MDMA users may encounter problems similar to those experienced by amphetamine and cocaine users, including addiction. In addition to its rewarding effects, MDMA's psychological effects can include confusion, depression, sleep problems, anxiety, and paranoia during, and sometimes weeks after, taking the drug. Physical effects can include muscle tension, involuntary teeth-clenching, nausea, blurred vision, faintness, and chills or sweating. Increases in heart rate and blood pressure are a special risk for people with circulatory or heart disease.

MDMA-related fatalities at raves have been reported. The stimulant effects of the drug, which enable the user to dance for extended periods, combined with the hot, crowded conditions usually found at raves can lead to dehydration, hypothermia, and heart or kidney failure. MDMA use damages brain serotonin neurons. Serotonin is thought to play a role in regulating mood, memory, sleep, and appetite. Recent research indicates heavy MDMA use causes persistent memory problems in humans.

Long-Term Brain Injury from Use of "Ecstasy"

The designer drug "Ecstasy," or MDMA, causes long-lasting damage to brain areas that are critical for thought and memory, according to new research findings in the June 15 issue of The Journal of Neuroscience. In an experiment with red squirrel monkeys, researchers at The Johns Hopkins University demonstrated that 4 days of exposure to the drug caused damage that persisted 6 to 7 years later. These findings help to validate previous research by the Hopkins team in humans, showing that people who had taken MDMA scored lower on memory tests.

"The serotonin system, which is compromised by MDMA, is fundamental to the brain's integration of information and emotion," says Dr. Alan I. Leshner, director of the National Institute on Drug Abuse (NIDA), National Institutes of Health, which funded the research. "At the very least, people who take MDMA, even just a few times, are risking long-term, perhaps permanent, problems with learning and memory."

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The researchers found that the nerve cells (neurons) damaged by MDMA are those that use the chemical serotonin to communicate with other neurons. The Hopkins team had also previously conducted brain imaging research in human MDMA users, in collaboration with the National Institute of Mental Health, which showed extensive damage to serotonin neurons.

MDMA (3,4-methylenedioxymethamphetamine) has a stimulant effect, causing similar euphoria and increased alertness as cocaine and amphetamine. It also causes mescaline-like psychedelic effects. First used in the 1980s, MDMA is often taken at large, all-night "rave" parties.

In this new study, the Hopkins researchers administered either MDMA or salt water to the monkeys twice a day for 4 days. After 2 weeks, the scientists examined the brains of half of the monkeys. Then, after 6 to 7 years, the brains of the remaining monkeys were examined, along with age-matched controls.

In the brains of the monkeys examined soon after the 2-week period, Dr. George Ricaurte and his colleagues found that MDMA caused more damage to serotonin neurons in some parts of the brain than in others. Areas particularly affected were the neocortex (the outer part of the brain where conscious thought occurs) and the hippocampus (which plays a key role in forming long-term memories).