MDMA—sometimes called Molly or ecstasy—is a stimulant with some psychedelic effects. It’s a popular recreational drug that may also have therapeutic benefits.
MDMA use causes increased empathy and pleasure. Researchers are currently studying it as a way to make therapy more effective, particularly when it comes to PTSD. The results have been promising, and in 2017, the FDA gave MDMA “Breakthrough Therapy” status, speeding up research on MDMA-assisted psychotherapy for PTSD.
However, MDMA also comes with significant risks and possible side effects. It can be difficult to source, overdoses can be fatal, and taking MDMA may cause substantial (but temporary) aftereffects, including depression and anxiety.
If you’re going to take MDMA, it’s a good idea to be informed. Here’s how MDMA works, as well as its effects, possible benefits, risks, dosage, and more.
What is MDMA?
The compound 3,4-methylenedioxymethamphetamine (MDMA) is a powerful stimulant. It belongs to the amphetamine family of drugs—compounds that make you feel energized and euphoric.
Pure MDMA is a yellowish-gray or white crystal that is sometimes crushed into a powder. It tastes like gasoline—bitter, oily, and pungent.
MDMA Street Names
MDMA is also called:
What Does Taking MDMA Feel Like?
MDMA’s effects last about 2-4 hours, depending on the dose. They may include: 1 https://pubmed.ncbi.nlm.nih.gov/15228154/
- Intense euphoria
- Increased empathy for others and yourself
- Feelings of happiness and connection with those around you
- Increased energy
- Increased social behavior
- Intensified emotions
- Visual hallucinations (mild compared to other psychedelics)
- Decreased inhibition
- Faster speech
- Bruxism (grinding your teeth)
- Increased muscle tension
- Stereotypies (compulsive, repetitive movements, speech patterns, or behaviors)
- Dilated pupils
- Increased heart rate
- Increased body temperature
Ecstasy’s effects vary depending on your surroundings, your mental state, and the dose you take.
However, MDMA’s effects are more consistent than those of other psychedelics. You’re less likely to have a psychologically negative experience, regardless of your mindset and environment.
Mechanism of action
MDMA activates your brain’s serotonin, dopamine, and norepinephrine pathways. It’s especially active in parts of your brain that involve reward and mood, as well as social behavior. 1
MDMA causes massive dopamine release in your reward pathway, causing intense euphoria and sensory pleasure. You may feel a pleasant tingling sensation all over your body, and touching pleasing textures, being touched, or hearing music may cause unusually intense reward. This effect scales with dosage, meaning it’s more pronounced the more MDMA you take. 2
MDMA also causes a flood of serotonin release, leading to positive mood and increased empathy, as well as moderate norepinephrine release, which causes many of MDMA’s physiological effects—like muscle tension, grinding your teeth, and increased heart rate.
Coming down from MDMA
The aftereffects of MDMA vary depending on the dose you take, as well as your personal tolerance.
Because MDMA makes your brain release so much serotonin and dopamine, there’s a recovery period after you take it, during which your serotonin and dopamine levels are low. That shift in brain chemicals can leave you with withdrawal symptoms like depression and anxiousness until your neurotransmitters reach balance again. 3
Comedown symptoms of MDMA can last for days to weeks, depending on the dose, and may include: 4
- Mood swings
- Anhedonia (decreased response to pleasurable things)
The aftereffects of MDMA can be intensely unpleasant, especially if you take a higher dose. However, it’s worth noting that MDMA assisted therapy typically uses lower doses, and in several controlled studies, patients have reported a mild comedown or no comedown at all. 5
MDMA Assisted Psychotherapy for PTSD
In 2018, the US Food and Drug Administration (FDA) gave MDMA “Breakthrough Therapy” status for managing post-traumatic stress disorder (PTSD).
MDMA is currently in final-phase clinical trials for treating PTSD, with excellent results.
A 2019 review found that after two MDMA assisted psychotherapy sessions, 54% of patients no longer had symptoms of PTSD, versus 22% in a group that did normal psychotherapy. 5
The theory is that MDMA makes patients feel happier, more open, and less afraid of negative emotions, which makes it easier for them to explore and resolve past traumatic events.
How to Prepare for an MDMA Session
MDMA is often cut with other drugs, so it’s a good idea to run a test kit on your MDMA before taking it.
You also want to make sure you have plenty of water available while you’re on MDMA. It raises your body temperature and increases your risk of both dehydration and heatstroke.6
Make sure you have steady access to water and drink whenever you’re thirsty. This rule is especially important if you’re taking MDMA in a hot, crowded place, or if you’re going to do something physical, like dancing.
How Do People Take MDMA?
