Methylenedioxymethamphetamine (MDMA)

(Ecstasy)

ByGerald F. O’Malley, DO, Grand Strand Regional Medical Center;
Rika O’Malley, MD, Grand Strand Medical Center
Reviewed/Revised Dec 2022
VIEW PROFESSIONAL VERSION

MDMA (3,4-methylenedioxymethamphetamine) is similar to an but has both stimulant and hallucinogenic effects.

(See also Amphetamines and Overview of Substance-Related Disorders.)

Symptoms of MDMA Use

MDMA causes excitement and disinhibition (a loosening of control over behaviors). It also accentuates physical sensation, empathy, and feelings of interpersonal closeness. Toxic effects are similar to those of the other amphetamines but are less common, perhaps because people are more likely to use MDMA intermittently. However, even with casual use, significant problems such as hyperthermia and hyponatremia (abnormally low levels of sodium in the blood) may occur. The effects of intermittent, occasional use are uncertain. Rarely, liver failure occurs.

Chronic, repeated use may cause problems similar to those of amphetamines, including dependence. Some users develop paranoid psychosis. Decline in mental functioning may also occur with repeated, frequent use.

Diagnosis of MDMA Use

  • Clinical evaluation

MDMA may not be detected by routine urine drug tests.

Treatment of MDMA Use

  • Observation and monitoring until the person is sober

Treatment for acute toxicity and dependency is similar to treatment for amphetamines, although treatment for acute overdose is less commonly needed.

More Information

The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.

  1. Dual Diagnosis.org: Resource for those who have co-occurring mental health conditions and substance use disorders, including access to the Foundations Recovery Network programs, which provide integrated treatment.

  2. Inpatient.org: Access to inpatient rehabilitation programs for drug and/or alcohol addiction.

  3. National Alliance on Mental Illness (NAMI): A national mental health organization that provides advocacy, education, support, and public awareness programs and services.

  4. National Institute on Drug Abuse (NIDA): MDMA-specific information from the federal agency that supports scientific research into the drug's use and its consequences.

  5. Substance Abuse and Mental Health Services Administration (SAMHSA): US Department of Health agency that leads public health efforts to improve behavioral health and provides resources, including treatment locators, toll-free helplines, practitioner training tools, statistics, and publications on a variety of substance-related topics.

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