3,4-Methylenedioxymethamphetamine (also known as ecstasy, E, XTC, molly, mandy, and MDMA) is an entactogen substance of the phenethylamine class. MDMA is a derivative of the amphetamine family and is considered to be the prototype member of a diverse group of substances that includes MDA, methylone, and 6-APB, all of which act by increasing levels of neurotransmitters serotonin, dopamine, and norepinephrine in the brain.
MDMA was discovered in 1912 and first saw use in underground psychotherapy circles in the 1970s. In the 1980s, MDMA spread into nightlife and rave culture and was subsequently banned. In 2014, MDMA was estimated to be one of the most popular recreational drugs used in the world, alongside cocaine and cannabis. Researchers are investigating whether MDMA may assist in treatment-resistant posttraumatic stress disorder (PTSD), social anxiety in autistic adults, and anxiety in those with life-threatening illness.
Subjective effects of MDMA include anxiety relief, disinhibition, enhanced empathy and sociability, relaxation, and euphoria. MDMA is classified as an entactogen due to how it facilitates feelings of closeness with oneself and others. It is commonly associated with dance parties, raves, and electronic dance music. Tolerance to MDMA builds unusually quickly and many users report that it dramatically loses its effectiveness if used on a regular basis. It is commonly recommended to wait one to three months between uses to give the brain enough time to restore serotonin levels.
Acute adverse effects of MDMA are usually the result of high or multiple doses, although single dose toxicity can occur in susceptible individuals. The most serious short-term physical health risks of MDMA are overheating and dehydration, which has resulted in deaths. MDMA has also been shown to be neurotoxic at high doses; however, it is unclear how much this risk applies to typical recreational use. It is highly advised to use harm reduction practices if using this substance.