Merck Manual

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Methylenedioxymethamphetamine (MDMA)

(Ecstasy)

By

Gerald F. O’Malley

, DO, Grand Strand Regional Medical Center;


Rika O’Malley

, MD, Grand Strand Medical Center

Full review/revision Dec 2022
VIEW PROFESSIONAL VERSION

Symptoms of MDMA Use

MDMA causes excitement and disinhibition (a loosening of control over behaviors). It also accentuates physical sensation, empathy, and feelings of interpersonal closeness. Toxic effects are similar to those of the other amphetamines but are less common, perhaps because people are more likely to use MDMA intermittently. However, even with casual use, significant problems such as hyperthermia Serotonin Syndrome Serotonin syndrome is a potentially life-threatening drug reaction that tends to cause high body temperature, muscle spasms, and anxiety or delirium. Serotonin is a chemical that transmits impulses... read more and hyponatremia Hyponatremia (Low Level of Sodium in the Blood) In hyponatremia, the level of sodium in blood is too low. A low sodium level has many causes, including consumption of too many fluids, kidney failure, heart failure, cirrhosis, and use of diuretics... read more (abnormally low levels of sodium in the blood) may occur. The effects of intermittent, occasional use are uncertain. Rarely, liver failure Liver Failure Liver failure is severe deterioration in liver function. Liver failure is caused by a disorder or substance that damages the liver. Most people have jaundice (yellow skin and eyes), feel tired... read more occurs.

Chronic, repeated use may cause problems similar to those of amphetamines, including dependence. Some users develop paranoid psychosis. Decline in mental functioning may also occur with repeated, frequent use.

Diagnosis of MDMA Use

  • Clinical evaluation

MDMA may not be detected by routine urine drug tests.

Treatment of MDMA Use

  • Observation and monitoring until the person is sober

More Information

The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.

  • Dual Diagnosis.org: Resource for those who have co-occurring mental health conditions and substance use disorders, including access to the Foundations Recovery Network programs, which provide integrated treatment.

  • Inpatient.org: Access to inpatient rehabilitation programs for drug and/or alcohol addiction.

  • National Alliance on Mental Illness (NAMI): A national mental health organization that provides advocacy, education, support, and public awareness programs and services.

  • National Institute on Drug Abuse (NIDA): MDMA-specific information from the federal agency that supports scientific research into the drug's use and its consequences.

  • Substance Abuse and Mental Health Services Administration (SAMHSA): US Department of Health agency that leads public health efforts to improve behavioral health and provides resources, including treatment locators, toll-free helplines, practitioner training tools, statistics, and publications on a variety of substance-related topics.

NOTE: This is the Consumer Version. DOCTORS: VIEW PROFESSIONAL VERSION
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