People take MDMA in a variety of forms, including:
- Pressed pills
Pure MDMA comes in a crystalline form that ranges in color from white to yellowish-gray. It tastes bitter and pungent. Users typically swallow the crystals or rub them into their gums; rubbing creates micro-tears in the surface of your gums, allowing the MDMA to reach your bloodstream faster.
Crystal MDMA is generally the safest form of MDMA to take. It’s hard to fake or cut with another stimulant. However, it’s still possible that you’re getting another crystalline stimulant that could be dangerous, so a test kit is still a good idea.
MDMA bound to a salt takes the form of a white powder. MDMA powder is usually sold in small baggies, and you take it the same way you take MDMA crystals—by swallowing it or rubbing it into your gums.
MDMA powder or crystals can be pre-portioned into gelatin capsules for easy swallowing. Some people prefer capsules because they can avoid MDMA’s unpleasant taste.
Pills contain MDMA and some kind of binder. They come in a variety of shapes, colors, and sizes, and may have graphical imprints, like smiley faces or hearts.
Of all MDMA’s common forms, pressed pills have the highest risk of containing other drugs. Manufacturers often mix MDMA with cheaper, more widely available stimulants like dextroamphetamine or methamphetamine before pressing them into tablets.
Many more experienced users avoid pressed pills.
For pure crystalline or powdered MDMA, a standard dose is 1.5 milligrams per kilogram of bodyweight.
It’s important to be precise with your dosing. MDMA overdoses are rare but possible, so it’s a good idea to use a scale to measure your dose.
Here’s a chart that tells how much MDMA to take, based on the dose of 1.5 mg/kg:
|Bodyweight (lbs)||MDMA dose (mg)|
|90 lb||61 mg|
|100 lb||68 mg|
|110 lb||75 mg|
|120 lb||82 mg|
|130 lb||89 mg|
|140 lb||95 mg|
|150 lb||102 mg|
|160 lb||109 mg|
|170 lb||116 mg|
|180 lb||123 mg|
|190 lb||130 mg|
|200 lb||136 mg|
|210 lb||143 mg|
|220 lb||150 mg|
|230 lb||157 mg|
|240 lb||164 mg|
|250 lb||170 mg|
If you’re taking pressed pills or capsules, be sure you ask the person providing them how much MDMA is in each one. Keep in mind that there’s no way to verify that information, which comes with a certain amount of risk.
Some people recommend microdosing psychedelics—taking small doses to improve your mental state throughout the day.
However, overall research on microdosing is scarce, and the little research there is on microdosing MDMA suggests that it doesn’t do much in small doses.
A 2008 study found that people who took low-dose MDMA in a clinical setting saw no benefits or mental changes, although they didn’t experience any negative effects either. 7
There isn’t enough research yet to tell whether microdosing MDMA has any benefit.
How Long Does MDMA Last?
You’ll start to feel MDMA’s effects about 30 minutes after taking it, and it lasts about 3-5 hours, depending on the dose. 1
MDMA shows up on a urine test for 3-5 days after you take it. However, the amount of time it stays in your system can vary from person to person. This is only a guideline.
Is MDMA Addictive?
MDMA has a low-to-moderate risk of drug abuse and addiction.
A 2015 study found that about 15% of repeat MDMA users become addicted. 8 That number is quite low compared to other stimulants, and to most other recreational drugs in general.
Part of the reason MDMA has lower drug abuse potential is that it heavily depletes your serotonin and dopamine stores. It takes time for your brain to reach normal levels again, which means if you take MDMA within a few days or weeks of your previous dose, you won’t feel much. You don’t have enough serotonin and dopamine in your brain for the drug to have a major effect.
Proper levels of serotonin and dopamine are necessary for mental health.
As a result, MDMA use is infrequent, and the risk of addiction is fairly low. However, some people do get addicted to MDMA.
What Could Go Wrong When On MDMA?
MDMA comes with a few different risks, including:
- Dehydration, overheating
- Drug interactions
MDMA overdoses are rare but possible. It’s a good idea to measure your dose using a scale that’s accurate down to the milligram range.
MDMA increases your body temperature and makes you less capable of regulating heat. This isn’t dangerous on its own, but if you’re in a crowded environment and are doing something physical, like dancing, your risk of dehydration and overheating increases. 6
Overheating and dehydration are the most common reasons people are hospitalized after taking MDMA. 6 Make sure you have plenty of water and drink whenever you’re thirsty.
