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Are There Long-Term Effects From Using the Party Drug Ecstasy?

By Gillian Tietz
The long-term side effects of drug abuse can be very harmful, and with ecstasy, it’s no different.

Ecstasy is an illegal, lab-made drug that can have dangerous effects on your body and mind. It’s also called MDMA and is a popular recreational drug. It's usually taken in tablet or capsule form. Ecstacy has the potential to affect your mood and distort how you perceive people and things around you, according to the National Institute on Drug Abuse.

Using ecstasy can have damaging long-term consequences, too. Read on to learn more.

Symptoms of an Ecstasy High

The National Institute on Drug Abuse says that about 45 minutes after you take a dose, you may feel:

  • A greater sense of well-being
  • More energy
  • Heightened physical senses
  • More warmth and empathy toward other people
  • Willing to talk about emotional memories

You could also have bad side effects, including:

  • Overheating
  • Jaw clenching
  • Feeling disconnected from your body or thoughts
  • Nausea
  • Hot flashes or chills
  • Stiff muscles or joints

Short-Term Effects of Ecstacy

Ecstasy is a stimulant that affects the nervous system. According to a 2021 review published in Critical Reviews in Toxicology, it increases the concentration of monoamines in the brain, like serotonin, norepinephrine, and dopamine. 

Because it increases the activity of these brain chemicals, this drug can cause effects like increased alertness, euphoria, loving feelings, and feeling more connected to others. However, ecstasy use has documented adverse effects too–including increased heart rate, blood pressure, and body temperature.

According to a 2021 review published in Neurotoxicity Research, the most common adverse side effects of short-term recreational ecstasy use are heatstroke, dehydration, and hyponatremia (low sodium in the blood). Overheating can lead to severe dehydration, rhabdomyolysis (the release of proteins and electrolytes into the blood from muscle damage), multi-organ failure, and abnormal blood clotting throughout the body.

Body temperature is maintained by a balance between heat generation and heat loss. Because of the way ecstasy affects the central nervous system and several different neurotransmitters, it causes an increase in heat generation and a decrease in heat loss.

Ecstasy also constricts blood vessels and inhibits an antidiuretic hormone called arginine vasopressin. This can lead to excessive urination and sweating, which can subsequently increase the risk of dehydration and cerebral edema (an accumulation of fluid in the brain). Combining this drug with alcohol will also increases the risk of dehydration.

Ecstacy's Long-Term Effects

According to The National Institute on Drug Abuse, some of the long-term problems from chronic ecstasy use may not be due to ecstasy alone. Rather, they might be connected to using ecstasy along with other drugs, like cocaine, alcohol, or marijuana. They may also be linked to risky ingredients in ecstasy tablets called adulterants.

A 2021 review published in Critical Reviews in Toxicology found that combining alcohol with ecstasy increased the negative effects of ecstasy on the brain, cardiovascular system, liver, and endocrine system. This increases the toxicity of ecstasy. 

“The drug itself is challenging to study in the real world, as adulterated forms of MDMA, or completely different forms of amphetamine, are used under the umbrella term of ‘ecstasy,’” says Harshal Kirane, MD, the medical director of Wellbridge Addiction Treatment and Research. Because of this, the long-term effects may vary from one particular ecstasy drug to another. 

Additionally, if you keep using ecstasy, you may develop problems including the following.

Memory and Cognitive Problems

According to a 2020 review published in Basic Clinical Neuroscience, clinical studies have found that ecstasy users had declarative memory impairments up to 6 months after drug use and significantly lower working memory. Declarative memory is long-term memory that helps you recall specific facts and events, while working memory helps you process and use information. 

Deficits in short-term memory, executive control, and learning have been observed in association with ecstacy, as well as increased impulsivity. Some studies have found that it is possible for these issues to persist in abstinence, even up to 18 months.

Mood and Emotional Issues

“Aside from the obvious physical risks and dangers that people typically associate with taking MDMA, it is important to be aware of the long-term damage that can occur to the way that the brain functions after taking the drug.” explains Martin Preston, founder and Chief Executive at Delamere. “As well as the short-term ‘comedown’ that people experience after taking MDMA, regular consumption can lead to a plethora of long-term cognitive issues and difficulties with regulating emotions.”

According to the NIDA, since ecstasy causes a large release in several neurotransmitters, especially serotonin, it causes the brain to become severely depleted of serotonin afterwards.  Prolonged decreases in serotonin levels can lead to days of depression.

In fact, positron emission tomography (PET) imaging studies on people who previously used ecstasy have found a decrease in brain activity at rest in many regions of the brain, including those involved in learning, memory, emotion formation, and emotion processing.

Potential Damage to the Brain and Nervous System

Ecstasy may lead to depression, and long term use can cause damage to the brain, resulting in decreased cognitive function. For chronic users who take high doses of ecstasy, this can cause permanent nerve damage, especially to serotonergic neurons. Serotonergic neurons are responsible for producing serotonin, so permanently damaging them can result in a loss of connection between these neurons and can cause depression and anxiety. 

Research in rodent models has given scientists insights into the potential damaging effects of ecstasy. A 2022 study published in the Journal of Neural Transmission, found that ecstasy exposure reduces the cell viability of serotonin neurons. Additionally, a 2018 study published in Frontiers of Cellular Neuroscience revealed that ecstasy can alter the physical structure of microglial cells, the immune cells of the nervous system..

Human studies are still mixed, and there is an ongoing debate about whether ecstasy causes permanent damage to the brain. Brain imaging studies in humans have found altered serotonergic functioning in ecstasy users. A 2019 meta-analysis published in Neuroscience and Biobehavioral Reviews found that heavy ecstasy users had significantly reduced serotonin transporter densities in the brain.

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