Heavy MDMA use has been shown to cause long-term effects on serotonin production, but researchers are trying to learn if long-term positive benefits exist as well.

MDMA, also known as ecstasy or molly, is a type of drug that causes stimulant and hallucinogenic effects.

According to the 2021 National Survey on Drug Use and Health, roughly 2.2 million people reported using MDMA at least once over the past 12 months.

Even though MDMA doesn’t necessarily have addictive properties like some other drugs, such as cocaine or methamphetamine, there’s still the potential for substance misuse. And chronic, heavy use of MDMA may even have long-term effects — especially on serotonin in the brain.

Below, we’ll explore what the research says about the long-term effects of chronic MDMA use, both recreationally and medically.

Methylenedioxymethamphetamine (MDMA) is a synthetic drug that’s most well-known for the short-term effects it has on the body — euphoria, increased energy, and sensitivity to touch, to name a few.

But while MDMA is commonly considered a “party” drug, some research has found that chronic MDMA use may potentially cause long-term mental and physical health effects.

An early study published in 2000 explored the literature on long-term cognitive effects of recreational ecstasy use.

According to the review, both animal and human studies found that MDMA can negatively affect the serotonergic systems in the brain. This system involves serotonin.

Serotonin is a neurotransmitter that plays a role in regulating everything from our emotions and memories to the way we feel pain.

In human studies, researchers found that MDMA use could cause changes in verbal, visual, and short-term memory, reasoning, and recognition. Chronic MDMA use may even occasionally cause conditions like psychosis ― though other psychiatric conditions arising from using MDMA are rare.

Since that time, only a handful of studies have explored the possible long-term health effects of chronic MDMA use.

In a 2019 meta-analysis, researchers suggest that heavy MDMA use is associated with decreased serotonin transporter (SERT) density in various areas of the brain. According to the researchers, it’s possible that factors such as dosage and frequency play a role in this effect.

A later review found that MDMA may also affect other areas of the brain outside of the serotonergic systems, such as the dopaminergic and GABAergic systems. Like serotonin, the neurotransmitters dopamine and gamma-aminobutyric acid (GABA) also play a role in mood, pleasure, and more.

Older research looking at MDMA misuse also found that it could have a negative effect on your immune system, similar to excessive stress.

One thing to note, however, is that many of the studies included in this review were animal studies, not human studies. So, we can’t necessarily apply these results to humans without doing more research first.

Overall, research on the effects of chronic MDMA use is limited, and more studies in humans are needed to determine the long-term effects of this drug.

The long-term effects of trying Molly or MDMA once

The main psychedelic effects of MDMA can last for an average of 3 hours. But it may take up to 40 hours to fully clear from your system.

Even taking MDMA once can possibly cause side effects that last for days or weeks after the initial effects wear off. Some of these potential side effects can include:

These symptoms are usually mild and pass quickly. However, side effects and intensity may vary with larger doses.

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MDMA is classified as a schedule I drug, which means that it hasn’t been accepted or approved to treat any medical conditions. However, early research suggests that MDMA may become a potential treatment option for several mental health conditions in the future.

In a 2021 review, researchers explored the literature on the use of several hallucinogens ― including MDMA ― for mental health treatment.

According to the review, there has been some evidence to suggest that MDMA may be beneficial for conditions like anxiety and post-traumatic stress disorder (PTSD). For example, several studies included in the review found that MDMA was able to produce long lasting reductions in severe PTSD symptoms.

A large observational study from 2022 found that MDMA use was connected to a lower risk of depression, and they advise further study to see if this is a true association.

Health experts will need to see a significant amount of research on the benefits and risks of MDMA use for health conditions before it could become a treatment option.

Get involved

If you’re interested in MDMA as a mental health treatment, you may be able to help researchers learn more about its effects in clinical testing. Many scientists are working to change the legalization of MDMA to allow for more testing to be done, but some research is still currently ongoing.

Always talk with your therapist or primary doctor before starting any kind of clinical test. However, if they agree that this style of treatment could be helpful for you, you can check out ClinicalTrials.gov to learn more.

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When used in a clinical setting, MDMA has been found to be a safe treatment. When people buy recreational MDMA, they often believe that they’re buying the drug in its pure form.

But while there are rules and regulations for prescription medications, there are no safety standards in place for the production of recreational drugs like MDMA. Because of this, there’s a risk that you could be buying MDMA that’s contaminated ― or even a different drug altogether.

For example, MDMA purchased on the street can possibly contain contaminants like methamphetamine, ketamine, dextromethorphan, and even cocaine. Many of these substances can have harmful effects, especially if you don’t know you’re taking them.

In fact, the U.S. Drug Enforcement Administration (DEA) has seized drugs marketed as “Molly” only to find out that they were actually harmful substances like methylone and ethylone.

It’s also important to know that alcohol can interact with MDMA and cause more severe side effects. It’s not recommended to drink while using MDMA.

MDMA is a popular stimulant and hallucinogenic drug that can cause feelings like euphoria, sensuality, and empathy. However, while the short-term effects of MDMA only last a few hours, chronic or heavy use of MDMA may possibly lead to long-term effects on the brain.

MDMA is currently being tested for use in treating PTSD and other mental health conditions. The early results are promising and show the possibility of positive long-term effects as well.

If you or someone you love wants to change your relationship to substances like MDMA, there’s no shame in reaching out to a health professional for help. With the right support and treatment, you can learn tools to change your habits.