MDMA

MDMA, or 3,4-methylenedioxymethamphetamine, is a synthetic psychoactive drug classified as an entactogen. It is commonly sold under the street names ecstasy or Molly. MDMA is used recreationally for its mood-enhancing and empathogenic effects, and it has been investigated for therapeutic use in controlled settings.

MDMA increases the release of serotonin, dopamine, and norepinephrine in the brain, with a notable rise in oxytocin, which is thought to contribute to feelings of closeness and empathy. The onset occurs within 30 to 60 minutes when taken by mouth, with peak effects at 1 to 2 hours and a typical duration of 3 to 6 hours, followed by a post-use period of fatigue and sleep disturbance.

Clinically, MDMA has been studied as an adjunct to psychotherapy for posttraumatic stress disorder (PTSD) and other conditions. Although some trials report improved outcomes when used in tightly controlled settings with professional support, MDMA is not approved as a medical treatment in most countries.

Potential adverse effects include hyperthermia, dehydration, hyponatremia, tachycardia, and anxiety or agitation during intoxication. Serotonin syndrome can occur if MDMA is used with other serotonergic drugs. Repeated use may be associated with sleep disturbances, mood changes, and possible longer-term effects on memory and cognition. The drug is sometimes adulterated with other substances, increasing risk. There is also a risk of overdose, especially in hot environments or with physical exertion.

Legality varies by country; in many places MDMA is illegal to manufacture, possess, or distribute. In harm-reduction contexts, users are advised to test substances for purity, avoid combining MDMA with alcohol or other drugs, stay hydrated with moderate water intake, rest in a cool environment, and seek medical assistance if severe symptoms occur.