MDMA drug interactions
MDMA interacts with a number of drugs, including 9:
- Muscle relaxants
- Stimulants (including Adderall, Ritalin, and other common ADHD drugs)
- Benzodiazepines (Xanax, Valium, Klonopin, Halcion, Ativan)
- Painkillers (especially opioid-based painkillers, like OxyContin, Percocet, and morphine)
- Certain antidepressants (bupropion, sertraline, venlafaxine, and citalopram)
- Olanzapine, an antipsychotic drug used to treat schizophrenia
Keep in mind that this may not be a complete list; because MDMA is illegal, it’s difficult to study its drug interactions.
Where to Get MDMA
Is MDMA legal?
MDMA is currently illegal in all 50 states in the U.S., which makes safe sourcing difficult.
Clinical trials for MDMA
At the time of this article’s publication, the only legal way to source MDMA is to sign up for a clinical trial. You can find a list of active clinical trials on the U.S. government’s clinical trial website. This is the safest way to take MDMA—under the guidance of a licensed therapist or medical professional.
Sourcing MDMA on your own
We do not encourage you to break the law or put yourself in harm’s way.
Nonetheless, if you’re going to buy MDMA outside of a clinical setting, do your due diligence to reduce harm. Avoid buying MDMA from strangers, and keep in mind that purchasing and possessing any illegal drug could get you into legal trouble.
If you source MDMA on your own, we strongly recommend using an MDMA test kit to ensure that you’re really getting MDMA.
MDMA Personal Stories
Here are people describing their personal experiences with MDMA:
“In the right circumstances, MDMA reduces or sometimes eliminates the neurophysiological fear response to a perceived threat to one’s emotional integrity… With a barrier of fear removed, a loving and forgiving awareness seemed to occur quite naturally and spontaneously.”
- Dr. George Greer, clinician and MDMA researcher
“How long will this last, this delicious feeling of being alive, of having penetrated the veil which hides beauty and the wonders of celestial vistas? It doesn’t matter, as there can be nothing but gratitude for even a glimpse of what exists for those who can become open to it.”
- Alexander Shulgin, psychopharmacologist and author, describing the feeling of taking MDMA
MDMA Frequently Asked Questions
Can you overdose on MDMA?
It is possible to overdose on MDMA, although it’s rare. A standard MDMA dose is 1.5 milligrams of MDMA per kilogram of body weight. For example, a 150-pound person would take about 100 milligrams of MDMA. Remember to stay hydrated when taking MDMA.
Is MDMA safe?
A 2007 study ranked the 20 most common recreational drugs based on harm; MDMA came in 18th, and the researchers concluded that it’s one of the safer common drugs. However, MDMA still comes with risk, especially if it’s cut with other stimulants. It’s also illegal to possess or use.
Can you mix MDMA and alcohol?
It can be dangerous to mix MDMA and alcohol. Taking the two together increases stress on your heart. Both drugs decrease inhibition, which can lead you to take more of one or the other than you intended. Finally, both dehydrate you, and their dehydrating effects stack, which can be dangerous.
Can you mix other drugs with MDMA?
It’s common to mix MDMA with LSD (called “candy flipping”) or psilocybin mushrooms (called “hippie flipping”), especially at raves and music festivals. However, both drugs increase serotonin release in your brain, and combining them can lead to serotonin syndrome, where your serotonin levels become dangerously high.
MDMA is a powerful stimulant with some psychedelic properties. It’s a popular party drug,\ and it recently received “Breakthrough Therapy” status from the FDA for its potential to help treat PTSD.
MDMA is fairly safe, provided you source it well and take it in a controlled environment. A 2007 study ranked the 20 most common recreational drugs based on their risk of harm; MDMA came in 18th out of the 20. 10
However, MDMA comes with more risk than other psychedelic drugs. If you choose to take MDMA, do so with appropriate preparation. Know your dosage, find a good source, stay hydrated, and keep in mind that using or possessing MDMA is a crime.
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8. Steinkellner T, Freissmuth M, Sitte HH, Montgomery T. The ugly side of amphetamines: short- and long-term toxicity of 3,4-methylenedioxymethamphetamine (MDMA, ’Ecstasy’), methamphetamine and D-amphetamine. Biol Chem. 2011;392(1-2):103-115. doi:10.1515/BC.2011.016
9. Cohen IV, Makunts T, Abagyan R, Thomas K. Concomitant drugs associated with increased mortality for MDMA users reported in a drug safety surveillance database. Sci Rep. 2021;11(1):5997. doi:10.1038/s41598-021-85389-x
10. Nutt D, King LA, Saulsbury W, Blakemore C. Development of a rational scale to assess the harm of drugs of potential misuse. Lancet. 2007;369(9566):1047-1053. doi:10.1016/S0140-6736(07)60464-4