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MDMA Facts

Stimulant; Entactogen; MDxx; Serotonin releasing agent

Description

MDMA (3,4-methylenedioxy-N-methylamphetamine) — ecstasy, molly — is a synthetic empathogen of the substituted amphetamine class. It floods the brain with serotonin, norepinephrine, and dopamine, producing emotional warmth rather than stimulant energy.[1][2]

Subjective effects include euphoria, intense warmth toward others, sociability enhancement and trust, and mild brightening of perception.[3] The experience is defined by its entactogenic quality — profound emotional openness and closeness to others unlike either stimulant energy or psychedelic expansion.

MDMA produces no physical dependence, though moderate psychological dependence is documented;[4] no human lethal dose has been established. The main dangers — overheating, dangerous sodium imbalance, and serotonin syndrome — multiply sharply in hot environments and when combined with serotonin-active drugs.[2]

Dose and durationby route · individual sensitivity varies

Oral(mg)
Threshold< 20 mgLight20 – 80 mgCommon80 – 120 mgStrong120 – 150 mgHeavy150+ mg

Starts in 30 – 45 minLasts 3 – 6 hoursAfter-effects 12 – 48 hours

Body and dependence

Acute toxicity
Moderate
Chronic toxicity
Moderate
Physical dependence
Low
Psychological dependence
Moderate
Withdrawal
Mild
Compulsive redosing
Moderate

Tolerance

Builds
Rapid
Fully resets after
75 days
Carries over to
MDA; MDEA; 5-APB; 6-APB; methylone; mephedrone; amphetamine

Effectslikely at a common dose

Perception
Touch enhancement; Music enhancement; Dreaming suppression; Auditory enhancement; +11 possible, including Visual haze / noise
Body
Appetite suppression; Dry mouth; Temperature dysregulation; Excessive sweating; Wakefulness; Pupil dilation; Spontaneous body sensations; Stimulation; Bruxism; Muscle tension; Body high; Body scan awareness; Insomnia; Physical fatigue; Tactile euphoria; Tingling / electric sensations; +25 possible, including Dehydration sensation, Vasoconstriction, Abnormal heartbeat
Thinking
Cognitive fatigue; Immersion enhancement; Cognitive euphoria; Aesthetic enhancement; Introspection enhancement; Openness enhancement; +29 possible, including Compulsive redosing urge, Cognitive impairment, Decision impairment
Feeling
Anxiety suppression; Emotional enhancement; Empathy enhancement; Euphoria; +9 possible, including Depression, Emotional lability, Anhedonia
Self
Disinhibition; Social connection; Communication enhancement; Emotional susceptibility; Sociability enhancement; Trust enhancement; +7 possible, including Craving, Social disconnection, Derealization
Time
none likely · 3 possible, including Temporal disorientation
Transpersonal
none likely · 1 possible
Awareness
Personal insight; +3 possible

Who shouldn't take it

Absolute
Cardiovascular disease; Pregnancy and breastfeeding; Pregnancy; DXM use; Concurrent MAOI therapy; MAOI use; Tramadol use
Relative
Epilepsy; Psychotic disorders; Hepatic impairment; Concurrent serotonergic medication

Combinations65 recorded

Lethal (6)
2-Aminoindane; 2-FEA; Dextromethorphan; MAOIs; Methylnaphthidate; Tramadol
Dangerous (34)
Anticholinergics; Atypical antipsychotics; Caffeine; Dopamine agonists; Ephedrine, Pseudoephedrine; Local anesthetics; MDMA, Amphetamines; MDMA, MDA; NRIs; Opioids; SNRIs; SSRIs; Stimulants; 5-HTP, Tryptophan; Alpha-2 adrenergic receptor antagonist; Antihistamines; Antipsychotics; Buspirone; Clonidine, Guanfacine; DXM; GHB, Baclofen; GHB, GBL; Ibogaine; Ketamine, DXM, PCP; and 10 more, see full page
Caution (22)
See full page: psychedex.org/substances/mdma
Not graded (3)
Not listed never means safe.

Seek help immediately if

  • Overheating / very high body temperature — heavy sweating, then hot dry skin (the leading cause of MDMA deaths, worse when dancing in hot venues)
  • Muscle rigidity, jaw clenching, tremor, or twitching (possible serotonin syndrome)
  • Fast, pounding heartbeat; chest pain
  • Agitation, confusion; seizures
  • Hyponatremia (water intoxication) — headache, confusion, drowsiness, vomiting, and seizures from drinking too much water
  • Nausea/vomiting; collapse or unconsciousness

What to do

  1. Move them somewhere cool and help them cool down — overheating is the main danger
  2. Sip water to stay hydrated but DO NOT overdrink — roughly a cup (250 ml) per hour if active; too much water can be deadly (hyponatremia)
  3. Get them to rest and stop dancing
  4. For overheating, seizures, chest pain, muscle rigidity/tremor, confusion, or unresponsiveness, call emergency services
  5. Recovery position if drowsy or vomiting; stay with them
  6. Be ready to give rescue breaths / CPR

Most resolve with cooling, rest, sensible hydration, and time. The life-threatening dangers are hyperthermia, serotonin syndrome, and hyponatremia (too much water) — each a medical emergency, not something to wait out.

988 Suicide & Crisis LifelineFireside Project: 62-FIRESIDE

Version r1 · Not medical advice

References

  1. [1]
    ^Pifl C, Nagy G, Berényi S, et al. (2005) Pharmacological characterization of ecstasy synthesis byproducts with recombinant human monoamine transporters — Journal of Pharmacology and Experimental Therapeutics PMID:15831439
  2. [2]
    ^abGreen AR, Mechan AO, Elliott JM, O'Shea E, Colado MI (2003) The pharmacology and clinical pharmacology of 3,4-methylenedioxymethamphetamine (MDMA, "ecstasy") — Pharmacological Reviews doi:10.1124/pr.55.3.3
  3. [3]
    ^Cami J, Farré M, Mas M, et al. (2000) Human pharmacology of 3,4-methylenedioxymethamphetamine ("ecstasy"): psychomotor performance and subjective effects — Journal of Clinical Psychopharmacology PMID:10917407
  4. [4]
    ^Syed OA, Nestor SM, Husain MI, et al. (2026) Adverse events associated with classic psychedelics and MDMA: a real-world population-based study using WHO pharmacovigilance database (VigiBase) — Psychiatry Research doi:10.1016/j.psychres.2025.116929
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