotransmitter reuptake transporters and their inhibition by MDMA results in increased concentrations of the associated neurotransmitter (serotonin, norepinephrine, or dopamine) in the neuron.

MDMA and its byproducts also have some activity on postsynaptic serotonin receptors 5-HT1 and 5-HT2 receptors.

Effects of MDMA

The desired short-term psychoactive effects of MDMA have been reported to include [14]:

  • Euphoria – a sense of general well-being and happiness
  • Increased sociability and feelings of communication being easy or simple
  • Entactogenic effects – increased empathy or feelings of closeness with others
  • A sense of inner peace
  • Mild hallucination
  • Enhanced sensation, perception, or sexuality
  • Altered sense of time

Setting Dependent Effects

The experience elicited by MDMA depends on the setting.

For example, MDMA used at parties is associated with high physical activity, reduced sense of self-identity, and poor awareness of one’s background surroundings.

Use of MDMA individually or in small groups in a quiet environment and when concentrating is described with increased lucidity, the capability of concentration, the sensitivity of aesthetic aspects of the background and emotions, as well as a greater capability of communication with others.

In psychotherapeutic settings, MDMA effects have been described by infantile ideas, alternating phases of temper, sometimes memories and moods connected with childhood experiences [13].

My Experience With MDMA and Takeaway From Psychoactive Drugs

A while back I experimented with this drug.  I really enjoyed the experience.  It gave me most of the effects that it’s supposed to give – euphoria, emotionality, increased socialness, and an increased sense of spirituality.

Given that I knew it increases vasopressin and that I was sweating, I took salt as soon as I started getting a slight headache the next day – and it nipped it in the bud.

My cognitive performance did decline in the following days by a bit, but nothing too dramatic.

I probably would’ve taken it again if I wasn’t worried about the purity of what I was getting.  Also, I didn’t like the decreased cognitive performance and productivity for a few days after.

Probably the only takeaway that stuck with me, is a similar takeaway that I get from other psychoactive agents: that we are products of biology.

Throughout my life, I’ve noticed profound changes in my biology, and I was able to see how my personality changes when my brain chemistry is altered in hundreds of different ways.

Changes included going from sick to healthy over a period.  It included the many hundreds of supplements and herbs that I’ve taken and the many diets that I’ve tried.

My experience with LSD hammered this point home even more than anything else.

MDMA likewise has its own psychoactive wrinkles that allow you to see how much you change based on a change in neurochemistry.

The sum of these experiences left me more fatalistic, which solidified the Zen and Taoist path that I was already on.

4 Potential Benefits of MDMA

1) May Promote Pro-social Behaviors

The use of MDMA is linked to increased pro-social behaviors [15].

Moderate doses (75 mg) have been shown to encourage closeness and strengthen the bond between people.

Exposure to MDMA enhances the level of a chemical known as oxytocin, which plays a key role in social behaviors.

Owing to the pro-social behaviors, many therapists considered it to be a useful approach for couple’s therapy and family therapy.

A placebo-controlled study in 15 human volunteers found that the amount of oxytocin increase in the blood was correlated with the subjective social effects of MDMA.

2) Promising Treatment Option for Posttraumatic Stress  Disorder (PTSD)

Recently, MDMA has been shown as a novel approach for the treatment of PTSD .

In two clinical trials, the intake of MDMA markedly improved symptoms associated with PTSD.

Research on an animal model of PTSD has shown that MDMA exposure may improve some of the brain abnormalities linked to PTSD.

MDMA has been indicated as possibly useful in psychotherapy, facilitating self-examination with reduced fear.

3) Possible Treatment Approach for Neurodegenerative Diseases

The use of MDMA been proposed as a new strategy for treating Neurodegenerative diseases such as Schizophrenia and Parkinson’s disease,

Research on an animal model of Parkinson’s disease has suggested that MDMA exposure can improve the uncontrollable arm and leg movements, common motor symptoms in people with Parkinson’s disease.

Similarly, some people diagnosed with Schizophrenia had reported that they have experienced a remarkable improvement in their mental behavior after using MDMA.

4) May Be Anti-Inflammatory

MDMA is an anti-inflammatory and people with Th1 dominance would benefit from the immune effects of this drug.  People with a Th2 dominant immune system would do worse with this drug.

In animals, MDMA inhibits the inflammatory cytokines IL-12, IL-1b, and TNF-alpha [2728].

MDMA suppresses neutrophil activity and increases the production of the anti-inflammatory cytokine IL-10 [28].

MDMA also suppresses circulating lymphocyte numbers and skews the immune system in a Th2 direction [28].

IgG2a levels were decreased following MDMA administration, possibly by reducing the production of the Th1 cytokine, IFNy [28].

In a few human trials, MDMA profoundly suppressed the number of circulating CD4+ T cells and increased the number of circulating natural killer cells.  However, natural killer cell numbers in MDMA users were reduced to 33% of that seen in control subjects.

It was also reported that MDMA promoted a switch to a Th2-type cytokine profile, as indicated by reduced IFNy and IL-2 production, with a concomitant increase in the Th2 cytokines, IL-4, and IL-6, and the T-regulatory (TREG) cytokines, IL-10 and transforming growth factor-β1 (TGF-β1).

cocaine, and methamphetamine all have significant immune suppressive properties in their own right.