Ecstasy

Ecstasy is a common name for 3,4-methylenedioxymethamphetamine (MDMA), a synthetic psychoactive drug of the amphetamine class. It is used recreationally to produce euphoria, energy, empathy, and heightened sensory perception. It is most often sold in tablets or capsules and may be adulterated with other substances; street formulations labeled "ecstasy" or "Molly" can vary widely in content.

MDMA increases the release of serotonin, and to a lesser extent dopamine and norepinephrine, by reversing transporter function. This surge underpins mood elevation, empathy, and increased sociability, with effects starting within 30–60 minutes and lasting several hours. Short-term effects include dry mouth, jaw clenching, dilated pupils, sweating, and increased heart rate; anxiety or agitation can occur in some users.

Risks include overheating and dehydration in hot environments, hyponatremia from excessive water intake, and rare serotonin syndrome with other serotonergic drugs. Repeated use can cause sleep disturbance, memory problems, and mood changes; dependence exists but is variable. Street products often contain adulterants, increasing acute risk.

Legal status varies; in the United States MDMA is a Schedule I substance and not approved for medical use outside research. It is being studied in MDMA-assisted psychotherapy for post-traumatic stress disorder, with phase 3 trials reporting symptom reductions under supervision. Regulatory decisions differ by country, and ongoing studies continue to assess safety, dosing, and long-term effects.