Long term effects of ecstasy on the brain (INFOGRAPHIC)

MDMA (ecstasy) affects the brain by increasing the activity of at least three neurotransmitters: serotonin, dopamine, and norepinephrine. But what happens in the brain after long term use? We explore here.

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Ecstasy and the brain

Taken in low to moderate doses ecstasy (3,4-methylenedioxy-N-methylamphetamine or MDMA) heightens sensitivity, causes changes and impairment of cognitive, perception, and mental associations. But what happens when ecstasy is taken in higher doses or for longer periods of time? We review here and invite your questions or comments at the end.

How long is long term?

Long-term use = 2 x 10 mg/kg per day when taken consecutively for four days or more.

Long term effects of ecstasy on the brain (INFOGRAPHIC)

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Chronic = Repetitive pattern following abuse that exhibits negative consequences to your:

  1. Health status
  2. Social interactions
  3. Financial state

What are typical doses of ecstasy?

  • Dose range in a series of pills: 10-150 mg
  • Average dose: 120 mg
  • Typical session: 50-700 mg
  • Long term damage: > 1.5-1.8 mg/kg body weight*

Specific effects of ecstasy on the brain

The nervous system

  • catatonic stupor
  • depersonalization
  • heightened sensitivity
  • increased responsiveness to touch
  • influences sensitivity to pain
  • significantly changes the regulation of mood, aggression and sleep


  • can damage serotonin producing neurons
  • increases dopamine levels
  • increases norepinephrine levels
  • influences the 5-ht 2 receptors
  • stimulant and psychedelic effects


  • agitation
  • aggression
  • impulsiveness
  • mood swings
  • restlessness


  • excited calm or peace
  • feelings of well-being
  • heightened libido
  • panic attacks and severe anxiety
  • relaxation and euphoria


  • amnesia
  • confusion
  • depression
  • disorientation
  • drug cravings
  • hallucinations
  • insomnia
  • memory impairment
Reference Sources: NIDA: The neurobiology of ecstasy
NIDA: Drug facts on MDMA, Molly, Ecstasy
NCBI: Human pharmacology of MDMA: pharmacokinetics, metabolism, and disposition.
NCBI: The pharmacology and toxicology of “ecstasy” (MDMA) and related drugs
NHTSA: Methylenedioxy methamphetamine
 *Risk of overdose increases when mixed with alcohol, marijuana or methamphetamines


About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.


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  1. I unknowingly drank a Fanta that was laced with MDMA. I took a drug test later to confirm. I got really sick with scarlet fever the day after and was pretty dehydrated, but on day 4 when I was recovering from my illness I stared having some visual hallucinations and some anxiety. I did not want this drug in my system and I have never taken any drugs before. Is this normal? Will these side effects subside?

  2. I was really afraid that i got myself some kind of a permanent damage to the brain that I’m not yet aware of because of my abuse for the past month. I took really alot. 5 times, and each night I took 3 pills, one time even 4. But 2 weeks past after my last dose, and I don’t have these symptoms, and if I do, I have only few, like anxiety for an example. I know that the road to recovery is long. Couple of weeks, maybe months, but the only thing I was worried about was if the damage I did to myself was permanent. But now, I don’t think that it is permanent anymore. Am I right? I don’t feel depressed, i feel hunger, I sleep well, I enjoy things I enjoyed before etc. My short memory is little messy, but that is getting better too. If I’m wrong please can you explain it to me why?

    1. Hi yes. It seems like you didn’t do any permanent damage to yourself. However, I suggest you visit a doctor so he/she can run some test and determine your overall well-being.

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