Health effects

Short-term effects

The effects of MDMA usually start about 20-60 minutes after taking it and are often felt as a sudden ‘come-up’ or ‘rush’ which can last up to half an hour and include:

  • feelings of wellbeing and confidence
  • feelings of closeness and empathy for others
  • jaw clenching/teeth grinding
  • jittery vision
  • an inability to concentrate
  • nausea
  • anxiety
  • increased temperature, heart rate and blood pressure.

After this initial ‘rush’ the user usually experiences a plateau in effects lasting around six hours before the beginning of the ‘come-down’. The ‘come-down’ from ecstasy use is characterised by: 

  • insomnia
  • depression
  • anxiety
  • paranoia
  • fatigue
  • difficulty concentrating
  • loss of appetite.

‘Come-down’ effects can last up to several days.

Ecstasy increases the desire to be physically active which carries with it the risk of overheating, exhaustion, seizures and collapse, especially when in the hot and crowded environments like dance parties and nightclubs. People with a history of heart disease, hypertension, epilepsy, liver problems or diabetes are at greater risk of harm from ecstasy use. 

Water consumption should be monitored when using ecstasy. Not enough water and too much physical activity can cause dehydration and overheating or hyperthermia. Too much water can lead to a condition called dilutional hyponatremia where the brain swells, inducing coma and sometimes death. See the reducing the harm section for guidelines on water consumption.

Higher doses do not appear to enhance the desirable effects of ecstasy, but do increase the risk of negative side-effects.

Long-term effects

There is limited evidence that ecstasy use causes damage to some parts of the brain, but it is unclear whether this damage is permanent.  Long-term ecstasy use is uncommon, likely due to the increase in undesirable effects and diminishing of the pleasurable effects over time. However, regular ecstasy users may find they are not eating or sleeping enough and that they become run down and susceptible to cold, flu, and infections.